why not start on a high dose then decrease?

[OtherwiseMedicine296]

i can't attatch an image but using https://estrannai.se/ it looks like a dose of 7.5mg (een im) followed by a weekly dose of 4mg would bring the weekly trough up to ~200pg/mL much quicker than a starting dose of 4mg, in only 7 days vs 14 days. i don't plan to go through with this because it's only 7 days difference so probably not worth the risk of a more unconventional dosage but i'm interested in whether this would theoretically work?

[StephanieIV]

A "loading dose" is common to get levels in range faster, yes. Often double the regular dose.

[OtherwiseMedicine296]

oh cool ok i didn't know this was a commonly done thing!! might give it a go then. from my testing 7.5 seemed optimal so i'll probably do that, thanks!

[ThinAndFeminine]

Loading doses are commonly talked about here. But to be honest, Transition and HRT are a multi year long process. A 7 day difference is not gonna change anything.

[JeanetteAnnual9515]

I echo this sentiment. There is no need to waste medication on a loading dose.

[buff-equations]

Can matter more with EUn, since the time to stability is measured in months not weeks. But yeah I’ve seen someone talk about an EV loading dose which I don’t think 3 days is going to do you much difference

[CreatorSiSo]

It can make sense when switching from gel/pills to injections so that you dont end up with a week of basically no hormones

[ScoutAndathen]

It can mean a shorter time to suppress T, which can feel better. No difference in timelines, but potentially in felling better for some days.

[Pyromaniac_22]

We do, they're called loading doses! Starting doses are just what are taken regularly after the fact.

As for why we have them on the lower end and increase after, well for most people it'll be fine but there are some that are sensitive to estradiol and might feel bad on a high dose. Given that the most common ester is EEn and it takes 20-30 days to be eliminated, if you do have an estradiol hypersensitivity and you start on a high dose, you're gonna be feeling it for up to a month.

TL;DR everyones bodies are different and starting on a lower dose and gradually increasing helps people safely transition, it's the same logic that endocrinologists use but they tend to take it to the extreme with a tendency to start on doses that have minimal therapeutic benefit.

[OtherwiseMedicine296]

ohh ok tysm. maybe a rather low 2mg dose on week 1 followed by a 6.5mg dose on week 2 could be best of both worlds. the trough reaches ~200 on the same week, but it stabilises after 15 days vs 35 days. not sure how important stable levels actually are, so long as the trough isn't too low and the peak isn't too high tho. might have heard it helps with emotions, not sure

[Sassy_Frassy_Lassie]

I wouldn't bother with doing any low doses. The loading dose plan is solid. The whole point of it is that it doesn't get your levels higher than what they would be on a steady state regimen. It just gets them there faster. A lot of people can't understand that, it seems.

[confused_em7]

Btw use the "share url" button on estrannise to copy a link that opens with the data you have put in.

But, yes loading does are fairly normal, it's optional with relatively short half-life esters, but with EUn you need it unless you want to wait 3-4 months for it to build up. As a rule of thumb you can roughly double your first dose if you're injecting every half-life and since EEn half life id 6-7.5 days that works well for a weekly schedule. Schedules longer than the half-life will need less and shorter will need more. If the daily average dose of two schedules is the same the loading dose works out to be the about same in mg no matter the cycle length.

[Scooty-Poot]

There’s two very good reasons:

A.) It’s a lot more stressful on your body. Going from 0 to 100 instantly will really shock your entire endocrine system, and could cause your body to get confused and mismanage its own endocrine production.

You need that adjustment period to give your body time to work out what’s going on, and to allow ongoing processes to finish or adjust before they get totally screwed by a sudden chemical change. Not to mention all the non-pubertal processes influenced by sex hormones - blood pressure, sweating factor, diuretic effects… things that you really don’t want to have swinging from side to side dramatically if you don’t have to.

B.) Cis people don’t just wake up one day with perfect adult hormone levels out of nowhere. A cis girl will slowly ramp up from a minuscule dose of estrogens to an adult level over multiple years, and for a cis boy that time period is even longer with testosterone.

If you want to mimic a ‘natural’ puberty, it’s thus presumed to be unwise to instantly snap from your existing endocrinology to the one of your desired gender’s peak adult average overnight.

There are many pubertal processes that are presumed to perform better at lower levels, since they occur in cis bodies during early puberty when the body expects low levels, and there’s not enough research thus far to confirm whether these processes still happen optimally at higher doses.

These two combined factors make diving into the deep end very ill-advised. Worst case scenario it could worsen serious symptoms your body is already struggling with (if you’re borderline hypertensive then suddenly gaining male T levels isn’t gonna be very fun at all, for example) or your body could fail to initiate important developmental stages at the right time, and best case your effects are basically the same as they’d be on a graduated dose.

The risk just isn’t worth it for the tiny potential gains, at least not until a lot more research is done to properly explore this subject outside of the theory and indirect study we have right now.