66 y.o. long time trt Q: phlebotomy hematocrit b.p.

[pqteb1r]

Q: Last phlebotomy was July, not sure if 51.6% HCT indicates another.

Blood pressure: very good until 3 years ago. now often 170 to 190 / 100 to 110. Started getting high diastolic about a six months ago.

ME: 66 y.o. decades on trt, began on hCG mono then office injections 2x/month, then patches, then A-gel for quite a few years until 2015. Tried mono hCG for a year then tri therapy t cyp-hCG-nandrolone injections. Cut nandrolone and reduced hCH after a year. bp and heart concerns. Debilitating upper mid back pain since 2015 diagnosed as spinal stenosis but coincidental to hrt injection use.

Procedures: last phlebotomy July, b.p. high for several years now,

Dosing: t cyp : 300 mg from 10/30 to 11/12 or about 150 mg /week.. inconsistent on dosing at times such as recently. Program: EOD to e3D but have gone 4 or 5 days. About 40 to 44 mg eod would likely be best with my low SBG but I get injection fatigue. hCG rarely these days, 2-3 doses per month.

supplements: currently SAM-e 400 mg/day try not to miss any ( should be available in U.S. as a script ) when I do 800 I feel much better, less fatigue, tart cherry juice concentrate liq recently (great stuff ), COQ10, Vacepa ( icosapent ethyl 2 gm ), NAC 600 mg, zinc, d3, milk thistle, methyl folate, b vits, eye vits, periods of whey and amino use but not recently.

Recent T-Cyp dosing:
10/02 70 mg
10/05 64 mg
10/09 70 mg
10/12 48 mg
10/16 64 mg
10/19 64 mg
10/21 46 mg
10/23 46 mg
10/25 60 mg
10/30 44 mg
11/03 64 mg
11/07 68 mg
11/10 60 mg
11/12 64 mg

05 NOV 2 pm Testosterone 1,214 ng/dL Standard Range 250 to 1,100 ng/dL

05 NOV 2 pm Testosterone Free 432.3 pg/mL Standard Range 35.0 to 155.0 pg/mL

24 OCT 4 PM Estradiol, Ultra-Sensitive 59 pg/mL Standard Range< OR = 29 pg/mL

24Oct C-Reactive ProteinYour Value2.8 mg/LStandard Range<8.0 mg/L

05 NOV CBC not fasting 2 pm:

WBC 10.1 Thousand/uL Standard Range 3.8 to 10.8 Thousand/uL

RBC 5.75 Million/uL Standard Range 4.20 to 5.80 Million/uL

Hemoglobin 18.8 g/dL Standard Range 13.2 to 17.1 g/dL

Hematocrit 51.6 % Standard Range 38.5 to 50.0 %
(49.4% in March)

MCV 89.7 fL Standard Range 80.0 to 100.0 fL

MCH 32.7 pg Standard Range 27.0 to 33.0 pg

MCHC 36.4 g/dL Standard Range 32.0 to 36.0 g/dL

RDW 13.9 % Standard Range 11.0 to 15.0 %

Platelet count Your Value166 Thousand/uL Standard Range
140 to 400 Thousand/uL
140 - 400 Thousand/uL
MPV Your Value11.8 fL Standard Range
7.5 to 12.5 fL

LIPID PANEL
Name (Standard Range) 4/13/17 3/26/19
Cholesterol, Total (<200 mg/dL) 207 156
Cholesterol/HDL Ratio (<5.0 ratio) 4.0
Direct LDL Chol (<130 mg/dL) 116
HDL Cholesterol (>40 mg/dL) 45 39
Non-HDL Chol, Calc (<160 mg/dL) 117
Triglyceride, Ser/Plas (<150 mg/dL) 172 150


Recommendations: Be sure and keep a journal with injections, vitals, supplements and symptoms. One running page for each. Its great if you trust your doc but you really need to be on top of things yourself and watch trends. Be careful with supplements. Lots of crap in most pills. Pure or not supps can mess you up. Money is always better spent on clean foods i.e. tart cherry instead of melotonin tabs.

Lab: Gov needs to step in and fix the mess so all docs + pt can view results as soon as they are in! Started using Quest recently and like them way better then LabCorp. Depends on your locale. Doctor's office is another issue. Requested Q to fax my specialist ( not trt ) and also requested Stanford to fax since my primary ordered the tests. Plus I called MD office ahead to request them. Drove 150 miles and he says he has no labs! Second time in a row too. WALOS!

Docs and Pharmacists Rant: Walgreens pharmacist now refuses the tele-med hard copy Rx. Highly suspicious, asks why I don't have a local office job to write for me. "But he works in concert with my local primary" A: "Then why doesn't she write the Rx?'' R: "Does your dentist write your aunties insulin scripts?" Then comes the standard lecture, dangerous controlled substance and how his license is on the line.

 

[Vince Carter]

In the narrow sense about HCT, we have indications of stability for some coming via long term stability...constant and consistent dosing.

I don't see it in your labs but if you do indeed have low SHBG having tested it recently, you're going about this all wrong in dosing and frequency.

You mentioned injection fatigue...if you can't commit to it and do it consistently in that way, you should evaluate other methods and go back to perhaps a topical, or something else.

Bottom line is you have a lot of problems that quite possibly derived from your unwillingness or ability to be consistent and that revolves around a bad protoc

 

[pqteb1r]

In the narrow sense about HCT, we have indications of stability for some coming via long term stability...constant and consistent dosing.

I don't see it in your labs but if you do indeed have low SHBG having tested it recently, you're going about this all wrong in dosing and frequency.

You mentioned injection fatigue...if you can't commit to it and do it consistently in that way, you should evaluate other methods and go back to perhaps a topical, or something else.

Bottom line is you have a lot of problems that quite possibly derived from your unwillingness or ability to be consistent and that revolves around a bad protoc

Thank you for your reply Mr Carter. I understand the value of consistent dosing. S..t happens like forest fires and so called 'public safety power shut-offs'. Injection fatigue contributes to missed doses but it is not the sole explanation. I do have low SHBG. That's why I said EOD is ideal. I have more to deal with health-wise than h. hypogonadism. Patients are more compliant and make progress when 90% of their time goes to care rather than wasting 90% of available time on pedaling backwards through the broken U.S. health care system. You mention "bad protocol". The poor compliance this past month aside what is bad about EOD or E3D t cyp protocol?