Abt switch
The Abt switch is a kind of railway switch used on funiculars (inclined cable railways) that doesn't have any moving parts. It allows two cars to pass each other going uphill/downhill while sharing the same tracks. While most train switches rely on physically moving a section of track so the train goes one way or the other, the abt switch doesn't move at all. Instead each carriage has a grooved wheel which makes it turn left or right at a junction by sticking to the track on one side.
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https://commons.wikimedia.org/wiki/File:Heidelberg_funicular_wheelset.jpg#mw-jump-to-license
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In april my T was 88 ng/dL, in july it was 331, and two weeks ago it was 227. I've been on 100mg a day of spiro the whole time. All the nurses in mychart keep saying it's fine... I don't like being in "normal male" range and I'm scared it's messing with my hair
If I could throw my own anecdote in, getting an effective E dose did more for dropping my T levels than spiro ever did. Though I am still on Spiro, just a lower dose now. And I will probably end up om monotherapy by the end of the year.
I'm on 8mg in tablets daily... maybe this is another reason to do injections
I've never done tablets but injections have been doing work
Yeah, if you're on 8 mg daily then it's probably a good idea to switch to injections.
they are lying to you, as "medical professionals" often do, especially when it comes to trans people and their healthcare! :D
would advice talking to endo to try and get a higher dose/switch to something that isnt ass (spiro is ass) and if they refuse then trying to get another doctor is your best bet
but also dont let them put you on anything higher than 12.5mg of cypro (ideally 6.25)
generally recommended levels for E(2) are 100-200 pg/mL(367-734pmol/L) and for T < 50 ng/dL (1.7 nmol/L)
I know you're usually skeptical of doctors, are you sure these levels are good? I worry with their attitude of minimal viable dose that they'd rec levels that are lower then ideal but shut up the patient
Also bc https://transfemscience.org/misc/injectable-e2-simulator-advanced/ estimates higher levels then that for very typical diy doses (and I have heard people talk about getting more feminization with diy- because their levels are better.)
yea these levels are good and whats normally recommended by the diy community (ie big homebrewers n such) and are also levels typically found in female puberty and have given many a many a trans girl good results
the most common diy dose is 4mg EEn and it sits at ~130pg/mL on that simulator (tho we recommend https://estrannai.se/ as its found to be generally more accurate) which is in the range specified
doctors often recommend levels lower than that, which is the problem (among many things)
moreover, doctors are liars and thieves, and not to be trusted. do your own research, advocate for yourself, dont assume they know what theyre doing or that they will give you the correct treatment. this goes for basically everything, but especially for trans people, especially for women, especially for those who are disabled or think they might be, etc.
4mg/week though, right? That's what I've seen homebrew recommend, or more for every 10 days. 4mg/week is like 250~300.
I haven't seen papers but I have seen people rec 200-300 pg/ml, inline with what both homebrewers I'm looking at recommend their doses at (4mg/week and 7mg/10 days).
edit: https://hexbear.net/post/6373414/6570932 Yea, you're doing 4mg/week same as me. That's like 250-300 on the calculator? Not trying to argue or gotcha or anything I'm just trying to understand because it sounds like you're recommending kinda low levels? But ik you're knowledgeable so its just confusing me
sorry im like hella tired and didnt change the time thing. its been a long day/days
anyway the 100-200 is just a general guideline you can go higher than that if u wants :p my levels were like 220 or 230 something and im pretty happy with that
im just giving what ive heard the general sentiment in diy spaces has been, also those are recommended levels at trough not at peak so itll change slightly (but a lot more with EV) but if u wanna be higher go for it
No you're good
I hope you get some rest soon.
Okay I see, thank you
This really sucks... The lady I've talked to for my last two follow-ups always seems annoyed with me too. You'd think if they work at Planned Parenthood they'd care
Spiro doesn't reduce your T levels, it just blocks it from attaching to receptors somewhat. What's your E at? My T went down to like 8ng/dL after being on E for a few months.
It's been around 96, 98 in July and September, and somewhere in the 80s in April?
yes it does, it functions both as an androgen receptor antagonist and an androgen synthesis inhibitor
Spiro is an androgen blocker, it doesn't actually affect the production of T in any way.
spiro decreases T levels, like, provably, factually, scientifically, etc, i dunno what to tell you
its not very good at it (the US should just use cypro like literally everywhere else) but it does
T levels being that high while taking E is ostensibly a bad thing, especially for the purposes of feminizing hormone therapy
not all antiandrogens decrease T (finasteride doesnt for example) but spiro does
Time for another anti androgen then?
Is it doing anything else different for you? All the typical T stuff, thicker or more facial hair, spontaneous erections, whatever. T does get converted into more E by aromatase in everyone's bodies, I mean I would want lower levels too but I guess your aromatase has plenty of T to work with right now. I did have to kick up to 200 mg and then 250 mg spiro for my T levels over time before I got switched to cyproterone (Im not in America, its indicated for feminizing HRT where I live).
none of this is necessarily typical T stuff, a lot of it can still happen even with T being well within range, which is why blood tests are so important
i think this is "technically true" (i forget if its actually been proven to happen in anything other than like.. an actual fetus (i say this because a lot of people like to say that theres a pathway for prog to turn into T but theres no proof of that actually happening in adults)) but in any case it would be so minute as to be nonexistent. you still want your T to be much lower than that. if T turned into estrogen so easily everybody would have excess estrogen, ya? :p
The only thing I can really think of is shedding more hair, but I'm suspicious that started about when I started prog and that it might be the backdoor conversion thing
there is no evidence that prog turns into t, dht, etc in adults. infact it has been shown to work as a (extremely mild) antiandrogen though thats mostly anecdotal
plus if it did then wouldnt all the cis girlies with prog also be having a bunch of issues? just doesnt really make sense if u think about it