My next blood test

[BigTex]

I will go see my doctor in about 4 weeks . Brief history and areas of concern:

* 750mg testosterone undeconoate every 12 weeks
January 2017
RBC - 5.65
Hemoglobin - 16.8
Hematocrit - 50.9
TESTOSTERONE, TOTAL, RGA MALES (ADULT), IA - 772

* 750mg testosterone undeconoate every 4 weeks
March 2021
TESTOSTERONE, TOTAL, RGA MALES (ADULT), IA 981 H

Did a pretty long washout and dropped T levels to 321.

December 2021
TESTOSTERONE, TOTAL, RGA MALES (ADULT), IA - 321

Doctor prescribed test abotu Jan 15th 2022

* Test cypionate dose 125mg every 10 days sub-q
March 2022
TESTOSTERONE, TOTAL, RGA MALES (ADULT), IA - 2103 H


* Dropped Test cypionate dose 100mg every 10 days sub-q
April
RBC - 6.42
Hemoglobin - 18.9
Hematocrit - 58.5
ESTOSTERONE, TOTAL, MALES (ADULT), IA - 839 H
ESTRADIOL - 38

July
RBC - 6.23
Hemoglobin - 20.2
Hematocrit - 57
TESTOSTERONE, TOTAL, MALES (ADULT), IA - 883
ESTRADIOL - 79 H

* I dropped the Test cypionate dose 80mg every 10 days sub-q after seeing this report

I have done 2 blood dumps since then (6 months) and have been taking 36mg of Iron in a supplement form since then.

My doctor also put me on anastrozole 1mg in July for the three days after each cypionate injection. So 3mg every 10 days I made the decision to stop the anastrzole after 3 cycles (30 days or 9 pills). I will not take it again.

So I go in the middle of October to see my doctor and have a list of things I want in a blood test:

TESTOSTERONE, FREE & TOTAL
CBC (H.H,RBC,WBC,PLT)
PSA, TOTAL
COMPREHENSIVE METABOLIC PANEL (CMP)
IRON, TOTAL
ESTRADIOL, ULTRASENSITIVE, LC.MS
FSH and LH

Any other items that should be a must in this case?

 

[FunkOdyssey]

I would say you don't need LH and FSH because we already know those will be suppressed close to zero forever unless you stop TRT. Also you would want to add total iron binding capacity (TIBC), transferrin saturation, and ferritin to get a complete picture of your iron status and how it is being affected by your blood donations and iron supplementation. Usually there's an iron deficiency panel available that would bundle those together.

 

[tareload]

Hematocrit and TRT. How to have balance.

Hello everybody. When I changed my protocol from Nebido to cypionate, I read that for those with low SHBG 12, the most recommended would be 20mg EOD, but with this protocol my hematocrit went up, BP increased, I had to do phlebotomy and ended up giving myself time to recover ferritin. I know...

www.excelmale.com

 

[BigTex]

OK, I have an appointment with my private care physician Monday and I am going to ask for:

– CBC
– CMP
- Lipids
– Testosterone, Free & Total
– Estradiol, sensitive
- PSA
- IRON, TIBC AND FERRITIN PANEL

 

[BigTex]

Got the results, my doctor decided to not run a lot of it because my appointment was at 2:30pm and I was not at all fasted. I had a huge lunch at noon. Anway, 3 months ago I dropped my test cyp to 80mg every 10 days. He also put me on Anastrozone 1mg for 3 days after each cycle. My estriadol 3 months ago was at 79. My testosterone was also at 884. After two blood dumps in this time fram my red blood cell etc and come down slightly but my RDW went up about 1.1 points from July.

WHITE BLOOD CELL COUNT 7.9 Reference Range: 3.8-10.8 Thousand/uL

RED BLOOD CELL COUNT 6.14 H Reference Range: 4.20-5.80 Million/uL (6.23)
HEMOGLOBIN 19.3 H Reference Range: 13.2-17.1 g/dL (18.9)
HEMATOCRIT 57.7 H Reference Range: 38.5-50.0 % (58.2)

MCV 94.0 Reference Range: 80.0-100.0 fL
MCH 31.4 Reference Range: 27.0-33.0 pg
MCHC 33.4 Reference Range: 32.0-36.0 g/dL

RDW 15.1 H Reference Range: 11.0-15.0 % (14.0)

PLATELET COUNT 218 Reference Range: 140-400 Thousand/uL
MPV 10.2 Reference Range: 7.5-12.5 fL
ABSOLUTE NEUTROPHILS 4953 Reference Range: 1500-7800 cells/uL
ABSOLUTE LYMPHOCYTES 1880 Reference Range: 850-3900 cells/uL
ABSOLUTE MONOCYTES 830 Reference Range: 200-950 cells/uL
ABSOLUTE EOSINOPHILS 198 Reference Range: 15-500 cells/uL
ABSOLUTE BASOPHILS 40 Reference Range: 0-200 cells/uL
NEUTROPHILS 62.7 %
LYMPHOCYTES 23.8 %
MONOCYTES 10.5 %
EOSINOPHILS 2.5 %
BASOPHILS 0.5 %

ESTRADIOL 47 H Reference Range: < OR = 39 pg/mL (79)

IRON, TOTAL 118 Reference Range: 50-180 mcg/dL

TESTOSTERONE, TOTAL, MALES (ADULT), IA 549 Reference Range: 250-827 ng/dL (884)

PSA, TOTAL 0.80 Reference Range: < OR = 4.00 ng/mL

I can't drop the testosterone eny more or I will be >500. I have yet to hear from my doctor in this one. I am sure he will call in the next day or 2.

 

[Cataceous]

Refresh my memory: When are lab tests relative to injections? What's your SHBG like?

 

[BigTex]

When I 1st got prescribed TC in Januray I was at 125mg/10 days. My serum testosterone went to 2104. He dropped it to 100mg every 10 days and the serum levels dropped to 884. However my E2 and red blood cells etc went up so I dropped the injections to 80mg ever 10 days. My doctor also put me on anastrozole, 1mg each 3 days after my injection. The dosage drop to 80 was 3 months ago. Trying to get RBC and HCT down. I have done 2 blood dumps in the past 4 months. Have not tested SHBG.

I have done testosterone for over 42 years now and never had high E2 or RBC.

 

[Cataceous]

Let me rephrase then: Are you measuring testosterone at peak, trough, or somewhere in between? If you're measuring at trough then you certainly have high levels earlier in the injection cycle. A total testosterone measurement by itself is of limited usefulness; you need to know what free testosterone is doing. If you had SHBG then you could estimate free T. Alternatively, use Quest's equilibrium dialysis free T test, even if you have to order it yourself. It seems likely that splitting your dose could help. There aren't so many men who do well injecting cypionate only once every two half-lives.

 

[BigTex]

I have been doing the testing on day 9 of a 10 day cycle. As far as splitting up the dose, after 42 years of using testosterone, I am honestly tired of the inejctions, even sub-q as I also do hGH 2-3 times a day. I tried to split the injections but could not keep it up.

I had planned to do the – Testosterone, Free & Total but my doctor said my insurance was not going to pay for it all. So I am going to have to do that on my own since I also need to do a CMP and Lipid profile. I never had to worry about all of this when I paid cash.

Seems I didn't have all of these blood issues when I was doing the test undeconoate at 750mg/4 weeks. My serum test levels stayed higher for a longer period too.

 

[Cataceous]

Undecanoate has a half-life that's about four weeks. To match the reduced variation with cypionate you'd probably need to inject at least every five days. Even then it's possible that you wouldn't respond quite as well to having those variations take place over days rather than weeks. But it would doubtless improve your blood work.

Are you using normal syringes for your daily hGH? If so then why not just include some cypionate in one of them, or better yet a cypionate/propionate blend? It's a very small amount when it's daily. That's what I do, except for using different peptides as the water-based component. I can pontificate on the technique if you're interested.

 

[BigTex]

Insulin syringers for both. I do 250mcg hCG on day 8, and day 9, the TC injection of day 10. I may reconsider going more frequetly. My doctor suggested I see a hemotologist but my cardiologist already told me their response would be to stop the testosterone.

 

[tareload]

Insulin syringers for both. I do 250mcg hCG on day 8, and day 9, the TC injection of day 10. I may reconsider going more frequetly. My doctor suggested I see a hemotologist but my cardiologist already told me their response would be to stop the testosterone.

Your peak could/would still be way up there. Twice weekly injections to cut the peak may help as we have discussed on here regarding setpoint for hepcidin suppression and exacerbation with age. A good hematologist would look to find root cause. Find one that has clinical experience manipulating peak/trough ratio for same AUC to lower Hct. You need to get Hct down.

325 mg/day aspirin significantly reduces RBC production for me but comes with other concerns.

If you want to continue with test cyp ... Appears you may have to (1) break up into multiple injections per week and (2) lower the weekly dose if (1) doesn't do it on its own.

Or like you said back to TU or another Test formulation.

Tool to Assess your TT Dose Response -- Percentile Curves

Summary: Tools to estimate your individual dose response for injectable testosterone ester in comparison to a normal distribution (95 percentile confidence estimate) of adult males (Ref). Plot below shows a summary of data from (1) clinical trials gathered from the literature + (2)...

forums.t-nation.com

As inferred from table above your peak and mean are much higher than the trough and leave you some room for item 2 above.

You also eat a sh*tload of iron.

 

[Cataceous]

Insulin syringers for both. I do 250mcg hCG on day 8, and day 9, the TC injection of day 10. I may reconsider going more frequetly. My doctor suggested I see a hemotologist but my cardiologist already told me their response would be to stop the testosterone.

When you said " I also do hGH 2-3 times a day..." were you meaning to say you do hCG 2-3 times in a testosterone injection cycle? If so then you still have a reasonable solution: Inject 20-25 mg of T cypionate every three days and include the hCG in two out of three injections, or in every injection. This results in little change in the total number of injections you must endure, while giving you considerably less variation in serum testosterone.

 

[tareload]

Related rambling...

Here I take the con instead of pro.

What Benefits with Different Injection Frequencies?

I’ll posit this has to do with both dose and frequency. If I remember correctly trying to trace back the kinetics of testosterone on hepcidin suppression and to EPO, it’s first order. Once you reach saturation, you can’t make more RBCs. If your dosages are too high then daily frequency ain’t...

forums.t-nation.com

What Benefits with Different Injection Frequencies?

See the dose response of testosterone effect on hepcidin followed by saturation after going past roughly 125 mg/week. Older guys more pronounced effect. So once you elevate past the upper limit on testosterone physiologic range, no additional penalty on Hepcidin suppression (i.e. saturation)...

forums.t-nation.com

 

[BigTex]

When you said " I also do hGH 2-3 times a day..." were you meaning to say you do hCG 2-3 times in a testosterone injection cycle? If so then you still have a reasonable solution: Inject 20-25 mg of T cypionate every three days and include the hCG in two out of three injections, or in every injection. This results in little change in the total number of injections you must endure, while giving you considerably less variation in serum testosterone.

No, I do hGH at 1iu 2-3 times a day. I am getting ready to change that for modified GRF (1-29)/GHRP-2 and 10mg of MK-677. I will try the every 3 days and see it it makes a difference and add teh hCG to two of the injections.

 

[BigTex]

Your peak could/would still be way up there. Twice weekly injections to cut the peak may help as we have discussed on here regarding setpoint for hepcidin suppression and exacerbation with age. A good hematologist would look to find root cause. Find one that has clinical experience manipulating peak/trough ratio for same AUC to lower Hct. You need to get Hct down.

325 mg/day aspirin significantly reduces RBC production for me but comes with other concerns.

If you want to continue with test cyp ... Appears you may have to (1) break up into multiple injections per week and (2) lower the weekly dose if (1) doesn't do it on its own.

Or like you said back to TU or another Test formulation.

Tool to Assess your TT Dose Response -- Percentile Curves

Summary: Tools to estimate your individual dose response for injectable testosterone ester in comparison to a normal distribution (95 percentile confidence estimate) of adult males (Ref). Plot below shows a summary of data from (1) clinical trials gathered from the literature + (2)...

forums.t-nation.com

View attachment 26285

As inferred from table above your peak and mean are much higher than the trough and leave you some room for item 2 above.

You also eat a sh*tload of iron.

I am taking 36mg/d iron but it looks like to me the blood dumps are killing my iron leve;s. I guess I will double up. I do take in about 92mg of iron daily through my diet.

Readalot my low back hurts so bad I take two asprin 1st thing when I get up. I will add that I have not done test cyp since the 80's. After prohibition on steroids test enanthate was much easier to find. Could be the problem. does seems strange that I have never had these issues until I started taking prescription TC.

 

[tareload]

Readalot my low back hurts so bad I take two asprin 1st thing when I get up.

325 mg tabs? You take 650 mg of aspirin every morning....for how long now?

 

[BigTex]

Months.....I have no disks between the L4 and L5, plus osteoarthritis. Aspirin hits me quickly and enables me to be able to stand up and do what I need to get to work at 7am. I take two Tylenol Arthritis Strength in the evening when the pain starts getting bad again. It also doesn't effect the liver values like Tylenol does.

 

[tareload]

Months.....I have no disks between the L4 and L5, plus osteoarthritis. Aspirin hits me quickly and enables me to be able to stand up and do what I need to get to work at 7am. I take two Tylenol Arthritis Strength in the evening when the pain starts getting bad again. It also doesn't effect the liver values like Tylenol does.

Well then we can rule out using aspirin to help your Hct issue.

I am a little more fortunate than you in that I am missing many thoracic disks so not as problematic as L4/L5. Does cause a lot of shooting pain though. Hope you find a good hemaotolgist you can trust. Also consider the hemochromatosis panels we discussed after consulting with your Doc.

Take care.

 

[BigTex]

Yea....finding someone I can trust is a huge obstacle. My cardiologist already warned me a hematologist would just tell me to get off the TRT. I'll check with my private care doctor.

So I take it micro dosing didn't help you?

I have some guys I know telling me to do cardio and that will solve the issue. Ahhhhh....