Switch to Topical T to Bring Hematocrit Down?

I am currently injecting T cyp. I am kicking around the idea of asking my NEW doctor to switch me to topical T, since my hematocrit, hemoglobin and RBC are so high.
I understand the idea of giving blood to lower these levels, but it may not be possible since my platelet count is below range. The Red Cross doesn't want my Apositive blood.
I was started on a compounded T, but I didn't absorb it well.
Does androgel and those type of T tend to absorb better than compounded T?
I have to give this some heavy thought since I don't want to be permanently off T cyp if androgel doesn't work for me.
Thanks

I don't like the idea of smearing that stuff all over me.

A 2 percent (200 mg/ml) compounded cream works as well as 1.62% Androgel. It costs about $70 for a month supply. Not covered by insurance usually.

If you have insurance, it may pay for Androgel or any of the other pharma products (Testim, Axiron, Fortesta).

To be honest, I think hematocrit issues are not that different with T creams or gels compared to injections, specially if you are injecting twice per week at dose under 100 mg.

You can have a doctor write you an order or call the blood center for you to get phlebotomy. I dot qualify for blood donation and have gotten my insurance to pay for the phlebotomy.

If the order for phlebotomy is for a double red cell phlebotomy that may work for you at your 52 hematocrit.

Double red cell donation is similar to a whole blood donation, except a special machine is used to allow you to safely donate two units of red blood cells during one donation while returning your plasma and platelets to you.

I have to make an appointment with a hematologist.

Will the Red Cross do a therapeutic double red draw if there is a doctors order? If not, will this need to be done at a hospital or is this commonly performed in hematologist offices?
I really don't want to go off injectable T.

Any doctor can order a phlebotomy. Yes, they would do a therapeutic double or single cell blood draw and returning your platelets back to your body.

Who is your TRT doctor? He/she should know this. Increased hematocrit is the number one side effect in many men on testosterone.

I just started with a new endocrinologist. I'm not convinced he knows what he's doing.
I think seeing a hematologist would be the best at ordering therapeutic blood draws.
I was a patient of Romeo Mariano in Monterey CA. Perhaps you know of him. He helped me a lot. Unfortunately, I can no longer afford the costs associated with his care.

For similar total T levels, I found that both Androgel and injections drove my hematocrit over the top of the range. The only way I could lower it was by lowering my T dose.

HarryCat,
You never tried double red draws to lower your hematocrit?

If I felt any benefit at all with my T levels that high I might have considered it. But for me I feel no different (lousy) whether my total T is at 300 or 800.

cadcard said:

I am currently injecting T cyp. I am kicking around the idea of asking my NEW doctor to switch me to topical T, since my hematocrit, hemoglobin and RBC are so high.
I understand the idea of giving blood to lower these levels, but it may not be possible since my platelet count is below range. The Red Cross doesn't want my Apositive blood.
I was started on a compounded T, but I didn't absorb it well.
Does androgel and those type of T tend to absorb better than compounded T?
I have to give this some heavy thought since I don't want to be permanently off T cyp if androgel doesn't work for me.
Thanks

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Many of us started with a topical testosterone, and many of us found that it failed to do a thing for us. I was one of those patients. That said, had it worked, and it certainly can, I'd have been quite pleased. Approach it with an open mind, and give the change a good-faith effort - long enough to see if your serum levels can be maintained.

CoastWatcher said:

Many of us started with a topical testosterone, and many of us found that it failed to do a thing for us. I was one of those patients. That said, had it worked, and it certainly can, I'd have been quite pleased. Approach it with an open mind, and give the change a good-faith effort - long enough to see if your serum levels can be maintained.

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I don't know for certain, but I would bet, Big Pharma has allocated vast sums of money, stigmatizing any type of injectable T. An may I add, squashing compouding pharmacies as well.

Just as a sidenote, I get disgusted just having to apply underarm deodorant on a daily basis.

cadcard said:

I don't know for certain, but I would bet, Big Pharma has allocated vast sums of money, stigmatizing any type of injectable T. An may I add, squashing compouding pharmacies as well.

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Most metropolitan areas have at least one good one. They don't have to be local. There are some excellent ones that provide service to people all over the US. One, Empower Pharmacy, has a link from this site (I have no relationship of any sort with Empower). You provide your doctor's prescription and they express the compound to you. It may be worth considering.

cadcard,

My hematocrit was 52 on cream...dropped to 45 on injections (180 mg a week). Dunno...I think it is based on the individual

Does this procedure help keeping the iron levels too?

I went into 8 Androgel pumps (4 in the morning/4 at night) and dontating blood every two months. Worked great for a few months but started to feel terrible again (really tired, mentally foggy, etc). Long story short, my ferritin was very low.... now, my dilema is if I can't donate, my hematocrit goes high (chest pain, headaches, increase cardio risk, etc)... I'm not sure what to do... any advice?

Nelson Vergel said:

Any doctor can order a phlebotomy. Yes, they would do a therapeutic double or single cell blood draw and returning your platelets back to your body.

Who is your TRT doctor? He/she should know this. Increased hematocrit is the number one side effect in many men on testosterone.

Click to expand...

jerry60 said:

Does this procedure help keeping the iron levels too?

I went into 8 Androgel pumps (4 in the morning/4 at night) and dontating blood every two months. Worked great for a few months but started to feel terrible again (really tired, mentally foggy, etc). Long story short, my ferritin was very low.... now, my dilema is if I can't donate, my hematocrit goes high (chest pain, headaches, increase cardio risk, etc)... I'm not sure what to do... any advice?

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It's a very difficult balancing act. You get high hematocrit and then donate often and then low iron from donating so often but hematocrit still stays on high side and ferritin crashes. My fella still trying to dial in. I suppose for immediate cardiac concerns you are better off bloodletting often and worrying less about low ferritin issues. Low ferritin won't kill you but high hematocrit might!

Low ferritin can affect your thyroid function and make you feel worse than having low T.

I'm having a helluva time with high hematocrit and low ferritin. Just 2 months ago I was at 44 hematocrit and just yesterday while giving blood again it skyrocketed to 54. I started supplementing with a daily iron pill and eating more red meat in those 2 months so that's probably the culprit. I'm more worried about the high hematocrit than the low ferritin at this point so will see about continuing the iron supplementation and doing monthly therapeutic blood draws. Since this seems to be a major concern maybe a sticky should get going with more ideas. Ferritin tests are cheap at Defy.

How frequently are you donating blood?

How long have you been on TRT?

What was your ferritin a month after taking iron (by the way, also take Vitamin C since it improves iron absorption). Be careful with overdosing iron since it can affect the liver.

Interesting post

Can Losartan decrease high hematocrit caused by testosterone replacement?