Hi Guys,
52 yo male here. I started TRT 4 1/2 months ago due to free test levels of 7.9, range 7.7 to 24. I had every hypogonadism symptom in the book. I have high SHGB and I'm a low estrogen aromatizer. I'd say I'm a TRT hyper responder. I use test enanthate and HCG both injected Mon/Thurs. I really would appreciate need some advice here from the pros.
Labs: (all labs are at trough). All 6 weeks stints include 250IU HCG twice a week. Test Enanthate also injected twice a week)
o 6 weeks at 100mg/wk + 500IU HCG/wk: Total T >1500 | Free T 40.5 - Felt amazing but doctor said too high.
o 6 weeks at 60mg/wk + 500IU HCG/wk: Total T 859 | Free T 15.4 - All TRT benefits vanished. I guess due to high SHBG I need high total T to achieve symptom relieving free T levels.
o 6 weeks at 80mg/wk + 500IU HCG/wk: Total T 1101 | Free T 21.5 – Felt much better vs 60mg/wk at first, but significant fatigue and brain fog crept in over the last 3 weeks. Even with these levels at trough, Estradiol is only 32 so I am a low aromatizer.
I decided to check my Ferritin last week due to the severe fatigue, it was flagged as low 24, range 38 to 380. Pre TRT my Ferritin was 145. I did not check my Ferritin at any other time since starting TRT so I only have Pre TRT levels and most recent levels taken last week.
Hematocrit Pre TRT = 46
Hematocrit during 100mg stint = 47.3
Hematocrit during 60mg stint = 47.5
Hematocrit during 80mg stint = 50.6 (most recent stint)
Interestingly, during the first 12 weeks my Hematocrit only went up a little from Pre TRT levels. But the latest 6 weeks at the 80mg dose shot it way up.
So it's the paradox of not being able to donate blood to bring hematocrit down since it will tank my Ferritin even more, and not being able to aggressively increase my Ferritin with iron pills since it will push my hematocrit even higher.
Option A: Lower dose to 70mg/wk + 500IU HCG/wk + Iron Bisglycinate 25mg M/W/F until Ferritin comes back up
Option B: Switch to 100mg day of Testosterone Gel (Atrevis Base) on shoulders/upper arms. This option is mainly because I really cannot go any lower than 70mg/wk in order to get a high enough Free T to relieve symptoms due to my high SHGB. However, am wondering if lowering to 70mg/week will just prolong the inevitable and my hematocrit will just creep back up again but over a longer period of time and continue draining my Ferritin causing fatigue. So I thought maybe gel/cream is better for my genetic makeup and may cause less hematocrit creep but I have read mixed reviews about if this is actually true? My plan would be once a day morning dosing for gel/cream
What would be the next move if you were me? TRT has been live changing before the low Ferritin fatigue so I'd like to find a way to stay on it but not damage my health with the high hematocrit of the punishing fatigue of the low Ferritin. Thanks very much in advance for the advice!
52 yo male here. I started TRT 4 1/2 months ago due to free test levels of 7.9, range 7.7 to 24. I had every hypogonadism symptom in the book. I have high SHGB and I'm a low estrogen aromatizer. I'd say I'm a TRT hyper responder. I use test enanthate and HCG both injected Mon/Thurs. I really would appreciate need some advice here from the pros.
Labs: (all labs are at trough). All 6 weeks stints include 250IU HCG twice a week. Test Enanthate also injected twice a week)
o 6 weeks at 100mg/wk + 500IU HCG/wk: Total T >1500 | Free T 40.5 - Felt amazing but doctor said too high.
o 6 weeks at 60mg/wk + 500IU HCG/wk: Total T 859 | Free T 15.4 - All TRT benefits vanished. I guess due to high SHBG I need high total T to achieve symptom relieving free T levels.
o 6 weeks at 80mg/wk + 500IU HCG/wk: Total T 1101 | Free T 21.5 – Felt much better vs 60mg/wk at first, but significant fatigue and brain fog crept in over the last 3 weeks. Even with these levels at trough, Estradiol is only 32 so I am a low aromatizer.
I decided to check my Ferritin last week due to the severe fatigue, it was flagged as low 24, range 38 to 380. Pre TRT my Ferritin was 145. I did not check my Ferritin at any other time since starting TRT so I only have Pre TRT levels and most recent levels taken last week.
Hematocrit Pre TRT = 46
Hematocrit during 100mg stint = 47.3
Hematocrit during 60mg stint = 47.5
Hematocrit during 80mg stint = 50.6 (most recent stint)
Interestingly, during the first 12 weeks my Hematocrit only went up a little from Pre TRT levels. But the latest 6 weeks at the 80mg dose shot it way up.
So it's the paradox of not being able to donate blood to bring hematocrit down since it will tank my Ferritin even more, and not being able to aggressively increase my Ferritin with iron pills since it will push my hematocrit even higher.
Option A: Lower dose to 70mg/wk + 500IU HCG/wk + Iron Bisglycinate 25mg M/W/F until Ferritin comes back up
Option B: Switch to 100mg day of Testosterone Gel (Atrevis Base) on shoulders/upper arms. This option is mainly because I really cannot go any lower than 70mg/wk in order to get a high enough Free T to relieve symptoms due to my high SHGB. However, am wondering if lowering to 70mg/week will just prolong the inevitable and my hematocrit will just creep back up again but over a longer period of time and continue draining my Ferritin causing fatigue. So I thought maybe gel/cream is better for my genetic makeup and may cause less hematocrit creep but I have read mixed reviews about if this is actually true? My plan would be once a day morning dosing for gel/cream
What would be the next move if you were me? TRT has been live changing before the low Ferritin fatigue so I'd like to find a way to stay on it but not damage my health with the high hematocrit of the punishing fatigue of the low Ferritin. Thanks very much in advance for the advice!
