Your comprehensive evidence-based nutrition strategy for optimal transition preparation, Barcelona integration, and long-term health.
Starting hormone replacement therapy at 45 presents unique opportunities for successful feminization while requiring careful nutritional preparation to optimize outcomes and minimize risks. This guide synthesizes current transgender health research, endocrinology studies, and Mediterranean nutrition science to create a practical 5-month preparation plan leading to your November 2025 HRT start date.
Foundation: Your current supplement regimen is excellent
Your existing supplements provide strong transition support. Vitamin D3 2000IU supports bone health and estrogen receptor function, while probiotics enhance gut-based estrogen metabolism through beneficial bacteria. Astaxanthin and CoQ10 deliver powerful antioxidant protection for cardiovascular health during hormonal changes. Stopping ashwagandha, maca, and tribulus terrestris was strategically smart – these adaptogens can interfere with natural hormone shifts and HRT effectiveness.
Continue your current supplements and add targeted nutrition to enhance their effects. Research shows that food-based nutrients work synergistically with quality supplements, creating more stable hormone levels and better overall outcomes than either approach alone.
June-August 2025: Building your metabolic foundation
Prioritize liver optimization for superior HRT processing
Your liver processes both estrogen and alcohol, making optimization crucial for your current 7-10 drinks weekly consumption. Support Phase I and Phase II detoxification pathways through targeted nutrition that enhances hormone metabolism while maintaining your social drinking habits.
Essential liver-supporting foods: Cruciferous vegetables like broccoli, kale, and Brussels sprouts contain diindolylmethane (DIM) that shifts estrogen metabolism toward the protective 2-hydroxyestrone pathway rather than potentially harmful metabolites. Consume 1-2 cups daily of these vegetables, lightly steamed or stir-fried to preserve beneficial compounds.
Methylation pathway support: Your liver requires B-vitamins for hormone processing. Emphasize folate-rich leafy greens, B12 from fish and eggs, and choline from eggs and cauliflower. These nutrients work with your existing supplements to optimize estrogen clearance and prevent hormone buildup.
Glutathione enhancement: Asparagus, avocado, and walnuts boost your body’s master antioxidant, protecting your liver during increased hormonal workload. Sulfur-rich foods like garlic and onions provide raw materials for glutathione production.
Weight management strategy for optimal fat redistribution
Research shows MtF individuals typically gain 1.8-2.2 kg in the first HRT year, with fat redistribution beginning at 6-12 months and completing over 2-5 years. Your preparation now significantly influences where this fat deposits.
Body composition targets for age 45: Maintain BMI between 18.5-24.9 with 15-20% body fat for optimal feminization outcomes. Preserve muscle mass through resistance training – HRT will naturally reduce lean mass by approximately 2.4 kg, so building a strong foundation now is crucial.
Strategic macronutrient approach: 25-30% protein to preserve muscle during hormonal changes, 40-50% complex carbohydrates for energy and mood stability, and 25-30% healthy fats for hormone production. This ratio supports your content creation energy needs while preparing your body for feminizing changes.
Exercise integration for feminine body preparation
Focus on lower body development – squats, lunges, and hip thrusts will enhance the glute and thigh areas where estrogen preferentially deposits fat. Moderate upper body training maintains functional strength without excessive mass that could interfere with feminine silhouette development.
Cardiovascular foundation: 4-5 sessions weekly of moderate-intensity cardio (walking, cycling, swimming) for 30-45 minutes builds the heart health essential for safe HRT at 45. This age requires enhanced cardiovascular monitoring due to increased thrombosis risk from estrogen therapy.
Foods that naturally support your transition goals
Phytoestrogen-rich foods for gentle hormonal support
Soy products deliver the most research-backed phytoestrogen benefits. Tofu, tempeh, edamame, and soy milk contain genistein and daidzein – isoflavones that preferentially bind to estrogen receptor β, supporting healthy estrogen metabolism. Consume 1-2 servings daily to provide gentle estrogenic activity that may complement future HRT.
Flaxseeds provide the richest dietary source of lignans – compounds that convert to enterodiol and enterolactone, supporting estrogen balance. Grind 1-2 tablespoons daily into smoothies or yogurt for maximum absorption. Ground flaxseed must be consumed within 24 hours to prevent rancidity.
Legumes, nuts, and seeds expand your phytoestrogen intake through diverse plant compounds. Lentils, chickpeas, sesame seeds, and almonds provide additional isoflavones and lignans while delivering protein, fiber, and healthy fats essential for transition nutrition.
Anti-inflammatory foods for better transition outcomes
Omega-3 fatty acids are your most powerful anti-inflammatory tool. Consume fatty fish 2-3 times weekly – salmon, mackerel, sardines, and herring provide EPA and DHA that reduce inflammatory cytokines and support skin health during hormonal changes. Plant sources like walnuts, chia seeds, and hemp seeds complement fish-based omega-3s.
Colorful fruits and vegetables deliver polyphenols and antioxidants that combat inflammation. Berries, cherries, and dark grapes contain anthocyanins that reduce inflammatory markers. Green tea provides catechins with proven anti-inflammatory and skin-protective effects – aim for 2-3 cups daily.
Turmeric and ginger offer potent anti-inflammatory compounds curcumin and gingerols. Add these spices to meals regularly or consider quality supplements if you dislike the taste. These compounds support overall immune function and may reduce transition-related inflammation.
Skin, hair, and beauty preparation nutrition
Collagen-supporting nutrients for youthful skin
Vitamin C is essential for collagen synthesis – your body cannot produce collagen without adequate vitamin C intake. Consume 500mg daily through citrus fruits, bell peppers, strawberries, and broccoli. This dosage supports optimal collagen production while providing antioxidant protection.
Complete proteins supply collagen building blocks. Emphasize glycine-rich foods like bone broth, gelatin, and fish with skin. Plant-based complete proteins from quinoa, hemp seeds, and properly combined legumes ensure adequate amino acid profiles for keratin production in hair and nails.
Silicon induces collagen secretion by fibroblasts while increasing skin elasticity. Whole grains, bananas, and green beans provide bioavailable silicon. Mineral water can supplement silicon intake – particularly important as you age and natural collagen production declines.
Hydration strategy for radiant skin
Optimal hydration requires 3,200mL (13.5 cups) daily for measurable improvements in skin hydration and elasticity. Research shows this intake significantly improves epidermal moisture content and skin biomechanics. Water-rich foods like cucumber, watermelon, and leafy greens supplement fluid intake while providing skin-supporting nutrients.
Electrolyte balance enhances cellular hydration. Natural sources like coconut water, mineral-rich foods, and high-quality sea salt help your skin retain moisture more effectively than plain water alone. This becomes increasingly important as estrogen affects fluid retention patterns.
Hair health optimization
Biotin, iron, and protein form the foundation of healthy hair. Your hair is primarily keratin protein, requiring adequate protein intake (1.2-1.6g/kg body weight) plus B-vitamins from whole grains and leafy greens. Iron from red meat, fish, or plant sources like lentils and spinach supports oxygen transport to hair follicles.
Scalp health benefits from omega-3 fatty acids that reduce inflammation and nourish hair follicles. Vitamin D supports hair follicle cycling – maintain serum levels above 30 ng/mL through your current 2000IU supplementation plus moderate sun exposure.
Pre-surgery nutrition recommendations
Surgical healing optimization
Increase protein intake to 1.5-2.0g/kg body weight starting 2-3 weeks before any gender-affirming surgery. High-quality complete proteins from eggs, fish, lean meats, or plant combinations provide essential amino acids for tissue repair and wound healing.
Vitamin C supports wound healing through enhanced collagen synthesis. Increase to 1000-2000mg daily during active healing phases. Zinc is essential for tissue repair – aim for 15-30mg daily from food sources like pumpkin seeds, chickpeas, and lean meats, monitoring for copper depletion with extended supplementation.
Anti-inflammatory support accelerates recovery. Emphasize omega-3 fatty acids, turmeric, and colorful fruits and vegetables while avoiding pro-inflammatory processed foods, excessive sugar, and alcohol during the surgical period.
Surgical timeline considerations
Most surgeons require 12 months of HRT before breast augmentation for optimal tissue development. Facial feminization surgery typically requires 2-3 weeks recovery time. Plan nutritional optimization 6-8 weeks before any procedure to ensure optimal nutrient status and healing capacity.
Bone health preparation for HRT at 45
Starting HRT at 45 provides significant bone protection benefits compared to later initiation. Estrogen therapy requires minimum 1200mg daily calcium from food sources like dairy, leafy greens, and fortified foods. Your current vitamin D3 supplementation supports calcium absorption – maintain this dosage and monitor serum levels.
Weight-bearing exercise is crucial for bone density. Resistance training 3-4 times weekly stimulates bone formation through mechanical stress. Walking, hiking, and strength training provide the mechanical loading necessary for bone health optimization.
Magnesium supports bone mineralization – aim for 400-600mg daily from nuts, seeds, and whole grains. Vitamin K2 directs calcium to bones rather than soft tissues – find this in fermented foods like natto, sauerkraut, and aged cheeses.
Barcelona integration and Mediterranean advantages
Leveraging Mediterranean nutrition for transition
Barcelona’s Mediterranean food culture perfectly supports transition nutrition goals. The traditional Mediterranean diet pattern provides anti-inflammatory benefits, cardiovascular protection, and hormone-supporting nutrients that complement HRT therapy.
Fresh markets like Boquería and Sant Antoni offer seasonal produce rich in antioxidants and phytonutrients. Excellent seafood access provides omega-3 fatty acids essential for hormone health and inflammation reduction. Premium olive oil supplies healthy monounsaturated fats that support hormone production and absorption.
Menu del día opportunities (€12-18) provide balanced, affordable Mediterranean meals featuring transition-supportive ingredients. Focus on dishes like suquet de peix (fish stew), escalivada (roasted vegetables), and gazpacho that combine anti-inflammatory ingredients with complete nutrition.
Content creator meal strategies
Batch cooking maximizes efficiency for your busy content creation schedule. Sunday meal prep (2 hours) plus Wednesday refresh (30 minutes) ensures consistent nutrition without daily cooking stress. Mediterranean quinoa bowls, Spanish-style lentil stews, and overnight oats provide nutrient-dense options that travel well for on-location filming.
Filming day nutrition: Mediterranean breakfast bowls with Greek yogurt, nuts, berries, and honey provide sustained energy. Hummus with vegetables offers convenient between-takes nutrition. Pre-assembled meals from batch cooking ensure consistent nutrition during demanding content creation periods.
Managing alcohol, smoking, and cannabis during transition
Alcohol integration strategy
Your current 7-10 drinks weekly falls within moderate consumption guidelines but requires monitoring during HRT. Both estrogen and alcohol compete for liver processing, potentially affecting hormone stability. Space alcohol consumption away from HRT medication timing and monitor for changes in mood, energy, or hormonal symptoms after drinking sessions.
Quality over quantity approach: Choose lower-alcohol options like wine spritzers or light beer. Drink with meals following Spanish dining culture to slow absorption and reduce liver burden. Support liver function with your planned nutrition while maintaining social aspects of moderate drinking.
Smoking cessation support
Your minimal smoking (5 cigarettes monthly) still significantly increases cardiovascular and surgical risks when combined with HRT. Smoking plus estrogen dramatically increases blood clot risk and impairs wound healing for gender-affirming surgeries.
Leverage transition motivation – research shows 64% of trans women successfully quit smoking when starting HRT compared to 25% of trans men. Connect cessation directly to transition goals and utilize Spain’s smoking cessation programs available through the healthcare system.
Cannabis considerations
Your current usage (2x monthly) appears safe with limited interaction data for HRT. Prefer edibles, tinctures, or vaping over smoking to avoid cardiovascular risks. Consider higher CBD, lower THC ratios for anxiety management without psychoactive effects that might interfere with hormone mood stability.
Implementation timeline: June through November 2025
June 2025: Foundation establishment
Begin liver optimization with cruciferous vegetables and methylation support. Establish exercise routine focusing on lower body development and cardiovascular health. Implement basic Mediterranean meal patterns using Barcelona’s fresh markets and dining culture.
July-August 2025: Optimization phase
Integrate phytoestrogen-rich foods through daily soy products and ground flaxseed. Refine batch cooking system for sustainable content creator nutrition. Address any weight management goals through balanced macronutrient approach.
September 2025: Barcelona integration
Establish local food relationships at markets and restaurants. Develop reliable meal delivery systems for busy content creation periods. Fine-tune supplement timing and monitor alcohol/HRT interactions as you prepare for hormone therapy.
October 2025: Final preparation
Stabilize nutrition and lifestyle patterns for HRT initiation. Complete final health screenings and ensure nutrient optimization through comprehensive blood work. Establish sustainable habits that will support long-term transition success.
November 2025: HRT initiation support
Monitor nutrient needs changes during early HRT adaptation. Adjust protein intake to support muscle mass preservation. Increase calcium intake for bone protection and continue anti-inflammatory nutrition to minimize side effects.
Foods to emphasize and avoid
Emphasize daily:
- Cruciferous vegetables: Broccoli, kale, Brussels sprouts for estrogen metabolism
- Soy products: Tofu, tempeh, edamame for phytoestrogen support
- Fatty fish: Salmon, sardines, mackerel for omega-3 anti-inflammatory effects
- Ground flaxseed: 1-2 tablespoons for lignans and omega-3s
- Colorful fruits and vegetables: Berries, leafy greens, bell peppers for antioxidants
- Nuts and seeds: Walnuts, almonds, pumpkin seeds for healthy fats and minerals
Limit strategically:
- Processed foods: Reduce inflammation and support liver function
- Excessive sugar: Maintain stable blood sugar and reduce inflammatory markers
- Trans fats: Protect cardiovascular health during HRT
- Excess caffeine: Prevent calcium losses and support sleep quality
Your transition nutrition strategy combines evidence-based science with Barcelona’s Mediterranean advantages and your lifestyle as a content creator. This approach optimizes hormone therapy effectiveness while supporting long-term health and authentic self-expression. The key is consistent implementation of sustainable practices that honor both your transition goals and your need for realistic, enjoyable nutrition that fits your creative lifestyle.
Begin immediately with liver support and anti-inflammatory foods, then gradually layer in additional elements as you approach your November HRT start date. This progressive approach ensures sustainable habit formation while maximizing your transition preparation success.