Consistent high hematocrit, low ferritin

[jsmma]

Hello all, trying to get back on the right TRT track and see what I can do better.

I've been on TRT for about 3.5 years

Current regimen

100mg test cyp - weekly, given in 2 separate shots into each shoulder, half and half, 27G 1/2"

Lately although not enough, approx 125iu HCG subQ 31G 1/4"

1mg/WK anastrazole

I'm mostly vegetarian only eaten occasional fish

Test levels 900+
Estradiol 25-30

I give blood 3-4x a year and I'm only able to get hematocrit to 51-52. It stays there, more on the high end than I'm comfortable with. When I had problems with blood center I didn't give for way too long and it got as high as 57, which was really bad. Anyways I'm back giving on schedule but hematocrit high.

My ferritin, I'm just learning about, and looking at labs, as a result of the blood giving I've been consistently in the 20s and 30s over the entire 3+ years.

Overall when I eat well, I feel great, and never had any side effects to the regimen.

I work rotating swing shift work, 12 hours, and it's miserable, but I handle it much better than mostly everyone I work with do to TRT.

But I still struggle with fatigue.

Is the ferritin level a serious problem?

Can I raise it without raising hematocrit?

I am not going to add red meat back into the diet as it didn't help when I ate it - how can I effectively supplement and raise the level?

Your time is appreciated, and thank you again for this site.

 

[Vince Carter]

Choose an Iron supplement and pair it with atleast 1g of Vitamin C, and you can also supposedly use the amino acid Lysine, both help with iron absorption. I've used a product called Vitron-C, and another called Ferrets as I have the same problem as you, my ferritin is subterranean in the teens and HCT/HGB and blood donations.

 

[Vettester Chris]

Agree with VC!! Might even make that 2g of Vitamin C, and me personally, I have had good luck with slow release elemental iron.

 

[Vince]

If you're not an any meds that grapefruit would interfere with. Just eat a grapefruit everyday to help lower your HCT. I've never tried this but many members have.

How to Manage Increased Blood Thickness (Hematocrit) Caused by Testosterone Replacement Therapy

https://www.excelmale.com/forum/showthread.php?137-How-to-Manage-Increased-Blood-Thickness-(Hematocrit)-Caused-by-Testosterone-Replacement-Therapy

 

[captain]

Maybe lower your T dose and the hematocrit will come down and you will not need to donate blood or anastrazole. Testing to check for sleep apnea.

 

[ratbag]

VC has an important point w/ vit c. I had the same problem. My ferritin was too low and taking Iron supps brought my HCT too high. So I would give blood and then my ferritin would tank and I'd suffer from low iron symptoms which includes hypothyroid symptoms. My labs for vitamin c looked fine but I wasn't supping vit c. I had read here that others who had the same problem started supping vit c and it solved their problem. So I tried it and sure enough my ferritin finally got back to normal range and my HCT was no longer a problem. This may not work for everyone with this problem but it was a lesson for me.

 

[madman]

Hello all, trying to get back on the right TRT track and see what I can do better.

I've been on TRT for about 3.5 years

Current regimen

100mg test cyp - weekly, given in 2 separate shots into each shoulder, half and half, 27G 1/2"

Lately although not enough, approx 125iu HCG subQ 31G 1/4"

1mg/WK anastrazole

I'm mostly vegetarian only eaten occasional fish

Test levels 900+
Estradiol 25-30

I give blood 3-4x a year and I'm only able to get hematocrit to 51-52. It stays there, more on the high end than I'm comfortable with. When I had problems with blood center I didn't give for way too long and it got as high as 57, which was really bad. Anyways I'm back giving on schedule but hematocrit high.

My ferritin, I'm just learning about, and looking at labs, as a result of the blood giving I've been consistently in the 20s and 30s over the entire 3+ years.

Overall when I eat well, I feel great, and never had any side effects to the regimen.

I work rotating swing shift work, 12 hours, and it's miserable, but I handle it much better than mostly everyone I work with do to TRT.

But I still struggle with fatigue.

Is the ferritin level a serious problem?

Can I raise it without raising hematocrit?

I am not going to add red meat back into the diet as it didn't help when I ate it - how can I effectively supplement and raise the level?

Your time is appreciated, and thank you again for this site.

Your fatigue could also be related to 12hr shift work rotation as lack of/disrupted sleep will have a negative impact on overall well being-energy,mood,libido,immune/digestive system,recovery regardless of being on a effective trt protocol. Sadly some of the negative issues people struggle with on trt are blamed on the protocol when in fact it can be simply a lack of sleep! Of course elevated hematocrit can cause fatigue among many other issues.

 

[Vince]

If you going to add vitamin C I would also add the same amount of lysine, just for the health benefit. I don't believe it's the higher amount of testosterone it's the spikes that causes a rise in HCT.

 

[jsmma]

Thank you all for the replies. Very helpful.

Please know I don't credit my fatigue to my TRT regimen. I've been working this schedule for 11 years and it's that in part that caused the need for TRT. I do know that low iron definitely doesn't help.

That said, I need some clarification.

Will an iron supplement raise my hematocrit further? As well as my ferritin?

I will definitely start supping the C and Lysine - I just need to know about the iron supplement as I know I can't have my HCT go up further. Thanks again.

 

[ratbag]

Yes taking iron supps does increase HCT. The same happened to me as mentioned in my previous post. But at the begininng taking more iron didn't raise my iron.It only raised my HCT. I was taking huge doses of iron at one point trying to get my ferritin to rise but it didn't happen until I started taking more vit c. After taking 2 grams a day of vit c with iron supps suddenly it went up quite quickly and then I realized what happened and stopped iron and with just vit c I was ok.

By definition low ferritin equals hypothyroidism so your symptoms are combined from both low iron and being hypothyroid. Google all those symptoms to cross-reference it for yourself.

 

[Vince]

I agree with ratbag, don't supplement with iron, get it with you diet. I donated blood every 8 weeks for over two years, I got my HCT under control by going to daily injections. No more spikes of T.

 

[madman]

Regarding testosterone and elevated hematocrit supra-physiological spikes of testosterone (usually caused by injectable as oppose to oral/patch/transdermal/pellet especially with once weekly or god forbid once every 2-3 weeks), larger doses of testosterone injected less frequently will spike levels in to the supra-physiological range and those peaks play a role in raising hematocrit but are not the sole reason for elevated hematocrit as there are other factors especially dosage and age (older men are more sensitive to elevations in hematocrit) and if you search the literature the exact mechanisms for elevated hematocrit have not been determined.

Vince it is great daily t injections with lower doses will eliminate the peaks/valleys and result in extremely stable testosterone levels possibly with less conversion to e2/dht and improving some peoples hematocrit but it is not guaranteed to work for everyone as many on transdermal which does not result in the same supra-physiological peaks as injectable still suffer from elevated hematocrit.

 

[Vince]

Regarding testosterone and elevated hematocrit supra-physiological spikes of testosterone (usually caused by injectable as oppose to oral/patch/transdermal/pellet especially with once weekly or god forbid once every 2-3 weeks), larger doses of testosterone injected less frequently will spike levels in to the supra-physiological range and those peaks play a role in raising hematocrit but are not the sole reason for elevated hematocrit as there are other factors especially dosage and age (older men are more sensitive to elevations in hematocrit) and if you search the literature the exact mechanisms for elevated hematocrit have not been determined.

Vince it is great daily t injections with lower doses will eliminate the peaks/valleys and result in extremely stable testosterone levels possibly with less conversion to e2/dht and improving some peoples hematocrit but it is not guaranteed to work for everyone as many on transdermal which does not result in the same supra-physiological peaks as injectable still suffer from elevated hematocrit.

Understand what you saying. But after reading and studying High HCT, it appears by eliminating my spikes of testosterone. I succeeded at which I hoped, that is eliminated my high HCT. I was happy I tried it. Of course my fear was could I inject everyday and be that discipline. I found it was easier for me to inject everyday compared to every three and a half days.

 

[jsmma]

Going to be trial and error I guess. I just recently went from every 3.5 days to 1/wk as I would often be late on my second shot or miss it. I've been able to do the 1shot weekly easily and feel much better - but then realized the ferritin had been a problem throughout, and I already knew my HCT was, even during my first year when I was doing SubQ injections! I guess it's my own chemistry making me more susceptible to high HCT - I just need to try the VitC/Lysine and see if that helps. I'm just glad it's at least steady at 52 and not higher. Thank you all again.

 

[HealthMan]

Regarding testosterone and elevated hematocrit supra-physiological spikes of testosterone (usually caused by injectable as oppose to oral/patch/transdermal/pellet especially with once weekly or god forbid once every 2-3 weeks), larger doses of testosterone injected less frequently will spike levels in to the supra-physiological range and those peaks play a role in raising hematocrit but are not the sole reason for elevated hematocrit as there are other factors especially dosage and age (older men are more sensitive to elevations in hematocrit) and if you search the literature the exact mechanisms for elevated hematocrit have not been determined.

Vince it is great daily t injections with lower doses will eliminate the peaks/valleys and result in extremely stable testosterone levels possibly with less conversion to e2/dht and improving some peoples hematocrit but it is not guaranteed to work for everyone as many on transdermal which does not result in the same supra-physiological peaks as injectable still suffer from elevated hematocrit.

If you look at the graph of total testosterone vs 24h provided by gels like Fortesta you can see some pretty big daily swings ~ 300. So not really stable levels. When i was using testosterone creams there were big swings as well (despite of using 2x day). So i think the idea that gel/creams always provide stable levels is incorrect. But indeed creams/gels usually dont provide supra-physiological spikes. But what would be relevant to HCT? Big swings of TT levels or supra-physiological spikes? Not sure. But if you looks at Vince experience his HCT was stable with TT > 1500. And some people with TT within range but injecting less frequently sometimes have HCT issues too. Tough to know for sure until we have some studies on this subject.
However daily injections of testosterone cypionate should produce virtually stable levels.

 

[Vince]

If you look at the graph of total testosterone vs 24h provided by gels like Fortesta you can see some pretty big daily swings ~ 300. So not really stable levels. When i was using testosterone creams there were big swings as well (despite of using 2x day). So i think the idea that gel/creams always provide stable levels is incorrect. But indeed creams/gels usually dont provide supra-physiological spikes. But what would be relevant to HCT? Big swings of TT levels or supra-physiological spikes? Not sure. But if you looks at Vince experience his HCT was stable with TT > 1500. And some people with TT within range but injecting less frequently sometimes have HCT issues too. Tough to know for sure until we have some studies on this subject.
However daily injections of testosterone cypionate should produce virtually stable levels.

You made some really good points, what works for some doesn't mean it will work for everyone.

 

[FeelingLost]

If you look at the graph of total testosterone vs 24h provided by gels like Fortesta you can see some pretty big daily swings ~ 300. So not really stable levels. When i was using testosterone creams there were big swings as well (despite of using 2x day). So i think the idea that gel/creams always provide stable levels is incorrect. But indeed creams/gels usually dont provide supra-physiological spikes. But what would be relevant to HCT? Big swings of TT levels or supra-physiological spikes? Not sure. But if you looks at Vince experience his HCT was stable with TT > 1500. And some people with TT within range but injecting less frequently sometimes have HCT issues too. Tough to know for sure until we have some studies on this subject.
However daily injections of testosterone cypionate should produce virtually stable levels.

I would never use Vince for an example. That man seems to be able to do anything and never experiences negative side effects.

I've never heard of Fortesta. Is that a common gel prescription?
In my research androgel 1.62 is the gel to rule them all. All other gels are compared to androgel 1.62 for their effectiveness.

 

[Vince]

I would never use Vince for an example. That man seems to be able to do anything and never experiences negative side effects.

LOL
I need at least 10 characters to post a laugh.

 

[Vince Carter]

I was about to say something similar that my friend Vince is a bit atypical in the TRT world for much of what he does or doesn't do and the results he gets!!!

 

[captain]

The doc had me try splitting and increasing the dose of gel from 3 pumps to 4. The result was lower TT with morning labs with higher HCT/HGB. I think it has more to do with the amount of T and not the spike. I also find Fortesta works better than Androgel. It may be the area of application works better for Fortesta as you have more area to spread it on the inner thigh. The amount of skin contact makes a big difference in results you get.