Daily protocol from 150mg total /3x week

[BigB77]

I have been on 50mg Test Cyp x3 weekly (150mg total M,W,F) with x3 .125 anastrozole (M,W,F) for several years now through Defy. I've always felt "ok" on it, not great but better than pre-TRT. I've had issues with high HCT and low ferritin from frequent blood donations so wanted to try and optimize my protocol. Especially the past couple years I get winded extremely easy and don't have any cardiovascular stamina. I recently tried a failed enclomiphene monotherapy (absolute nightmare) and wanted to try a daily protocol. My question is what is the equivalent everyday dosing for daily as compared to my x3 protocol or what would be appropriate? Defy said 20mg everyday but that seemed to be a bit much compared to what I have been reading but I could be wrong. These are the results from my last labs from 2 months ago on my x3 protocol (trough, also may have been a bit dehydrated). Also i'm 6'8 260lbs if that matters, working on the weight, down 70 lbs over the last year.

RBC - 6.83 x10E6/uL High
Hemoglobin - 16.6 g/dL
Hematocrit - 53.4% High
MCV - 78 fL Low
MCH - 24.3 pg Low
MCHC - 31.1 g/dL Low
RDW - 16.5 % High
Albumin - 4.9 g/dL
Testosterone - 496 ng/dL
Free Test (Direct) - 17.4 pg/mL
DHEA-Sulfate - 270 ug/dL
TSH - .984 ulU/mL
Estradiol, Sensitive - 23.3 pg/mL
Ferritin - 16 ng/mL
SHBG - 16.6 nmol/L

 

[Systemlord]

MCV - 78 fL Low
MCH - 24.3 pg Low
MCHC - 31.1 g/dL Low
RDW - 16.5 % High

This is iron deficiency, no wonder your have no stamina.

Hemoglobin - 16.6 g/dL
Hematocrit - 53.4% High

The hematocrit to hemoglobin ratios is off, you’re dehydrated.

Iron deficiency can cause dehydration.

Also injections raise CBC more than anything, maybe try a shorter ester (test prop) or other delivery method. Since you’re considering daily injections…

 

[BigB77]

This is iron deficiency, no wonder your have no stamina.

The hematocrit to hemoglobin ratios is off, you’re dehydrated.

Iron deficiency can cause dehydration.

Also injections raise CBC more than anything, maybe try a shorter ester (test prop) or other delivery method. Since you’re considering daily injections…

Really appreciate the response. I was pretty sure I was dehydrated for those labs. Had more labs done after 6 weeks of the enclomiphene debacle (so about 7 weeks of no injections). I really tried to stay well hydrated for those and they were as follows:

RBC - 6.59 High
Hemoglobin - 16.6
Hematocrit - 51.4 High
MCV - 78 Low
MCH - 25.2 Low
MCHC - 32.3
RDW - 17.1 High
Testosterone - 277
Free Test - 8.2
Estradiol Sensitive - 5.1
Ferritin - 102
As you can see, the enclomiphene wasn't effective and I couldn't stand it any longer, had really bad low E and T symptoms (pretty much bedridden for a week or two, lost 25 lbs). The enclomiphene was an attempt to remedy the CBC issues by cutting out the injections but that failed spectacularly.
I also stopped TRT for 9 months a couple years ago and all my CBC results returned to normal range, just got my hypogonadal symptoms back so I went back on. I was hoping maybe reducing my dosage with the daily shots could help the CBC results. I'll admit I haven't looked into Jatenzo, I've really only heard it mentioned on this forum. I thought about trying a topical if the daily shots at a reduced dosage don't work but I will look into your suggestion as well. Once again, really appreciate the response!

 

[BigB77]

Any other suggestions? @Cataceous @Vince I've read alot of your posts and I know you two are big proponents of daily dosing.
150mg Test Cyp /3 MWF +.125 Anastrozole x3 MWF over the past couple years typically puts me around:
Testosterone - 500-600 ng/dL
Free Test (Direct) - 18-22 pg/mL
Estradiol, Sensitive - 18-23 pg/mL
SHBG - 14-17 nmol/L

Trying to figure out a proper daily dosage, I started 12mg daily with no AI about a month ago (just received labs below). Free Test is a little lower than where I feel good but E2 is already creeping up. If I increase to maybe 16mg daily not sure if I should incorporate a tiny dose of Anastrozole (.03mg ED or EOD maybe?)
Testosterone - 302 ng/dL
Free Testosterone - 12.0 ng/dL
Estradiol, Sensitive - 21.3 pg/mL

Been pretty much stuck at the house since the beginning of February so I'm desperate to feel better. Trying not to go back to my old protocol since my HCT/Ferritin issues will just resume at that point. Made an appointment with Dr. Saya (never actually spoken with him even though I've been with Defy for 5 years) but it's not for another month. Any input is very much appreciated.

 

[t_spacemonkey]

I am in a somewhat similar boat as you. 3x week (200mg total). HCT goes up. frequent donation. however ferritin is at 70. also been supplementing iron.
also have been given .125 AI but never took it. there is really no need to suppress your e2 out of the box. my e2 has been running at 40.
my last labs at 180mg/week were 600total/25 free

i started doing those things:
a) started daily injection with a lowered dose (0.1cc/day)=140mg/week
b) added back the HCG at 0.35cc 2x week to compensate somewhat (felt crap below 150mg)
c) considering switching to a short ester (propionate)
d) started telmisartan 20mg due to BP (reading it might lower HCT maybe), and baby aspirin (reading same, maybe will lower)
not seeing myself getting of TRT tbh. my Hemoglobin runs up to 19 at times. but overall I have no symptoms. energy libido good. (with some swings here and there)

 

[BigB77]

I am in a somewhat similar boat as you. 3x week (200mg total). HCT goes up. frequent donation. however ferritin is at 70. also been supplementing iron.
also have been given .125 AI but never took it. there is really no need to suppress your e2 out of the box. my e2 has been running at 40.
my last labs at 180mg/week were 600total/25 free

i started doing those things:
a) started daily injection with a lowered dose (0.1cc/day)=140mg/week
b) added back the HCG at 0.35cc 2x week to compensate somewhat (felt crap below 150mg)
c) considering switching to a short ester (propionate)
d) started telmisartan 20mg due to BP (reading it might lower HCT maybe), and baby aspirin (reading same, maybe will lower)
not seeing myself getting of TRT tbh. my Hemoglobin runs up to 19 at times. but overall I have no symptoms. energy libido good. (with some swings here and there)

Appreciate the response. I'm pretty sensitive to even moderately high E2 (could be due to low SHBG = higher free E2) and feel best in the low 20s, high teens. I'm not sure if I just aromatize more than most but even when I did a 9 month reset (no test/HCG at all) my T dropped to 282, Free T was 10.1 but Estrogen was still 23.3. To your points:

a) I think this might be where I made a mistake by dropping dosage too much. I went from 150mg per week, to a failed Enclomiphene try, to 84mg per week. I think I need to run a little higher but not sure how much to maintain TRT benefits and try and cut sides as much as possible.
b) In the beginning of my TRT journey I ran HCG as well. Then when Defy stopped offering it, I didn't really notice a difference honestly with/without except my E2 dropped a bit and i lowered AI.
c) This might be something I need to look into, I've only ever used Test Cyp.
d) I take Losartan 25 mg daily (was at 50mg but my BP has dropped a good bit over the past couple of months, could be the weight loss or the lower levels of testosterone as well).

I just seem to need more Testosterone than most to even reach moderate levels of Total/Free but the higher dose does not agree with my HCT/HGB/RBCs etc. Also my NPs I've spoken with at Defy have never discussed any dosage dropping, injection frequency, alternative esters etc. to address the need to donate blood. Sleep apnea was always suggested (I have no sleep apnea symptoms other than elevated HCT, sleep fine, feel rested, don't snore, etc.). I had a sleep study, have mild sleep apnea, got a CPAP and no change at all. That was my hail mary and it failed so now I'm looking for other alternatives. Once again thanks for your reply!

 

[BigB77]

I am in a somewhat similar boat as you. 3x week (200mg total). HCT goes up. frequent donation. however ferritin is at 70. also been supplementing iron.
also have been given .125 AI but never took it. there is really no need to suppress your e2 out of the box. my e2 has been running at 40.
my last labs at 180mg/week were 600total/25 free

i started doing those things:
a) started daily injection with a lowered dose (0.1cc/day)=140mg/week
b) added back the HCG at 0.35cc 2x week to compensate somewhat (felt crap below 150mg)
c) considering switching to a short ester (propionate)
d) started telmisartan 20mg due to BP (reading it might lower HCT maybe), and baby aspirin (reading same, maybe will lower)
not seeing myself getting of TRT tbh. my Hemoglobin runs up to 19 at times. but overall I have no symptoms. energy libido good. (with some swings here and there)

Also interesting info regarding ferritin. Here are my results from the past 3 labs I had.
1/10/2023 - 150mg Test Cyp Weekly - Ferritin 16
3/1/2023 - End of Enclomiphene (No Test) - Ferritin 102
3/30/2023 - 84mg Test Cyp Weekly (daily shots) - Ferritin 26

No blood donations during that time at all. I guess it's true that TRT suppresses Ferritin on it's own, even with no donations. Although my CBC did actually improve on 84mg weekly even without donating even compared to my Enclomiphene labs, I just feel terrible.

 

[Vince]

Your testosterone levels are so low. Even though you're injecting a high amount of testosterone. Ever tried not using an AI and letting your estrogen increase. Some men feel better with higher levels of estrogen.

 

[BigB77]

Your testosterone levels are so low. Even though you're injecting a high amount of testosterone. Ever tried not using an AI and letting your estrogen increase. Some men feel better with higher levels of estrogen.

Thanks for replying! I was put on an ai from the beginning of trt with defy. Before trt I had a urologist put me on 50mg Clomid daily. I made it a month, e2 was 60 10 days after my last dose of the Clomid and I was a basket case. Highest I’ve had my estrogen on trt was around 38 e2 sensitive but my total Test was around 800 and free test was about 35 at the time. That was on 180 test cyp weekly with HCG at the time. I felt fine with that e2 but I also had high free t as well so I guess the ratio of the two were ok. I am a pretty big dude (6’8, 260 pounds) but I’m not sure if that has anything to do with normal doses not getting me up to good levels . I’d like to use the least amount possible but it seems the amount is more than most.

 

[Vince]

Thanks for replying! I was put on an ai from the beginning of trt with defy. Before trt I had a urologist put me on 50mg Clomid daily. I made it a month, e2 was 60 10 days after my last dose of the Clomid and I was a basket case. Highest I’ve had my estrogen on trt was around 38 e2 sensitive but my total Test was around 800 and free test was about 35 at the time. That was on 180 test cyp weekly with HCG at the time. I felt fine with that e2 but I also had high free t as well so I guess the ratio of the two were ok. I am a pretty big dude (6’8, 260 pounds) but I’m not sure if that has anything to do with normal doses not getting me up to good levels . I’d like to use the least amount possible but it seems the amount is more than most.

If you feel good at that protocol, why did you change it? I always run my free T above range. I think it's pretty common for someone on TRT.

 

[BigB77]

If you feel good at that protocol, why did you change it? I always run my free T above range. I think it's pretty common for someone on TRT.

HCT issues. If I take enough test to get to those levels, my body turns into a blood factory, lol. Trying to find the balance

 

[Vince]

HCT issues. If I take enough test to get to those levels, my body turns into a blood factory, lol. Trying to find the balance

I was on TRT for 2 years before my HCT stabilized and I no longer had to donate blood. I did go to daily injections and I believe it did help me stabilize my HCT. It's been over 6 years now since I had to donate blood.

 

[BigB77]

I was on TRT for 2 years before my HCT stabilized and I no longer had to donate blood. I did go to daily injections and I believe it did help me stabilize my HCT. It's been over 6 years now since I had to donate blood.

Right, your success was part of the reason I wanted to go to daily shots. Just trying to determine the correct dosage because 12 didn’t seem to cut it. I’m thinking of going on to my old MWF protocol so I can feel like a person again and then trying the dailies. Maybe start at 20mg daily (140mg weekly, 10mg less weekly than my old protocol) and adjust from there.

 

[Vince]

Right, your success was part of the reason I wanted to go to daily shots. Just trying to determine the correct dosage because 12 didn’t seem to cut it. I’m thinking of going on to my old MWF protocol so I can feel like a person again and then trying the dailies. Maybe start at 20mg daily (140mg weekly, 10mg less weekly than my old protocol) and adjust from there.

I would definitely try it. I usually stay on a protocol for at least 12 weeks. Before I can feel the difference.

 

[realdeal1977]

Also interesting info regarding ferritin. Here are my results from the past 3 labs I had.
1/10/2023 - 150mg Test Cyp Weekly - Ferritin 16
3/1/2023 - End of Enclomiphene (No Test) - Ferritin 102
3/30/2023 - 84mg Test Cyp Weekly (daily shots) - Ferritin 26

No blood donations during that time at all. I guess it's true that TRT suppresses Ferritin on it's own, even with no donations. Although my CBC did actually improve on 84mg weekly even without donating even compared to my Enclomiphene labs, I just feel terrible.

This is exactly what I am seeing. My T crashed to 10 while injecting. I stopped T and started enclomiphene and my Ferritin is up to mid 50's after 2 months.

I feel better with my Ferritin coming up, but will be stopping the enclomiphene shortly and can imagine that I am going to feel much worse.

Is there anything else I could be taking to raise T but not taking T itself? Peptides? Something else?

 

[t_spacemonkey]

didn't somebody mention vit C + iron on an empty stomach

 

[Systemlord]

vit C + iron

Orange juice and iron together would be better.

 

[Steve78]

Did you do a sleep study?

Your testosterone is pretty low, I doubt the test is causing your elevate HCT. I’d put my money on sleep apnea, that’s why you feel tired etc..

Crazy how different doses affect people differently, I do 100 mg and my TT is 900 and free T is 300 (25-155 range).

 

[BigB77]

Did you do a sleep study?

Your testosterone is pretty low, I doubt the test is causing your elevate HCT. I’d put my money on sleep apnea, that’s why you feel tired etc..

Crazy how different doses affect people differently, I do 100 mg and my TT is 900 and free T is 300 (25-155 range).

Yeah, did a sleep study 1 1/2 years ago. Mild apnea, use an APAP. Although important to note I didn't display any sleep apnea symptoms except increased HCT (no snoring, felt rested, didn't wake up during the night, breathe through nose, etc.). I stopped TRT completely for 9 months at one point and all my CBC markers dropped down to normal range. Started it back (150mg MWF dose) and within 3 months i'm back to needing to donate. I'm thinking I just eliminate test quickly and my peaks are alot higher than the troughs which causes the HCT/HGB issues even on 3x weekly. Makes sense with my low SHBG. That's why I was attempting to go on the daily protocol but I think I underdosed by alot.

 

[BigB77]

Also on my MWF protocol I have been drawing labs on Monday mornings before my next shot. So it's 3 days of no testosterone, not sure how much lower that puts me vs. doing it on like a Friday before my shot which would only be 2 full days. Basically a full extra day for levels to drop below the trough I have during the week.
If I use test quickly I think that could be somewhat substantial.