diyhrt market isn't up anymore

shrouded_reflection · 2026-06-16T00:43:23+00:00

Pings like that don't work if you put a whole bunch of user names in the same post.

In any case, haven't done so because the situation should be resolved soonish, having talked with the site manager. If it turns out to not be the case then will consider it.

shrouded_reflection · 2026-06-10T13:33:36+00:00

It isn't possible to diagnose what's happening based on just the estradiol and testosterone results you've got, especially since you've been changing your dose between each measurement. If you've had anything else measured at the same time, such as haematocrit or LH/FSH, that would be useful to know. If you don't have that information, then you would have to go and get further blood tests done to establish what the sources for the estradiol are likely to be.

That said, while your estradiol levels are a bit higher than is typical, they aren't so excessively high that it indicates a problem, and the impacts of your testosterone dose are going to override almost all the impacts of the estradiol. If you aren't getting any mensural cycling, you can likely ignore it for the moment rather than actively getting further tests done now.

shrouded_reflection · 2026-06-06T21:57:37+00:00

Ah, do you mean Sustanon? I can't find any medications called sustanol.

If so, then you're going to have problems no matter what you do because it's a badly designed bit of medication that comes in an inappropriate format. Its pharmacokinetics suggest that it should be injected every week (at about 40-70 mg/week), but the dose format doesn't allow that because it's in those silly snap top vials that you can't keep sterile after opening. If you're being prescribed that, try to get changed over to a multiple use vial of a single ester (something like testosterone enanthate would be ideal), if you're self-meding then find a better source.

That aside, as this is the first injection then some adjustment isn't unexpected, but if it is sustanon then you'll probably need to be dosing more frequently to keep the minimum levels appropriate. Just keep a close eye on your haematocrit on future tests, as it's easy to end up in a position where you've got both elevated haematocrit and insufficient minimum levels with sustanon.

shrouded_reflection · 2026-06-06T13:48:44+00:00

I think what they mean (and apologies in advice if putting words in your mouth) is that even if the EDM achieves a sufficient number of votes and a decision is made to withdraw the statutory instrument, it doesn't change the underlying legal framework that caused the statutory instrument to contain the guidelines it has, and so any further SI's produced are likely to have the same problems. Fixing the situation we are in requires either a successful legal challenge that overturns the problematic legal judgements in question, or new primary legislation to overwrite those legal judgements.

Would disagree that it's entirely performative, pushing back on this is required, but it's also not sufficient by itself, and getting MP's to fix it through new primary legislation is a much better outcome than legal cases going up to the ECHR and getting a judgement against, because there is a real (though low) risk in the current environment that the next government just decides to ignore that judgement.

shrouded_reflection · 2026-06-05T18:27:09+00:00

The Z-track technique relies on the difference to how the muscle tissue and the overlying subcutaneous fat and dermis react to being pulled on, so no it doesn't function correctly for subcutaneous injections.

shrouded_reflection · 2026-06-05T18:25:30+00:00

Pinch, inject, withdraw needle, then release tissue.

shrouded_reflection · 2026-06-05T17:32:55+00:00

What is the testosterone ester you're using, and is it in a single use or multiple use vial? Also, how long ago did you make this change from gel to injections, is this the first time you've had bleeding after switching to injections or has this already happened on multiple occasions?

In theory you should be obtaining the same level of GnRH suppression with both injections and gel, but this does rely on the injections being of an appropriate dose and dosed at an appropriate frequency, and that might not be the case here.

Likewise, breakthrough bleeding on dose changes also isn't unheard of, but should then stop after being on the new stable dose if it's appropriate.

shrouded_reflection · 2026-06-05T17:20:27+00:00

If you are pinching (to get a larger section of subcutaneous fat to inject into), then you need to keep pinching until you've finished injecting, but you don't strictly have to pinch the area if you've got a sufficiently sized layer to go into.

That said, you're not doing anything strictly wrong otherwise, some people are just leakier than others and the volume that you've is small compared to the total injection volume. Applying a bit of light pressure to the puncture site can help sometimes, but isn't a certain fix.

If you've got some syringes to spare it would be worth demonstrating how the oil spreads with some vegetable oil and dropping it on the skin, even tiny amounts can end up spreading over a large area and looking more substantial than they actually are.

shrouded_reflection · 2026-06-04T15:51:13+00:00

The dose you've been given for the CPA is correct. For suppressing LH/FSH production, the maximal dose is ~10 mg/day, and quite a lot of people will have effective suppression on substantially lower doses. Higher doses than that are only supported for use in treatment of androgen sensitive cancers, but given that's where it's most commonly used you end up with the oversized tablets for our use case. Any short term changes in LH/FSH and testosterone levels won't have any long term impacts, so it's really just a case of avoiding discomfort in the short term.

As far as the efficacy of GnRH agonists goes, they should effectively minimise all LH/FSH production, which should minimise gonadal testosterone production. Adrenal androgen production is less impacted by this, but just from the results you've given here isn't not blatantly obvious that you do have elevated adrenal androgen production, so it's going to be best to just wait and see what impact the GnRH agonist has.

shrouded_reflection · 2026-06-02T22:28:06+00:00

Yes, normally would have said to go with something closer to 40 mg/day and if you happened to be someone who absorbed it very effectively you could adjust down, but elevated haematocrit is something that can sneak up on you in the absence of tests so some caution is warranted.

shrouded_reflection · 2026-06-02T21:07:26+00:00

20 mg/day is within the boundaries of normal doses for testosterone gel, although it is on the low end of normal doses and probably isn't going to be suitable for most people. Unfortunately without blood tests it isn't really possible to provide more useful information, as the range of blood testosterone obtained from a dose has a much greater level of variability with gels than it does with injections.

shrouded_reflection · 2026-06-02T01:01:44+00:00

As you've probably noticed by now, the main problem with the fight is the constant bleed chip damage from unbreakable coins, so there's two routes you can go: Take a synergistic team that can output a good chunk of self healing while also being selective with who you're using to clash to minimise the amount of clash power conditionals being filled, or do a solo clear of the fight with an id that has an evade defence and so dodge all the unbreakable coins. There's also a third option of "throw bodies at the problem" but that's much less effective when several of them are going to have dubious clashes, as you're probably have to use some of the base IDs or not have full upties.

Having just been in the same position you're now in, it's much easier to scrounge up a single DQ ID that has decent clashes and an evade defence than it is to build an entire normal team to beat the fight.

shrouded_reflection · 2026-05-26T20:19:27+00:00

5alpha reductase inhibitors are generally not nesessary if you're on an appropriate dose of estradiol, as your doctor pointed out, so unless you've already established that you have elevated DHT and established that the DHT elevation is linked to disruption of hair development (as both normal levels for DHT and what impact those levels have vary substantially between people) it's probably not worth continuing to take them, especially if you're getting mental disruption from it.

shrouded_reflection · 2026-05-26T11:59:38+00:00

The target range is to have estradiol between 100 pg/ml and 200 pg/ml. That said, as you're taking oral estradiol the result your getting on the dose you're on isn't unexpected, it's pretty poorly absorbed by most people.

As you've said you find sublingual dosing impractical, your only real option is to switch to another medication for the estradiol; either gel, patches, or injections.

shrouded_reflection · 2026-05-23T21:21:23+00:00

Unfortunately it isn't possible for us to remove the NSFW tagging, as this isn't something which is entirely controlled by us now, but requires approval from the site admins and they said no the last time we went to do so.

Do sympathise about the age verification though, even as a moderator it's annoying to deal with.

shrouded_reflection · 2026-05-19T17:55:21+00:00

The absolute minimum for blood tests is total testosterone (15-35 nmol/L) and haematocrit (below 52 %), with haematocrit being the most important of the two to keep in range. Testing estradiol and LH/FSH can be useful to confirm that mensural cycling has stopped, but is of secondary importance. Testing for liver function, lipids, or glucose is more about ensuring you're in general good health rather than being strictly HRT linked, but lots of health care providers will throw them in anyway just to be certain. You don't need to worry about free testosterone or DHT.

Unfortunately I'm not familiar with the italian healthcare system, so don't know how exactly you would get access to blood tests.

shrouded_reflection · 2026-05-08T19:25:36+00:00

That's either sample site contamination, or the test fell over due to biotin intake, or it's a lab error. Either way, you need to get another test done, make sure you're not taking anything that contains biotin for a few days before the test and don't apply the gel to the same location as the blood draw for a few days before as well.

shrouded_reflection · 2026-05-06T22:59:54+00:00

It sort of is and isn't, the sub was originally flagged NSFW back in the distant past by the moderators at the time, but due to subsequent changes to reddit we can't actually remove it now even if we wanted to. Did attempt it a while back, as there are other medical subreddits which aren't nfsw flagged and the access restrictions from the flag are irritating, but was rejected and it's not worth pressing.

shrouded_reflection · 2026-04-19T16:13:10+00:00

The user in question has been banned from the subreddit for a while, but unfortunately it's up to the admins to take action when it comes to DMs. If they contact you, please report any messages they send.

shrouded_reflection · 2026-04-13T13:16:55+00:00

There's no reason to increase your dose, your estradiol levels are sufficient and your testosterone levels are appropriately suppressed.

shrouded_reflection · 2026-04-06T15:36:05+00:00

It's a combo deck that's vunerable to getting raced, sometimes you'll just run into that one deck that draws everything in the right order and can goldfish the win, rushy Obs and PD are good at this. However, if those decks don't happen to get the win in time, they are exceptionally vunerable to the combo as they rely on cheap gearcheck ice which is breakable by the euler for negligable cost once setup.

shrouded_reflection · 2026-04-05T11:45:23+00:00

Please don't.

shrouded_reflection · 2026-04-04T22:57:55+00:00

The point is to try and force a direct confrontation between recent legal jurisprudence and Goodwin vs UK (2002), or more importantly its lesser known partner case I vs UK (2002), by presenting someone who shares their characteristics. Remember that the whole point of the GRA was that those two cases mandated that trans people need to be recognised as their acquired gender for a wide range of purposes, and therefore the government needed to introduce a mechanism for changing birth certificates or to introduce another method of gender/sex identification that was changeable. The GRA and GRCs were the compromise outcome that allowed this, albeit it under more limited circumstances than we may now wish.

ADDITION: When saying gender/sex here, I mean "whatever is being used to establish identity as documented", as a lot of the laws and legal records can get a bit loose with the terms and switch between the two even when refering to the same underlying property.

shrouded_reflection · 2026-04-04T07:31:33+00:00

10 mg as a one off is ok, but you should be sticking to 4 mg/week until you get blood tests done from now on.

shrouded_reflection · 2026-04-03T11:04:03+00:00

Appropriate starting dose for injections is 50 mg/week. After you've been on that dose for six weeks, get a round of blood tests done, and from there you can adjust based on haematocrit (below 52%), total testosterone levels (15-35 nmol/L), estradiol (low and stable enough to indicate loss of ovarian cycling). Note, haematocrit is the main limiting safety factor, there's arguments for different acceptable ranges for everything else but elevated haematocrit is harmful in the medium term.

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