For those who have problems with secondary erythrocytosis or high HCT, the newer oral testosterone undecanoate, Jatenzo, Orlando, Kyzatrex are recommended and do not cause secondary erythrocytosis in any of the clinical trials.
I'm surprised your Mayo PCP doctor didn't recommend any of these oral T options.
If you're on TRT, and you can't maintain normal ferritin, it’s because TRT increases EPO which increased erythroferrone, lowering hepcidin and ferroportin lets iron release from hepatocytes and therefore ferritin doesn't rise.
So if this is the case for you, if you don't supplement iron, ferritin will not rise!
A lot of doctors talk like they know what they're talking about when it comes to TRT, but trust me, the majority of them are mostly clueless!
Your Mayo PCP is dropping the ball! Fire him!
Many experts are now saying the bottom 25 percentile is a sign of hypogonadism. The normal ranges have nothing to do with quality of life.
So you're not just a little bit low, you are low.
Anything that increases testosterone, uses up iron, affects ferritin and increases hematocrit.