Dialing In - Haematocrit & Estradiol Management

[mercury]

Hey guys,

I've been on TRT for about 9 months, and had a very positive experience thus far. Unfortunately, my most recent blood results indicated a couple of anomalies and I was hoping that some of the more knowledgable members here might be able to assist from a knowledge point of view. I've posted by blood results below, but it seems I have 2 issues.

1 - High haematocrit (0.562 - very high?). I've just donated 1 unit in an attempt to reduce this, and I feel better with less 'tightness' across the chest. I've introduced 1 grapefruit per day into my diet. I'm also taking half an aspirin per day. Any thoughts / advice / suggestions? Should i donate again next month to reduce haematocrit, and then go to a twice yearly regimen?

2 - High oestradiol (211 p/mol) - I'm a little confused about how best to manage this. I don't take the Anastrozole which was prescribed by my Dr, because even half a tablet per week was making me feel awful (low energy etc). I've no symptoms of breast tenderness to contend with, but do have a high BMI of about 27. I've listened to some of the more recent science presented by Jay Campbell in his podcasts which seems to contradict conventional medical opinion, and suggest that an AI inhibitor is not required. So, is my high oestradiol a problem that should be managed (to help reduce BMI), or can i safely continue not to take the AI and leave it at current levels?

Thanks in advance for any input, knowledge and assistance you can add.

 

[SilverSurfer]

Your E2 is high, but how do you feel? Mine is usually 60 - 82 usually and I feel fine so I leave it alone. Maybe try 1/4th or 1/8th of a pill otherwise?

There is also new thought out there that unless your platelets are high, just high hemocrit isn’t that big of a deal. https://m.youtube.com/watch?v=mH-J5kXU-jQ

 

[mercury]

Interesting video - thanks for the link.

'how do you feel?' - a good question, and my response would be 'OK'. I certainly don't feel as 'on it' as I did in the first few months of TRT, but expected that to be the case as my body responds to treatment.

1/4 or an 1/8 of the pill might be challenging, but perhaps worth a go. The pills are so tiny, that when I split them in 2, they've already become a crumbly/powdery mess. At 1/4 / 1/8th, I'm not sure i could accurately control the dose.

I've read some info regarding potential over sensitivity to AI in some patients - but it's probably unlikely that I fit into that particular 1% category. If i did manage to reduce the estradiol, exactly how might someone feel 'better'?

Thanks

 

[abe]

If you're not have any bad side effects to your estrogen levels, I wouldn't bother with an AI. It can cause way too bad side effects and take forever to get the proper dose.

For your high HCT, make sure you're well hydrated, take your baby aspirin. Eating half a grapefruit daily can help lower your HCT. Plus trt longevity can also help.

 

[mercury]

Have forum members experienced any benefit from twice, rather than once weekly5injections? I'm currently on 500 mg Sustanon 250 eo6d. Would 250mg eo3d potentially have any impact on oestradiol and haematocrit?

 

[fifty]

Yes

 

[SilverSurfer]

Interesting video - thanks for the link.

'how do you feel?' - a good question, and my response would be 'OK'. I certainly don't feel as 'on it' as I did in the first few months of TRT, but expected that to be the case as my body responds to treatment.

1/4 or an 1/8 of the pill might be challenging, but perhaps worth a go. The pills are so tiny, that when I split them in 2, they've already become a crumbly/powdery mess. At 1/4 / 1/8th, I'm not sure i could accurately control the dose.

I've read some info regarding potential over sensitivity to AI in some patients - but it's probably unlikely that I fit into that particular 1% category. If i did manage to reduce the estradiol, exactly how might someone feel 'better'?

Thanks

My E2 runs a bit high when using HCG, but the only downside is back acne, which is annoying. I’ve tried 1/8th mg Arimidex now on three separate occasions and it kills my erections and morning wood for 2 - 3 days, and shrinks my flaccid size by half. I tossed them in the garbage.

 

[VacationMan]

Splitting those tiny Anastrazole tablets is a royal pain. I've gotten around that by getting a small glass dropper bottle from the pharmacy. I fill it with 16 cc of "decent" vodka, then drop four 1 mg Anastrazole tablets in and let them dissolve. When it comes time to dose the AI, 1 CC in the likes of a tuberculin syringe equates to .25 mg of Anastrazole. Of course, I shake it up to make sure the drug is in suspension before drawing it out.

With that, you can titrate your AI dose up or down as needed and get a far more accurate dose each time.

I'm best when my E2 is in the 25 - 40 range. Each person is different though, and dialing in E2 can be challenging. Best advice is to change only *one* thing at a time and gauge it on how you feel.

 

[WillHouston]

High E2 blocks available testosterone, thus your free test is likely low unless you’re taking megadoses of testosterone. Your Shbg is also a factor

 

[ripadgett]

Have forum members experienced any benefit from twice, rather than once weekly5injections? I'm currently on 500 mg Sustanon 250 eo6d. Would 250mg eo3d potentially have any impact on oestradiol and haematocrit?

Until I went Every other day (EOD), my HCT was steadily creeping up! On EOD it has stabilized at below 40.

 

[DDD]

Until I went Every other day (EOD), my HCT was steadily creeping up! On EOD it has stabilized at below 40.

Did you notice any other benefits by going EOD? Was libido more consistent? How do you inject on an EOD schedule?

 

[ripadgett]

I am getting more consistent morning erections! Something I’d though would never happen again! I alternate between shallow IM in my delts and sub-cutaneous 2 inches below my belly button!

 

[DDD]

I am getting more consistent morning erections! Something I’d though would never happen again! I alternate between shallow IM in my delts and sub-cutaneous 2 inches below my belly button!

Were you not getting morning erections when you weren't on EOD schedule? Why did you think that would never happen again? Do you find your libido more consistent on the EOD schedule? What dose of T do you take on that schedule and does it still include anastrozole? Thank you for sharing.

 

[mercury]

Splitting those tiny Anastrazole tablets is a royal pain. I've gotten around that by getting a small glass dropper bottle from the pharmacy. I fill it with 16 cc of "decent" vodka, then drop four 1 mg Anastrazole tablets in and let them dissolve. When it comes time to dose the AI, 1 CC in the likes of a tuberculin syringe equates to .25 mg of Anastrazole. Of course, I shake it up to make sure the drug is in suspension before drawing it out.

Would using the bacteriostatic water that I have to mix with my HCG, act as a suitable solvent for the AI, in the manner that SilverSurfer describes above, using vodka?

I love the ingenuity, but is mixing an AI with vodka, actually safe? Can you feel any alcoholic 'effects'?

 

[lowTengineer]

Would using the bacteriostatic water that I have to mix with my HCG, act as a suitable solvent for the AI, in the manner that SilverSurfer describes above, using vodka?

I love the ingenuity, but is mixing an AI with vodka, actually safe? Can you feel any alcoholic 'effects'?

I can't comment on mixing medicines into alcohol, however I can tell you the consumption of the alcohol quantity mentioned above does not matter.

1cc of vodka is 0.034oz. Imagine dividing up a 1oz shot into 30 pieces and having 1 of them. Or another way... divide the shot in half and throw the other half away, and then divide the shot in half and throw the other half away, and then do that 3 more times and you are left with the same amount.

I promise you people are not out in the world getting drunk on 0.034oz of vodka.

 

[ripadgett]

Were you not getting morning erections when you weren't on EOD schedule? Why did you think that would never happen again? Do you find your libido more consistent on the EOD schedule? What dose of T do you take on that schedule and does it still include anastrozole? Thank you for sharing.

Not consistently! I thought it would never happen again because it had been nearly 5 years since I’d had one. Yes, I find my libido is more consistent. I started 200 mg Testosterone Cyp with 1 mcg of Anestrozole twice a week. After reading the TOT Bible and listening to multiple TOT docs on Jay Campbell’s vodcast on YouTube (and seeing my estradiol was under 13) I decided no more AI and to take the once a week dose of 200mg and divide it equally into 4 50 mg doses. A little less than the 200 a week. No more Anestrozole!
I rarely see my TRT Doc. Only the first time. We talked, he listened to my heart and approved the treatment. He did no Digital/rectal examine and no testicular exam. His office assistant/nurse runs the whole show! Neither is up to date on the latest protocols! They simply make money! $300 for every visit to get blood work and prescription.

 

[mercury]

My E2 runs a bit high when using HCG, but the only downside is back acne, which is annoying. I’ve tried 1/8th mg Arimidex now on three separate occasions and it kills my erections and morning wood for 2 - 3 days, and shrinks my flaccid size by half. I tossed them in the garbage.

That exactly mimics my own experience. I'd be of a mind to permanently commit them to the bin, if it wasn't for my 211 pmol/L Estradiol. As another poster mentioned, I'm concerned that the impact of the T is reduced, due to my high E. Should i continue to do something about the high E or just ignore the issue? That's the question!!!

 

[Starplex]

Don't overwork the numbers on paper. If you feel good and are having no negative side effects than your protocol is working. Just stick with it and don't chase the numbers. For reference, in the beginning I had the same concerns as you.

Protocol: 250mg T cyp split into two doses a week. Daily Tadafil and Deha-S. Same protocol for 4 years now. On paper I have high E2 and high Hemocrit, but feel great. Good libido, morning erections, good energy, etc. I donate blood maybe twice per year and see doc once per year with labs. He is very pleased with all values. I couldn't be happier with my protocol. I do have higher sbhg which effects my T.

 

[madman]

Don't overwork the numbers on paper. If you feel good and are having no negative side effects than your protocol is working. Just stick with it and don't chase the numbers. For reference, in the beginning I had the same concerns as you.

Protocol: 250mg T cyp split into two doses a week. Daily Tadafil and Deha-S. Same protocol for 4 years now. On paper I have high E2 and high Hemocrit, but feel great. Good libido, morning erections, good energy, etc. I donate blood maybe twice per year and see doc once per year with labs. He is very pleased with all values. I couldn't be happier with my protocol. I do have higher sbhg which effects my T.

If you feel good and are having no negative side effects than your protocol is working.

-true up to a point.....as regardless of one not experiencing negative effects it is still critical to know where ones TT and more importantly FT levels sit on such protocol ( T dose/injection frequency) as some are running way too high FT levels and in many cases could still reap the beneficial effects of testosterone running much lower levels

- to top it off as you should very well know most on trt are using the piss poor inaccurate direct immunoassay when testing FT and have no idea where their FT levels truly sit when in fact they should be using the gold standard Equilibrium Dialysis or Ultrafiltration or better yet using the newer calculated TruT method.


* believe it or not even with having higher SHBG although one may need a higher TT in order to achieve a healthy FT.....the higher TT levels needed are not as high as most people would think due to newer research regarding T:SHBG binding






Protocol: 250mg T cyp split into two doses a week.

- where does your TT/FT levels sit at trough and what is your SHBG as you state it is higher?

- bet your FT levels are sky high on such dose as 250 mg/week is not a trt dose as most men are using anywhere from 100--->150 mg/week and can easily achieve a TT which will result in a healthy FT level.

- sure some are using 200 mg/week but it is not common and even at that dose it would have most men's TT/FT levels way too high


On paper I have high E2 and high Hemocrit, but feel great.

- in the absence of negative symptoms higher e2 is not an issue when running higher TT/FT levels but as far as high hematocrit even though you state you feel great.....thicker blood is thicker blood and overall is harder on ones cardiovascular system in the long term

-just because one is not experiencing any negative effects from higher hematocrit levels presently does in no way mean having more viscous blood is healthy in the long term.

 

[Starplex]

Madman, thanks for the response. We have had this same conversation before. We will continue to disagree on a few things, but that is okay. No harm.
All the answers are in the below thread that I posted back in July. I don't go for new labs for a couple months.

250mg - 2 Yrs Labs Attached