Problem with polycythemia

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Tron

Member
Hi:

I'm 50 years old and I'm on TRT. 250 mg cypionate each 15 days since 4 years ago. The problem is my hematocrite is high (between 52 and 55). I feel fine with no problems, no headache, a lot of energy, and sex drive.

I understand that such a high hematocrite is on risk of cardiovascular disease. Here in Spain the state pays my TRT but there are no too much blood test (one per year) and my endocrinologist doesn't not consider that my hematocrite level is dangerous. He is not very sure of that or at seems he doesn't give it any solution for this problem.

I don't want to talk with him too much about this problem because I know he is going to reduce my cypionate dose to 21 days. I know this is not the solution and, of course, I want my test levels as high as possible in view of the cypionate half life is not more than 15 days.

I know a possible solution I make a phlebotomy or a blood donation.

The problem is that I can't donate blood because 6 years ago I had tonsil HPV cancer very soon treated. Now I'm fine and completely recovered but I can't be a blood donant. I'm a big man with 120 kg bodyweigh (150 kg bench press and 200 kg squat....)

Another solution is to extract blood myself with a 14g needle. It sounds crazy, I know, but for my there are not any more possibilities because I'm sure that my endocrinologist is going to reduce my cypionate dose with doing any blood test more than one per year. Of course I'm sure he will not want to order any phlebotomy for me.

I'm very conformable with needles I'm capable to puncture a vein in my arm without any problems. Of course, my wife or my son were with me if any problem arise. I have read the equation of Dr. Michael Scally, but it seems too much blood quantity for me. I would star only with 300 cc each 3 months to see if this is enough or not.

Which are the problems I could find if I make a phlebo myself? I'm afraid with the air entering a vein and causing embolism.

Please, any help will be welcome. I haven't much more possibilities here in Spain and with my condition?

Best regards.
 
Defy Medical TRT clinic doctor

Speed

Member

Tron

Member
Thanks a lot. I see the infusion system has two needles. I think one of them is for the vein but the other one, is it needed or not?

The bottle plug has two holes. One of them is used to give any air exit, correct? I think this is very important to remark. The end of the tube inside the bottle is at atmospheric pressure.

I have another question. Would be any problem in using the 18G (or a bigger one 16G or 14G) needle without any tube?. I mean, may I use a needle punctured to the vein and a cup to collect the blood directly from the needle (the end of the needle would be also at atmospheric pressure). Of course, it would less comfortable but a lot more easier to prepare.

And finally, reducing the cypionate dose from 15 days to 21 days, will it reduce the hematocrite levels too? I can sacrifice part of my sex drive and strength for wellness and I would forget about phlebotomies.
 

Speed

Member
Like I said, you just need needle in your vein and tube to transfer blood to the bottle. (yes, you can make two holes on the top) You do not need any sophisticated device. You have a pump in your body. It's your heart :D
18g was just fine for me and blood was going very fast.

Puncture the top of the bottle like in the video and put the tube inside..... Lay on the bed, and put the bottle on the floor and eat some chocolate while enjoying the view :D

You will not be able to do this without a tube. Needle will probably move in the vein doing so and you can hurt yourself.....

Good luck and post some pictures after you're done....
 

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Tron

Member
Ok, I will need some bravery to do that but I will try...

What frequency do yo bleed yourself and which volume? I think a blood test would be needed some time before, two weeks before for example?

I think I will start with 300cc each two months. I think it could be a moderated start up for me.

Thanks for the photos
 

Tron

Member
I have also found a steroid forum with a user called bass who posted the same video of youtube, are you?

There is an interesting post about using the BP cuff to block only the arterial side and not the venous one setting the cuff pressure just bellow the sistolic pressure.

Do you sterilize the tube after using it? How to? I think it is necessary to do it and that's why I would avoid the use of the tube. I don't see any reason for the needle move in the vein without tubing. The only problem without tubing is that it would be necessary to hold the cup with the free hand and this would be a little unconfortable during 10 min or so.
 

Speed

Member
You throw tube away in trash after using it. What do you mean about sterilization? This is my picture, not my video. Put the tube in the needle and enjoy. It is not in the vein, (tube is in the needle) you do not need it sterile (but it is sterile when you open the package of infusion system) It cost 4dolars in my country why do you have problem with it.... . Blood is moving away from body, not the opposite. If you are not secure abot doing it alone.... please don't :) Better for you.....

And, also, read this to avoid problems with low ferritin (when drawing too much blood)

https://www.excelmale.com/forum/sho...ia-Caused-by-Testosterone-Replacement-Therapy
 
Last edited:

ERO

Member
Thanks a lot. I see the infusion system has two needles. I think one of them is for the vein but the other one, is it needed or not?

The bottle plug has two holes. One of them is used to give any air exit, correct? I think this is very important to remark. The end of the tube inside the bottle is at atmospheric pressure.

I have another question. Would be any problem in using the 18G (or a bigger one 16G or 14G) needle without any tube?. I mean, may I use a needle punctured to the vein and a cup to collect the blood directly from the needle (the end of the needle would be also at atmospheric pressure). Of course, it would less comfortable but a lot more easier to prepare.

And finally, reducing the cypionate dose from 15 days to 21 days, will it reduce the hematocrite levels too? I can sacrifice part of my sex drive and strength for wellness and I would forget about phlebotomies.

Dosing your Test Cyp once every 15 days is a hugely outdated protocol. You would be far better off dosing something like 50mg every 3.5 days. Far less E2 conversion and you maintain a steady Test level instead of a huge rollercoaster effect of going super high and then super low before your next dose. This assumes you are allowed to self-inject, of course.
 

Tron

Member
Dosing your Test Cyp once every 15 days is a hugely outdated protocol. You would be far better off dosing something like 50mg every 3.5 days. Far less E2 conversion and you maintain a steady Test level instead of a huge rollercoaster effect of going super high and then super low before your next dose. This assumes you are allowed to self-inject, of course.

Yes I know that my protocol puts me like a rollercoaster. But for 3 years it has been very much worse becasuse I was using 1000 mg of Reandron (Nebido out of Spain) every 8 weeks.

It is true that the test esterification is diferent in each case. The Nebido is undecanoate, the cypionate is cyclopentylpropionate and when you say 50 mg every 3.5 of course I suppose you are talking about propionate alone. In all case, every 3.5 days are too many shots and it would be uncomfortable.

Perhaps they are another possibilities like gel (cream) or patches. I don't know if this presentations behave in the same way in respect to hematocrite elevation. This would be very a interesting information to know.
 

CoastWatcher

Moderator
Yes I know that my protocol puts me like a rollercoaster. But for 3 years it has been very much worse becasuse I was using 1000 mg of Reandron (Nebido out of Spain) every 8 weeks.

It is true that the test esterification is diferent in each case. The Nebido is undecanoate, the cypionate is cyclopentylpropionate and when you say 50 mg every 3.5 of course I suppose you are talking about propionate alone. In all case, every 3.5 days are too many shots and it would be uncomfortable.

Perhaps they are another possibilities like gel (cream) or patches. I don't know if this presentations behave in the same way in respect to hematocrite elevation. This would be very a interesting information to know.

The question of shots twice a week, is something that a number of men have questioned. With the appropriate gauge needle, and a bit of time you don't notice it. It is worth the effort to consider twice-weekly dosing.
 
Will your doctor order a therapeutic phlebotomy?

He's in Europe but here in the states I had trouble getting any one/place to do it, ended up having to play all the screening games to donate, which isn't any kind of issue, just makes things 2-3 times longer than is necessary. I considering this home bloodletting for about 3 seconds.
 

Tron

Member
http://marginalrevolution.com/margi.../why-do-vampires-attract-so-many-readers.html

Transform this chore in to something enjoyable.

The contemporary trend is one of "abstention" so search for old skool. If you are not metrosexual consider a temporary change of wardrobe, such as "all-American boy".

This is my go to plan if unsuccessful on getting a variance on my lease which prohibits both mobile homes and pets. If that's not you check out leechesusa.

Really, I prefer bleeding myself than to use a lot of leeches...

As I said before, it would be a good thing to know if the use of gels or patches would create the same polycythemia than the testo with syringe.

The other problem is that if the option of self bleeding is the choosen one then perhaps it would be necessary to do it for the rest of the life and also the blood tests each one or two months. In the same case, if the doctor order periodic therapeutic phlebotomies. At least, this would be more economic...

Another possibility is to live with the risk to stay with a high hematocrite (lower than 55% but higher than 50%) and to expect nothing bad (a stroke or a heart attack) is going to happen.

Really it is a difficult decision to take.
 

Re-Ride

Member
Not everyone is alarmed at hematocrit slightly over 52. What is your blood pressure, resting pulse, overall cardio health? How much has it increased over the last year? This is something you should measure daily. Persistent high blood pressure can lead to renal impairment. eGFR once a year or more is wise. If you self phlebotomize then consider using a butterfly.
 

Tron

Member
Not everyone is alarmed at hematocrit slightly over 52. What is your blood pressure, resting pulse, overall cardio health? How much has it increased over the last year? This is something you should measure daily. Persistent high blood pressure can lead to renal impairment. eGFR once a year or more is wise. If you self phlebotomize then consider using a butterfly.

My blood pressure is around 145/100. I don't know why the sistolic pressure is so high but the diastolic one is no so bad. My resting pulse is in between 60 and 70. The hematocrite has been lower than 54% for 4 years since I started TRT. Sometimes it has been descending to 50% but sometimes it has increased to 53%.

I haven't done any eGFR but my CPK and urea levels are ever good.

My face has been a little flushed like sunburned since I started TRT and sometimes people ask me if I have taken a sunbath. It doesn't bother me because it looks healthy.

I have read somewhere that the hematocrite levels tend to stabilize over the years but that's not my situation.

Some days ago I punctured the cubital vein of my arm but the needle was a 21G and the blood flow was too slow and it finally stopped. I only achieved 10cc of blood in ten minutes. I think that a 16G will work much better but I can find this size (only 21G) in the pharmacies of my town.
 

Re-Ride

Member
high blood pressure
Stage one hypertension
Systolic: From 140 to 150
Diastolic: From 90 to 99

High Blood Pressure
(Hypertension) Stage 2
Systolic: 160 or higher
Diastolic: 100 or higher

Hypertensive Crisis
(Emergency care needed)
Systolic: Higher than 180
Diastolic: Higher than 110





 
I live in Portugal and I can donate blood anytime but I always get high blood pressure just before so the doc sends me home saying simply it if far too high to let you in (happend already twice). At home I have normal blood pressure so it really sucks. My tips would be try to get a nurse to help you most of us know someone who knows a nurse. I have a retired neighbor that can help me if needed. Good Luck!
 

Tron

Member
I live in Portugal and I can donate blood anytime but I always get high blood pressure just before so the doc sends me home saying simply it if far too high to let you in (happend already twice). At home I have normal blood pressure so it really sucks. My tips would be try to get a nurse to help you most of us know someone who knows a nurse. I have a retired neighbor that can help me if needed. Good Luck!

Blood donation is of course a solution but I think is not the best for me. I can't imagine me having to self-blooding myself each 3 months (or less) for the rest of my life.

I think that I can't stay with a 120kg body weight and 50 years old. This has been my weigh for 15 years but the time to reduce weight it has arrived, I think. Diet and running are going to be my new friends. My benching marks are gonna be reduced, sure...

Another thing I will try to do is reduce the cypionate dose from 15 days to 21 days. I know I will be in a rollercoaster state but my hematocrite will start to reduce. Perhaps in 5 or 6 months is a little better like my blood pressure.

I know that is a difficult decision but it is better than self blooding myself for the rest of my life. If it doen't work then I would start to think in self blooding again.
 
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