Visited the TG Doc this afternoon, with a stop in the blood lab first...

Blood work

TESTOSTERONE me: 180 ng/dL normal range: 249 to 836 ng/dL

This is after stopping the supplemental T about 6 weeks ago. (it was 424 ng/dL on 12/13/21.) This is about what the doc was expecting to see.

She also had a CBC done, with everything coming back in the normal ranges.

We had a considerable discussion about options for next steps. The current plan is for me to get 30 day luprelide / Lupron shots as soon as insurance approves the prescription. This will let me get a feel for what having zero T is like, and she said that 1-3 months of no T does not pose significant bone health risks. So it appears that I will be starting chemical castration as soon as the insurance comes through.

However we need to figure out a bone health solution before looking at further chemical treatment or any sort of surgery. There seem to be two main options, and she says that there are tradeoffs with each, and I need to figure out which direction to take.

I'd like to get suggestions on these given my desire to go to go from T to E mode hormones, but not get a lot of feminizing as I desire to continue to think of my self as, and present as male...

On the medical effects side, my disability already makes me a risk for osteoporosis (I'm in the osteopenia range already) and increases my risk of blood clots.

Option 1, is to go with a SERM type drug, probably Raloxifine which may be slightly better for bone health, and minimizes breast growth, but may not provide the mental effects of E, and has a higher risk of blood clots.

Option 2, is a low dose estrogen. Good for bone health (possibly less so than Raloxifine, but still good) gives mental / mode effects, and lower risk of blood clots, but more potential for breast growth (Although the doc says that at almost 65, I'm not likely to get a lot of boobs any way...

One of the problems she admits to is the lack of medical research, so it seems like the folks here are better for at least getting a feel for the 'lived experience' input.

WheelyCurious

Thanks for the advice BGB, as always you bring a lot of wisdom to the discussion...

I'm looking forward to getting down to zero T as that will give me a much better idea of what it is like. All the descriptions of experiences have been great, but they aren't the same as actual first hand experience.

On the paperwork fronts, the gears are slowly grinding... I got a letter from the nurse at the TG center, telling me I've gotten the insurance prior approval for Lupron Depot 3.75mg, so now it's a question of waiting for things to process at the CVS "specialty pharmacy." Supposedly they will be contacting me as soon as things go through on their end to arrange for it to either be delivered to me or to pick it up at the local store (I'm not sure which...)

One thing I'm wondering about a little is that my understanding of Lupron is that it stops ALL T production, both from the testicles and from the adrenals so you end up at absolutely ZERO T.... How much difference is there between that and the small amount of T from the adrenals that you would get post-orchiectomy?

The other thing I'm a little nervous about is how much I'm going to get the hot flashes and other undesirable symptoms - I may want to rush into some sort of treatment for those, but I guess time will tell...

WheelyCurious

The gears have ground another step forwards... Just got off the phone w/ the specialty pharmacy, everything has processed through the insurance. They will be shipping the Lupron to my local CVS for pickup on Wednesday the 4th... So I'm now in countdown mode to starting the test for real...

Wheely Curious

May the 4th be with you.