Hypothetical Dosage Question

[GreenMachineX]

I’ve read just a couple reports of guys having better success with once a week shots vs twice a week shots. I’m on 50mg twice per week now, and my total test is 550 or so (any higher and my hematocrit skyrockets), free T is 19, but sensitive e2 is 17. I feel pretty good, but I wonder if I’d do better with a little more e2. DHEA doesn’t agree with me, but perhaps switching to once a week 100mg, or 60mg Sunday and 40mg Wednesday? The 60/40 might just give a little more e2 to aromatize without making my h/h go up too much higher like a 100mg dose might. Anyone have any thoughts on that?

 

[Vince]

What does your shbg sit at.

 

[GreenMachineX]

What does your shbg sit at.

Not sure; hasn’t been tested in years.

 

[Systemlord]

My SHBG is 22 and a Total T of 500 has Free T at 21 pg/mL, so let's assume yours is slightly higher or at least more sticky. If you go for once weekly, this will likely increase hematocrit.

HCG will very likely increase estrogen, but may also increase T and therefore hematocrit.

If it isn't broke...

 

[GreenMachineX]

So higher shbg will increase hematocrit more? How does this work?

 

[Blackhawk]

Higher T increases hematocrit. If you take a bigger dose, your peak will be higher, and potentially more prone to higher HCT.

 

[GreenMachineX]

Higher T increases hematocrit. If you take a bigger dose, your peak will be higher, and potentially more prone to higher HCT.

I understand that, but it sounded like the previous 2 posters were insinuating/saying shbg plays a role too.

 

[GreenMachineX]

My SHBG is 22 and a Total T of 500 has Free T at 21 pg/mL, so let's assume yours is slightly higher or at least more sticky. If you go for once weekly, this will likely increase hematocrit.

HCG will very likely increase estrogen, but may also increase T and therefore hematocrit.

If it isn't broke...

Also, to comment on the last line, I may not be broke, but optimized surely not either. I still have mild e2 deficiency symptoms like mild joint pain, emotional ‘sensitivity’ (this one I’d argue has actually made me a better husband and father though honestly), and other stuff like that. Nothing crazy, but not 100% right either. I’m still trying to determine if I’m really okay with my hematocrit hitting 54 and hemoglobin over 18 or 19 so I can be at a higher free T and e2. The logical part of me knows that people at high elevation have hematocrit that high and they aren’t at increased risk, but the other lower e2 side of me can’t let go of that fear when it gets that high lol.

 

[Vince]

Higher T increases hematocrit. If you take a bigger dose, your peak will be higher, and potentially more prone to higher HCT.

My T has always run over 1000, last lab it was 1112 in my HCT have been 48 or less for the last 2 years.

 

[Blackhawk]

My T has always run over 1000, last lab it was 1112 in my HCT have been 48 or less for the last 2 years.

Vince didn't you also have to donate for a while? Seems I remember your HCT finally came down after a while, don't remember whether that was along with switching to daily?

My HCT went up with TT over 1500 to where I was symptomatic. It came down with dosage reduction and increasing dosage frequency. My TT is running close to yours, around 1000, HCT now 47.

 

[Systemlord]

Also, to comment on the last line, I may not be broke, but optimized surely not either. I still have mild e2 deficiency symptoms like mild joint pain, emotional ‘sensitivity’ (this one I’d argue has actually made me a better husband and father though honestly), and other stuff like that. Nothing crazy, but not 100% right either. I’m still trying to determine if I’m really okay with my hematocrit hitting 54 and hemoglobin over 18 or 19 so I can be at a higher free T and e2. The logical part of me knows that people at high elevation have hematocrit that high and they aren’t at increased risk, but the other lower e2 side of me can’t let go of that fear when it gets that high lol.

It's not just about hematocrit, you have to look at the bigger picture, HCT, HBG and RBC.

 

[madman]

Not sure; hasn’t been tested in years.

Hard to believe you are following a trt protocol without even knowing where your SHBG sits.

Regarding hematocrit.....it is related to supra-physiological T levels resulting from one injecting larger doses of testosterone.

When injecting larger doses less frequently or running too high of a testosterone level (TT/FT) than one would be very prone to increased hematocrit.





Erythrocytosis Following Testosterone Therapy


Considerations for Future Research
A complete understanding of the molecular mechanisms of testosterone-induced erythrocytosis is essential to prevention and treatment of this common and significant adverse effect of TTh. Furthermore, the clinical implications of testosterone-induced erythrocytosis must be further elucidated to identify any actual risks associated with this condition. Alternative options for management of hypogonadal men, such as clomiphene citrate, human chorionic gonadotropin or aromatase inhibitors, may represent treatment options that can provide symptomatic benefit with rare supraphysiological T levels and low rates of erythrocytosis, though these therapies need further study in this context. Finally, randomized controlled trials are still needed in order to rigorously determine the effects of TTh on erythrocytosis, and the potential thromboembolic sequela that may result.




Conclusions
Erythrocytosis is often a limiting variable in patients on TTh. Direct and indirect effects related to supraphysiologic T levels are thought to mediate the effects on erythrocytosis. The true mechanism of erythrocytosis and its role on thromboembolic events remains unclear, though few data support an increased risk of CV events resulting from testosterone-induced erythrocytosis. Large multicenter randomized controlled trials are required to study TTh, its effects on Hb and Hct, and the clinical significance of treatment induced elevations in red blood cell mass.

Figure 1 illustrates the proposed direct and indirect effects of testosterone on erythropoiesis.

 

[Vince]

Vince didn't you also have to donate for a while? Seems I remember your HCT finally came down after a while, don't remember whether that was along with switching to daily?

My HCT went up with TT over 1500 to where I was symptomatic. It came down with dosage reduction and increasing dosage frequency. My TT is running close to yours, around 1000, HCT now 47.

Yep, I haven't had to donate for just over two years now. Plus never needed an AI.

I'm having labs done tomorrow.

 

[madman]

My T has always run over 1000, last lab it was 1112 in my HCT have been 48 or less for the last 2 years.

Where does your ferritin sit as I know you mentioned in a past post that you have never had it tested and that you do not supplement iron as if this is true than if your ferritin is really low it could also be part of the reason your hematocrit has stabilized.

 

[Vince]

Where does your ferritin sit as I know you mentioned in a past post that you have never had it tested and that you do not supplement iron as if this is true than if your ferritin is really low it could also be part of the reason your hematocrit has stabilized.

I may have had it tested but never paid attention to it because it range was good. I am having Labs tomorrow and I'll see if it's on there. In all honestly I'm not concerned about my iron levels, if I was having some type of issue then I probably would be concerned.

 

[Vince]

I may have had it tested but never paid attention to it because it range was good. I am having Labs tomorrow and I'll see if it's on there. In all honestly I'm not concerned about my iron levels, if I was having some type of issue then I probably would be concerned.

I can check my labs on the LabCorp website. I'm currently at work right now and I'm using my phone. I'm sure I'll have some time tomorrow to check them out.

 

[madman]

I can check my labs on the LabCorp website. I'm currently at work right now and I'm using my phone. I'm sure I'll have some time tomorrow to check them out.

Would be interesting to see where your ferritin/iron levels sit!

 

[GreenMachineX]

Hard to believe you are following a trt protocol without even knowing where your SHBG sits.

Why? I know my free and total T and e2 sensitive. What would knowing my shbg help? Then if it’s too high or low, how do I fix it?

 

[madman]

Why? I know my free and total T and e2 sensitive. What would knowing my shbg help? Then if it’s too high or low, how do I fix it?

Knowing ones SHBG is critical as it will dictate ones dose/injection frequency and regardless if one has high SHBG and may do well using larger doses injected less frequently or one has low SHBG and may do well using lower doses injected more frequently it is not set in stone as some deviate from this in order to feel their best.

Ones pre-trt SHBG levels can change when injecting exogenous testosterone depending on dose/injection frequency and although some may only notice a slight change others injecting higher doses may notice a larger drop.

It is important to know where your levels sit.

It is not a given that ones levels will be altered when on trt.

 

[GreenMachineX]

if one has high SHBG and may do well using larger doses injected less frequently or one has low SHBG and may do well using lower doses injected more frequently it is not set in stone as some deviate from this in order to feel their best.

Everything here counters that it’s critical to know.