Estradiol monotherapy.
Started HRT 3 months ago with 2mg Estradiol oral tablets. Have a doctor appointment in a few days and wanted to ask to double my oral prescription, split up 4mg into 4 doses sublingual every day. Not sure if my Estrogen levels are too high and my doctor will deny my request.
Pre-HRT Estrogen (TOTAL IA): 181 pg/mL
Pre-HRT Testosterone (Total IA): 246 ng/dL
Levels this week Estrogen Total IA: 438 pg/mL
Levels this week Testosterone Total IA 115 ng/dL
From what I understand I feel like I'm definitely not achieving Testosterone suppression. https://transfemscience.org/ recommends T levels around 10 ng/dL. But having E levels of 400 pg/mL is the right range for E.
Can I convince my doctor to double my dose if my E is already at >400 pg/mL?
Edit 01: I did not take my daily dose until after my blood was drawn. Blood draw was already 24+ hours since last oral dose.
Edit02: Thank you all for your responses. My doctor approved the prescription doubling. My idiot brain realized after the fact that I didn't even need the doubling in the first place (I guess I get to stockpile now). I intended to follow the 0.5mg four times a day protocol shown here https://pubmed.ncbi.nlm.nih.gov/38130980/ . Really could have just cut my 2mg pills into four pieces.
You don't generally do monotherapy by oral route, you would switch to injections. Monotherapy with injections is pretty safe, they shouldn't be worried about large doses unless it's oral.
Your estrogen was surprisingly high pre-HRT, have you tested for intersex conditions?
6. Intersex people can't have sex, get pregnant, or have children.
Many intersex variations include mostly typical internal reproductive anatomy. Everyone is different. There are intersex people who can have periods and carry children, and intersex people who can produce sperm. There are some who can't. There are intersex people who find out they have both ovarian and testicular tissue after having given birth.
We report herein a remarkable family in which the mother of a woman with 46,XY complete gonadal dysgenesis was found to have a 46,XY karyotype in peripheral lymphocytes, mosaicism in cultured skin fibroblasts (80% 46,XY and 20% 45,X) and a predominantly 46,XY karyotype in the ovary (93% 46,XY and 6% 45,X).