Hematocrit and TRT. How to have balance.

[Ribeye]

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 that some people can resist and carry on with their protocol, but with these side effects I couldn't.

I read several articles and topics about TRT and hematocrit control, but many people did not finish the topics saying how they managed to control or ended up giving up TRT and that Undecanoate would be the ester that least caused erythrocytosis. My own experience also says this because I spent 1 year in Nebido and the hematocrit was controlled, but it is a very long ester and any adjustment is time consuming.

If you are sensitive like me to the cypionate, could you share your protocol and your experience of how you did it to control the hematocrit and follow the TRT? If you do phlebotomy, how do you replace the iron so that your ferritin is around 70?

About the TRT protocol I read about the suppression of hepcidin and EPO and that what causes the increase in hematocrit would be more frequent doses such as DOE or ED since it would have little oscillation in the valley and thus our organism would spend more time producing RBCs and that the protocol, for example, 100 mg E7D with the cypionate the organism would stay longer ¨without producing¨ RBCs because there was a greater oscillation in the valley. How to reach the dose / frequency balance of the injections? What is your peak and your ideal valley? I'll leave one of the links where I read it if anyone wants to.

Does Injection Frequency Affect Hematocrit?

I switched from 76mg once a week to 38mg twice a week 2 months ago and my HCT did indeed rise a bit in last weeks blood. I only have 1 blood draw on the new protocol, but for whatever it’s worth RBC, Hemoglobin, Hematocrit, Platelets all rose higher than my previous 5 blood tests on various...

forums.t-nation.com

As this subject has many variables and that each person reacts differently to the frequencies and doses of testosterone I decided to post this topic.

This forum has helped a lot around the world and this topic should help a lot of people who are starting in TRT and who sometimes give up due to lack of information.

Thank you for participating. Good weekend to everyone.

At your level of hematocrit, every blood donation should remove about 3% from your Hematocrit, taking you down to 50% or lower. That’s in the good range and if your BP responds, you could be good to go with little change. You can donate with little risk to ferritin every 8 weeks as long as your BP doesn’t climb too high before each blood donation. There is some thought over time your body slows down Hematocrit and Hemoglobin production too. I think before I mess with an otherwise good regimen, I would try regular donations at 8 weeks.

 

[BigTex]

I went to dump blood today at Gulf Coast Regional and was asking a lot of questions. When I started at the beginning of 2022 my HTC was 58%. Today it was at least 55%. They told me my doctor has left a standing order for me to come as much as I want. They also told me I could easily go every two weeks. Also I was told to do not supplement with iron if I ever wanted to get this issue solved. The woman also told me once I hit at HTC of 45% they will cut me off and that is where my doctor wants me.

WHat have I done so far.....I cut my prescribed dose from 100mg ever 10 days to 80mgs ever 10 days. After that I went to 40mg ever 5 days. That seemed to help some but not enough. So do I take their advice and go ever say, 3 weeks?

I want to get this solved so I can get my dose back up to 100mg/10 days. I honestly feel like crap with a total test of 460. I might as well be drug free at this point. I have been at the 800-950 levels for years using TU and felt great.

 

[NeverSayNeverAgain]

I went to dump blood today at Gulf Coast Regional and was asking a lot of questions. When I started at the beginning of 2022 my HTC was 58%. Today it was at least 55%. They told me my doctor has left a standing order for me to come as much as I want. They also told me I could easily go every two weeks. Also I was told to do not supplement with iron if I ever wanted to get this issue solved. The woman also told me once I hit at HTC of 45% they will cut me off and that is where my doctor wants me.

WHat have I done so far.....I cut my prescribed dose from 100mg ever 10 days to 80mgs ever 10 days. After that I went to 40mg ever 5 days. That seemed to help some but not enough. So do I take their advice and go ever say, 3 weeks?

I want to get this solved so I can get my dose back up to 100mg/10 days. I honestly feel like crap with a total test of 460. I might as well be drug free at this point. I have been at the 800-950 levels for years using TU and felt great.

I was on a two week donation cycle and only switching to gels and creams did it stop no amount of injection dosage, timing or schedule changes helped in any way maybe bought me an extra week or so. I don't know what happened but my days with injections are over, I feel your pain going way down to get it under control sucks and defeats the purpose of even being on it.

Try gels first then transition to stronger creams if gels isn't enough. You still got a long road to feeling optimized again I wish you the best.

 

[BigTex]

I worry about using the transdermals because I have known so many who used them and their T levels dropped to <200. I am at 460 and already feel like crap. I felt much better in the 800 range.

I am also wondering if 55% HTC is so important when my platelet count is a 218 (140-400).

 

[Systemlord]

I worry about using the transdermals because I have known so many who used them and their T levels dropped to <200. I am at 460 and already feel like crap. I felt much better in the 800 range.

I am also wondering if 55% HTC is so important when my platelet count is a 218 (140-400).

As you know BigTex I’m on Jatenzo at 237 mg twice daily and approaching my evening dosage, I feel the same as I did 2 hours after taking my morning dosage.

My levels vary wildly, 1052 ng/dL four hours and 289 ng/dL at 12 hours.

I feel more fluctuations on injections.

 

[NeverSayNeverAgain]

@BigTex

Nothing wrong with trying it half the symptoms people claim with transdermals I don't experience all the benefits with injections I never got glad I switched up no telling if it will last so here's hoping for the best. My doctor also claimed Jatenzo was the last stop in controlling H&H and it worked for the few she had that couldn't get it under control getting insurance to pay for it is the hardest part and she said her patients absorb it well. Apparently Natesto is the best for it but she was against nasal spray but said she would research it more.

 

[Sly]

I donated blood at a different place and they used a finger cuff apparatus to measure my hemoglobin. First time I had ever saw this, usually it’s a finger prick. Anyways, I usually come in at 17 at the lowest, 20 at the highest. I did a home finger prick test the night before and it read 19.4. The finger cuff at the donation center said14! Lol! I’m pretty sure it was wrong, but hey I was able to donate! I get my blood draw for my usual trt requirement next week, so it will be interesting to see what that comes back as.

 

[NeverSayNeverAgain]

I donated blood at a different place and they used a finger cuff apparatus to measure my hemoglobin. First time I had ever saw this, usually it’s a finger prick. Anyways, I usually come in at 17 at the lowest, 20 at the highest. I did a home finger prick test the night before and it read 19.4. The finger cuff at the donation center said14! Lol! I’m pretty sure it was wrong, but hey I was able to donate! I get my blood draw for my usual trt requirement next week, so it will be interesting to see what that comes back as.

Yea they are not suppose to use that for anyone with a prescription they did it for me once and then I guess policy changed and all TRT donors need to be pricked. I ask to use it when the Hemocue came back 17.2 and they said sure and it also came back 14 lol. I get a vibe they believe it's not all that accurate in general I tried to pull up some studies on it but didn't find much.

 

[Ribeye]

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 that some people can resist and carry on with their protocol, but with these side effects I couldn't.

I read several articles and topics about TRT and hematocrit control, but many people did not finish the topics saying how they managed to control or ended up giving up TRT and that Undecanoate would be the ester that least caused erythrocytosis. My own experience also says this because I spent 1 year in Nebido and the hematocrit was controlled, but it is a very long ester and any adjustment is time consuming.

If you are sensitive like me to the cypionate, could you share your protocol and your experience of how you did it to control the hematocrit and follow the TRT? If you do phlebotomy, how do you replace the iron so that your ferritin is around 70?

About the TRT protocol I read about the suppression of hepcidin and EPO and that what causes the increase in hematocrit would be more frequent doses such as DOE or ED since it would have little oscillation in the valley and thus our organism would spend more time producing RBCs and that the protocol, for example, 100 mg E7D with the cypionate the organism would stay longer ¨without producing¨ RBCs because there was a greater oscillation in the valley. How to reach the dose / frequency balance of the injections? What is your peak and your ideal valley? I'll leave one of the links where I read it if anyone wants to.

Does Injection Frequency Affect Hematocrit?

I switched from 76mg once a week to 38mg twice a week 2 months ago and my HCT did indeed rise a bit in last weeks blood. I only have 1 blood draw on the new protocol, but for whatever it’s worth RBC, Hemoglobin, Hematocrit, Platelets all rose higher than my previous 5 blood tests on various...

forums.t-nation.com

As this subject has many variables and that each person reacts differently to the frequencies and doses of testosterone I decided to post this topic.

This forum has helped a lot around the world and this topic should help a lot of people who are starting in TRT and who sometimes give up due to lack of information.

Thank you for participating. Good weekend to everyone.

You (or someone) questioned if the creams are able to provide enough T replacement. I can absolutely say the newer compounded creams supply enough and more. My total T levels went in excess of 2,000 ng/dl on bid cream usage. Why I took that much, is another question, needless to say, once I saw the results I took more control over my regimen and dosing. In theory at least, because the creams are typically applied on your scrotum, and absorbed quickly thru the thin skin, more T gets converted into DHT, which may have less impact on HCT. I cut my dose down, donated blood a few times, and my total and HCT both went down to better levels. My HCT now bounces around 47-52 and when I see my BP begin to rise, I know its time to donate blood again. It is only very mildly affecting my ferritin, and I am simply making sure I eat enough iron rich foods. Since I love a good steak anyway, this works out nicely for me. For those trying to cut down on red meat, there are plenty of other sources of iron. In my mind, this might well be the biggest risk to taking T supplementation. Increased HCT in itself my not be that big of a problem, but long term, increased BP is a huge problem. It leads to heart disease, heart failure, cardiac arrest, kidney disease, strokes, and more. It isn't a question of if, it is only a question of when. So, don't play with that very basic number (BP) respect it and take care of it.

 

[JimGainz]

For those thinking about creams - the TRT Hormone Optimization channel on YouTube did several videos about why creams, or even using a blend of creams plus injections, is superior. Here is one video but the site has many others including interviews with doctors. It seems that the newer creams can significantly raise testosterone and provide daily energy and libido even more than shots. The guy who runs the channel is known as the Lifting Dermatologist and is quite jacked, and claimed he built his physique on creams.
I am definitely considering this now that I run nandrolone year long and hematocrit has always been an issue for me. The only downside I see is cost. An Rx of Test cyp costs $60 and lasts me 5 months. creams would cost $50 per month.

 

[BigTex]

For those thinking about creams - the TRT Hormone Optimization channel on YouTube did several videos about why creams, or even using a blend of creams plus injections, is superior. Here is one video but the site has many others including interviews with doctors. It seems that the newer creams can significantly raise testosterone and provide daily energy and libido even more than shots. The guy who runs the channel is known as the Lifting Dermatologist and is quite jacked, and claimed he built his physique on creams.
I am definitely considering this now that I run nandrolone year long and hematocrit has always been an issue for me. The only downside I see is cost. An Rx of Test cyp costs $60 and lasts me 5 months. creams would cost $50 per month.

I have a friend that got put on the cream. His Androgel and his T levels went down to 140 even with double doses. His doctor put him on Xyosted and now his levels are back up. I have heard stories like this over and over on another private board these transdermals just don't work for everyone.

As far as I know here are the gels being sold:

• Androgel
• Fortesta
• Testim
• Vogelxo

Can a compound pharmacy make one? Certainly, these are easily made, you can even do it at home.... Testosterone base, alcohol, isporophyl mysistate, sodium hydroxide, water, and carbomer homopolymer type c (or many other solutions). I have a friend that makes this stuff, puts it in metered pump bottles and claims it is over 85% transdermal absorbed. From what he tells me, he sells very little of it. My wife used a transdermal cream, and it didn't work for her either. Now she uses test base and either anavar or torinabol. It’s pretty easy to tell she is not a normal 60-year-old or even one on HRT.

Just a warning to be very careful of where you get your advice. Jim, I have been doing steroids for 43 years now and been extremely strong and "jacked." I was not on TRT doses either. You are not going to get "jacked" on TRT doses. TRT doses put low T guys on the same level with everyone else that walks into a gym. I saw the video guys pictures and he pretty muscular, especially for his age, but saying he is doing this on TRT doses (gel for that matter) reminds me of the Liver King's claims. Just showed the pictures to my wife who is a former IFBB pro and she started laughing, "no way he is just taking hormone replacement doses." IMHO, be very careful of what this guy is claiming and the advice he is giving.

You also noticed the difference in price. My insurance company paid last year for 3, 10ml vials of testosterone cypionate last January. Today I still have about 15 ml left. That will more than get me through 2023. Cost? I paid $15 total. I would have to pay premium cost through insurance for any one of the brand-named gels which $40/month.

I am not doubting your claims of T levels of 2000 on the cream, I am just saying I have never seen this happen to anyone I know using it. So this may be a rare occasion. If you are getting supraphysiological levels of blood testosterone from using a gel then it is no longer TRT, but you will be able to add a substancial amount of musclemass. My doctor put me on 150mg of test cypionate last January and I tested 2103. I felt great but had to lower it down to 80mg quickly.

 

[JimGainz]

I have a friend that got put on the cream. His Androgel and his T levels went down to 140 even with double doses. His doctor put him on Xyosted and now his levels are back up. I have heard stories like this over and over on another private board these transdermals just don't work for everyone.

As far as I know here are the gels being sold:

• Androgel
• Fortesta
• Testim
• Vogelxo

Can a compound pharmacy make one? Certainly, these are easily made, you can even do it at home.... Testosterone base, alcohol, isporophyl mysistate, sodium hydroxide, water, and carbomer homopolymer type c (or many other solutions). I have a friend that makes this stuff, puts it in metered pump bottles and claims it is over 85% transdermal absorbed. From what he tells me, he sells very little of it. My wife used a transdermal cream, and it didn't work for her either. Now she uses test base and either anavar or torinabol. It’s pretty easy to tell she is not a normal 60-year-old or even one on HRT.

Just a warning to be very careful of where you get your advice. Jim, I have been doing steroids for 43 years now and been extremely strong and "jacked." I was not on TRT doses either. You are not going to get "jacked" on TRT doses. TRT doses put low T guys on the same level with everyone else that walks into a gym. I saw the video guys pictures and he pretty muscular, especially for his age, but saying he is doing this on TRT doses (gel for that matter) reminds me of the Liver King's claims. Just showed the pictures to my wife who is a former IFBB pro and she started laughing, "no way he is just taking hormone replacement doses." IMHO, be very careful of what this guy is claiming and the advice he is giving.

You also noticed the difference in price. My insurance company paid last year for 3, 10ml vials of testosterone cypionate last January. Today I still have about 15 ml left. That will more than get me through 2023. Cost? I paid $15 total. I would have to pay premium cost through insurance for any one of the brand-named gels which $40/month.

I am not doubting your claims of T levels of 2000 on the cream, I am just saying I have never seen this happen to anyone I know using it. So this may be a rare occasion. If you are getting supraphysiological levels of blood testosterone from using a gel then it is no longer TRT, but you will be able to add a substancial amount of musclemass. My doctor put me on 150mg of test cypionate last January and I tested 2103. I felt great but had to lower it down to 80mg quickly.

Good info. Yeah, I was skeptical of that guy's physique too. He posts a lot of other videos with doctors inquiring about other compounds with TRT such as anabolics, and his physique certainly suggests that. Another video with a doctor on that channel stated that the new “gold standard” of TRT is using shots And creams together. Comments in the video were overwhelmingly positive about how this improved energy, libido,etc. I feel it is likely from the DHT-based creams giving them a kick. Personally, I would rather run anavar blasts with my shots but that’s just me.

 

[BigTex]

I am also skeptical when a dermatologist starts giving advice on TRT. Of course I am one of those critical thinkers that questions everything I see and hear. I have heard about people using shots and cream together.

Combining cream and injection

I'm seeing lots of guys are really liking doing this. They are typically lowering their injection dosage and doing 50mgs of cream in the morning. Anyone here doing this with good results and will Defy be agreeable to this approach?

www.excelmale.com

 

[Systemlord]

I have heard about people using shots and cream together. Got to ask why. If the cream is that good then wny the injection.

I watched that video from Gil T. The suggestion not to use injections and creams limits options that may actually work for some people who are having problems with subpar DHT when on injections.

 

[AnotherPersonOnTRT]

Reading this thread from start to the last post it certainly confirms that everybody reacts so differently to hormones!

I myself am struggling with high hemoglobin and hematocrit. When i was feeling great living life at around 116mg or more a week i had to donate blood every 2.5 months on the dime!

Due to injury i wanted to try to control my hemoglobin and hematocrit and slowly worked myself down to only ~75mg a week on daily shots! Wow what a difference. This has not solved my problem but has possibly extended the time needed before next donation time to now about 4 months. I read one user say once they got down to 70mg it stopped, but how you really going to feel at that?

Of course the question is now, am i really living the best life of my life right now with that low dose? Should i keep on trying a different frequency, ie: Every other Day next? Later on try a cream, pellets?

I recently switched from Cypionate to Enanthate! (be a miracle if that makes a difference as they are very similar, however; different carrier oil and preservatives).

This is obviously adding stress.

 

[Systemlord]

I recently switched from Cypionate to Enanthate! (be a miracle if that makes a difference as they are very similar, however; different carrier oil and preservatives).

There’s a slight half-life difference.

 

[AnotherPersonOnTRT]

There’s a slight half-life difference.

I know. But I don’t see this help with better hemoglobin control, do you? Praise the good Lord if it does help!

 

[M.J]

Reading this thread from start to the last post it certainly confirms that everybody reacts so differently to hormones!

I myself am struggling with high hemoglobin and hematocrit. When i was feeling great living life at around 116mg or more a week i had to donate blood every 2.5 months on the dime!

Due to injury i wanted to try to control my hemoglobin and hematocrit and slowly worked myself down to only ~75mg a week on daily shots! Wow what a difference. This has not solved my problem but has possibly extended the time needed before next donation time to now about 4 months. I read one user say once they got down to 70mg it stopped, but how you really going to feel at that?

Of course the question is now, am i really living the best life of my life right now with that low dose? Should i keep on trying a different frequency, ie: Every other Day next? Later on try a cream, pellets?

I recently switched from Cypionate to Enanthate! (be a miracle if that makes a difference as they are very similar, however; different carrier oil and preservatives).

This is obviously adding stress.

Trt never helped me, high dose or low still the same libido issues and ED issues, so I went down to 16EOD just to control hemoglobin, hemocritic is stable .

Do you really feel different when you went down ?

Note: every three weeks I stop my hcg (500 eod) and that’s gives me a post in libido for a week or two. Sometimes more.

 

[AnotherPersonOnTRT]

Trt never helped me, high dose or low still the same libido issues and ED issues, so I went down to 16EOD just to control hemoglobin, hemocritic is stable .

Do you really feel different when you went down ?

Note: every three weeks I stop my hcg (500 eod) and that’s gives me a post in libido for a week or two. Sometimes more.

To make sure I understand this right, you had hemoglobin and hematocrit issues in the past too and Switching to Every Other Day solved it????

What was your dosing frequency before you changed?

Thanks!

 

[M.J]

To make sure I understand this right, you had hemoglobin and hematocrit issues in the past too and Switching to Every Other Day solved it????

What was your dosing frequency before you changed?

Thanks!

Yes, I went all the way from 100 weekly and changed to eod. Down to 16eod.
Hematocrit was stable around 75 maybe 80 a week or eod. But hemoglobin keeps going to 17,6. I donate every 6 month and now moved lower to 16mg EOD. I enjoy nice libido when I stop my hcg (500 eod) which last for a week or two maybe 3 !!! I also see the point of changing protocols it does increase libido and all that.I was actually playing around a bit but not with high variation I may do that and also stop hcg every 3 weeks ! To get this libido.