New blood results - Need some help

Thread starter #1
Maybe Doctor Saya can shed some light. I am so depressed after checking my latest blood work. I am thinking about quitting TRT (which would be devastating since it has made me feel good again after years feeling miserable).

My current protocol is:
90 mg testosterone cypionate 2 x week
500IU HCG 2 x week
50IU FSH 2 x week
0.25mg anastrozole E3D

Total testosterone 947 (264-916)
Free testosterone 33.1 (8.7-25.1)
SHBG 23.6 (16.5-55.9)
Estradiol sensitive 27.2 (8-35)

Up to here everything is fine. The bad part is my iron panel. Before someone says i have hematochromatosis I haven’t tested before but my iron panel before TRT was normal.

Serum iron 348 (38-169)
Iron saturation 85 (15-55)
TIBC 410 (250-450)
UIBC 62 (111-343)
Ferritin 30 (30-400)

I was fasting. Not supplementing iron. No lab error i think given my serum iron has been slowly increasing since TRT. I am worried these levels can be dangerous and actually messing up with organs (creatinine slightly high and blood glucose too and they were normal before).

HCT high as wel 53.5. Before donating 1.5 month ago it was 52.5.

So i am pretty sure TRT + donating blood is messing with my iron big time. Not sure what to do. I already tried a lower testosterone dosage and that didnt help much with HCT.

I am so depressed cannot even tell you guys. I am feeling so great! But i dont think i can continue with these iron levels. Again they were normal before TRT. I suspect this is what is called iron avidity and given TRT requires me to donate blood and probably TRT by itself also lower ferritin my body is not being able to handle things and is going nuts.
 
#2
Maybe Doctor Saya can shed some light. I am so depressed after checking my latest blood work. I am thinking about quitting TRT (which would be devastating since it has made me feel good again after years feeling miserable).

My current protocol is:
90 mg testosterone cypionate 2 x week
500IU HCG 2 x week
50IU FSH 2 x week
0.25mg anastrozole E3D

Total testosterone 947 (264-916)
Free testosterone 33.1 (8.7-25.1)
SHBG 23.6 (16.5-55.9)
Estradiol sensitive 27.2 (8-35)

Up to here everything is fine. The bad part is my iron panel. Before someone says i have hematochromatosis I haven't tested before but my iron panel before TRT was normal.

Serum iron 348 (38-169)
Iron saturation 85 (15-55)
TIBC 410 (250-450)
UIBC 62 (111-343)
Ferritin 30 (30-400)

I was fasting. Not supplementing iron. No lab error i think given my serum iron has been slowly increasing since TRT. I am worried these levels can be dangerous and actually messing up with organs (creatinine slightly high and blood glucose too and they were normal before).

HCT high as wel 53.5. Before donating 1.5 month ago it was 52.5.

So i am pretty sure TRT + donating blood is messing with my iron big time. Not sure what to do. I already tried a lower testosterone dosage and that didnt help much with HCT.

I am so depressed cannot even tell you guys. I am feeling so great! But i dont think i can continue with these iron levels. Again they were normal before TRT. I suspect this is what is called iron avidity and given TRT requires me to donate blood and probably TRT by itself also lower ferritin my body is not being able to handle things and is going nuts.
In my uneducated opinion no matter how great 180/wk of T cyp makes you feel you cannot take that much for all the reasons you have listed.

If my bloods came back looking like yours I go donate ASAP maybe even a double red. IMO your HCT and Iron are flashing red lights.
Then supplement to bring your ferritin back up.
 
Thread starter #3
In my uneducated opinion no matter how great 180/wk of T cyp makes you feel you cannot take that much for all the reasons you have listed.
I tried much lower dosage (140mg) and still had issues (but at the time I wasn’t measuring iron). Maybe i should try something lower and see if that helps before giving up on TRT

When i was using 140mg testosterone a week my total testosterone was 770 and free testosterone 21.8 all well within range and my HCT was as high as 53... so... but what puzzles and worries me is the iron panel

I am donating blood tomorrow
 
#4
I tried much lower dosage (140mg) and still had issues (but at the time I wasn't measuring iron). Maybe i should try something lower and see if that helps before giving up on TRT

I am donating blood tomorrow
With your awesome SHBG 23.6 (16.5-55.9) a I am surprised you don't respond to 100mg/week. I would target a 22-25 FT and to hell with whatever TT that is.
 
Thread starter #6
And when i started TRT using 140mg my TT was over 1300 and FT over 35 and HCT only 51.7. So not sure why my HCT doesn’t correlate with TT or FT at all.
I will have a double red cell donation tomorrow to take care of HCT. And thinking about trying 100mg a week and drop anastrozole. See if i will feel good at this low dosage and if that would fix the HCT issue. I think if i can stop donating and my ferritin goes up all the iron issue goes away
 
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Thread starter #7
Going to donate blood now. Another question. My understanding is given i have enough transferritin to bound to serum iron my free iron is actually ok. And given my ferritin is low there are no issues in terms o organ toxicity right? It is just my body trying to replenish ferriting by loading iron in the blood. Stopping the blood donations should take care of all my iron imbalances
 
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Thread starter #8
Unable to donate double red (HCT cut off is 55 vs 60 for whole blood and my read there was 57).
I will have a consultation with 2 weeks with Dr Saya and think I will reduce dosage to 100mg a week and stop the anastrozole. Doing the match here last time i was using 112mg a week I didnt donate blood for 5 months and my HCT went from 51.7 to 52.4 with one whole blood donation only in 5 months.
I am thinking about supplementing with iron to bring back ferritin (prabable cause of all messed up iron panel). Before TRT my ferritin was high 200s so i guess my body needs a higher ferritin to find iron balance
 
#9
Unable to donate double red (HCT cut off is 55 vs 60 for whole blood and my read there was 57).
I will have a consultation with 2 weeks with Dr Saya and think I will reduce dosage to 100mg a week and stop the anastrozole. Doing the match here last time i was using 112mg a week I didnt donate blood for 5 months and my HCT went from 51.7 to 52.4 with one whole blood donation only in 5 months.
I am thinking about supplementing with iron to bring back ferritin (prabable cause of all messed up iron panel). Before TRT my ferritin was high 200s so i guess my body needs a higher ferritin to find iron balance
Be prepared, with a HCT of 57 he might take you off of TRT completely before your blood turns to sludge.

Have you had any blood pressure issues with the high HCT?

Did they allow you to donate whole blood?
My blood bank only tests Hemoglobin on donation day they don't seem to care about anything else. You got a Bonfils near you?

Personally I would postpone my consult until you get your HCT back under control with blood tests to prove it. Even if that means putting your Tcyp bottle away for a few weeks.

I believe I payed 30 bucks, thru Defy for a quick check of my CBC and ferritin.

 
Thread starter #10
Be prepared, with a HCT of 57 he might take you off of TRT completely before your blood turns to sludge.

Have you had any blood pressure issues with the high HCT?

Did they allow you to donate whole blood?
My blood bank only tests Hemoglobin on donation day they don't seem to care about anything else. You got a Bonfils near you?

Personally I would postpone my consult until you get your HCT back under control with blood tests to prove it. Even if that means putting your Tcyp bottle away for a few weeks.

I believe I payed 30 bucks, thru Defy for a quick check of my CBC and ferritin.

HI feeling lost my hct was 53.5. The finger prick machines they use always yield higher numbers. So the 57 is the finger number. Labwork was 53.5.
My BP was normal. Zero side effects. I just noticed at the gym that my skin was a bit more red after doing a heavy set.
Yes i was allowed to donate (their cutoff is 60 hct)
 
Thread starter #12
Nothing like one day after the other. I guess i overreacted. Donated blood and now HCT back to normal. I think my mistake was not to supplement iron after donating so many times (and actually reducing iron consumption).
Reducing my testosterone dosage should at least decrease the amount of time i need to donate blood to keep HCT in check. So that combined with iron supplementation should allow my ferritin to recover and serum iron/transferritin saturation to go back to normal.
 
Thread starter #13
In hematochromatosis hepcidin is very low. TRT decreases hepcidin (and it is positively correlated with dose). Iron avidity is very common in hematochromatosis patients who are overbleed. I don’t have hematochromatosis but i might as well have one mutation (just speculating here) which makes me more susceptible to higher testosterone dosages.
For me now it is pretty clear. I need to reduce dosage to reduce hepcidin supression and to reduce hematocrit stimulation so i can either stop donating or donate less often. This way i avoid iron avidity and iron homeostasis is established again.
 
#14
I need to reduce dosage to reduce hepcidin supression and to reduce hematocrit stimulation so i can either stop donating or donate less often. This way i avoid iron avidity and iron homeostasis is established again.
This is logical HealthMan and is the “tightrope walk” I refer to for some guys with TRT/hematocrit/iron levels.
 
Thread starter #15
I reduced my dosage from 180mg/week to 120mg/week (60mg E3.5D). I considered 100mg but I think that would be too low. At 140mg a week my trough for TT was 798 and FT 20. So i guess i would go too low on 100mg. I dropped the Anastrozole and i am still using DIM. Lets see if everything goes back on track now :)
 
#16
I reduced my dosage from 180mg/week to 120mg/week (60mg E3.5D). I considered 100mg but I think that would be too low. At 140mg a week my trough for TT was 798 and FT 20. So i guess i would go too low on 100mg. I dropped the Anastrozole and i am still using DIM. Lets see if everything goes back on track now :)
Looking forward to reading how this goes.
 
Thread starter #20
2 weeks into lower dosage and no Anastrozole. Estradiol definitely not high. I know that because everytime my estradiol goes slightly over range (or too close to high end of range) i get gyno. And no gyno. Overall i feel good (last time i reduced my dosage it took 4-5 weeks for things to settle so I could really access how I felt). Oddly enough i am getting some strong morning wood (which i wasnt before).
Blood pressure slightly lower on average (105/70 vs 120/75 before on average)
Looking forward to see how i feel in 3 weeks
 
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