Hormone Levels
During HRT, especially in the early stages of treatment, blood work should be consistently done to assess hormone levels and liver function.
Israel et al. have suggested that for pre-castration FTM individuals, therapeutic testosterone levels should optimally fall within the normal male range, whereas estrogen levels should optimally fall within the normal female range. Before castration, it is difficult and usually impractical to fully suppress estrogen levels into the normal male range, especially with exogenous testosterone aromatizing into estrogen, hence why the female ranges are referenced instead. In post-castration FTM individuals, Israel et al. recommend that both testosterone and estrogen levels fall exactly within the normal male ranges. See the table below for all of the precise values they suggest.
| Hormone | Bio. female ref. range | Bio. male ref. range | Optimal trans. female (MTF) range | Optimal trans. male (FTM) range |
|---|---|---|---|---|
| Estrogen (total) | 40–450 pg/mL | < 40 pg/mL | 400–800 pg/mL (pre-castration) 40–400 pg/mL (post-castration) |
< 400 pg/mL (pre-castration) < 40 pg/mL (post-castration) |
| Testosterone (total) | 25–95 ng/dL | 225–900 ng/dL | 95–225 ng/dL (pre-castration) 25–95 ng/dL (post-castration) |
225–900 ng/dL (pre-castration) 225–900 ng/dL (post-castration) |
The optimal ranges listed for testosterone only apply to individuals taking bioidentical hormones (i.e., testosterone, including esters) and do not apply to those taking synthetic or other preparations such as androgenic anabolic steroids (e.g., nandrolone).
Male and female reference ranges for hormones and other compounds are not exact and usually vary slightly depending on the source referenced. The same applies to optimal FTM (and MTF) ranges, naturally.
Read more about this topic: Hormone Replacement Therapy (female-to-male)
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