What ester are you injecting, I assume because you’re in the US it’s valerate? I bet your estrogen is pretty low at trough, given valerate’s half life is 3.5 days … When are you getting blood drawn for the labs? The recommendation I have always heard is to always draw blood at trough.

As an aside, my cis-sexual female spouse has levels that exceed 300 pg/mL each month (those being “natural” physiological levels, no HRT or birth control).

I would be concerned if you were taking oral route of administration from the possible tax on your liver, but since you’re using injections, I think they are going to have a harder time proving there is any real risk from having blood estrogen levels like that, it’s totally within normal physiological ranges of cis women.

I’ve had levels in the 500s pg / mL and my endo wasn’t concerned because he know it was a temporary monotherapy approach until I had surgery.

A doctor that is alarmed by seeing 300 pg / mL is probably not a good doctor, and they should be checking how you feel primarily to determine dose, not just the numbers that are read back. The hormone levels a person needs for their health varies, including cis people.

If you are experiencing symptoms from too much estrogen, you might consider lowering your dose - but is that happening?

I would talk to the local trans community and see what doctors people recommend - you want someone who will give you autonomy in your care and who is educated enough to know where the actual risks are.

I wish I had a doctor who could look at a number like 300 and say “this is fine.” I’ve been at more or less baseline E doses for over a year and they mainly increased the spiro, which then got my potassium too high, so I lowered that without consulting anyone because I can’t just email my provider, and for the past 3 months I’ve had no clear picture of where my levels are at. I wish this stuff were in the cereal aisle so I could take care of things based on my own knowledge.

DIY is the cereal aisle option (admittedly with extra steps / more hassle). Still, I agree. In places like Thailand you can buy oral estrogen over-the-counter at a pharmacy!

EDIT: I do think there could be harm in making sex hormones available over the counter, but mostly for cis people who get scammed into believing their son needs extra testosterone to be an alpha male, etc. It would be good for harm reduction reasons for some guard rails be in place for the majority, but access to HRT for trans people (a minority) is still too restrictive.