Multiple issues and correlating bloodwork

[TRTinNY]

Guys...

Just got test results back.

My iron saturation and ferritin are low.

My red blood cell count, hemoglobin and hematocrit are high

See attached screenshots.

I'm taking 18mg daily (.09mL) of testosterone cypionate due to low SHBG.

My DHEA is also low.

I do smoke cigarettes. Yes I'm an asshole.

Taking 10mg of Cialis daily and still have random ED problems of weak erections which were better for a while when I lowered my cypionate dosage.

Any thoughts how to handle?

 

[Systemlord]

My red blood cell count, hemoglobin and hematocrit are high

Any thoughts how to handle?

You can decrease you TRT dose and quit smoking to lower hematocrit. Smoking also causes permanent damage to DNA over time.

If you start iron supplements hematocrit and red blood cells will likely increase.

 

[TRTinNY]

You can decrease you TRT dose and quit smoking to lower hematocrit. Smoking also causes permanent damage to DNA over time.

If you start iron supplements hematocrit and red blood cells will likely increase.

Decrease from .09mL? How much lower can i go? Also, ferritin and iron Saturation is already low. I could donate blood but im not sure what to do. I have problems quitting smoking.

 

[Systemlord]

I have problems quitting smoking.

I have a friend that tried to quit smoking and saw firsthand how difficult and debilitating it can be. He wasn't able to deal with the withdrawal systems and will never be able to quit.

Decrease from .09mL? How much lower can i go?

I didn't see where this dose has your Total and Free T levels, so it's difficult to advise. Do to having low SHBG, you should be able to get away with a lower Total T and still have sufficient Free T.

 

[TRTinNY]

I have a friend that tried to quit smoking and saw firsthand how difficult and debilitating it can be. He wasn't able to deal with the withdrawal systems and will never be able to quit.

I didn't see where this dose has your Total and Free T levels, so it's difficult to advise. Do to having low SHBG, you should be able to get away with a lower Total T and still have sufficient Free T.

I'm waiting for the current ones but they have mostly been under control

 

[lukas_az]

nicotine is not a big problem IMO. not as damaging as they say. switch to smoking something more pure like cuban cigars. cigarettes are hell, not because of tobacco but additives.
try adding some naturals for ED and modify diet. KETO ramps me up high. I also take d-aspartic acid 3g, boron 10mg, red-maca (sometimes), l-citrulline/dl-malate 2:1, you might add HCG as well.
your numbers mean shit, try what I said your dick might feel young again

​

 

[madman]

Guys...

Just got test results back.

My iron saturation and ferritin are low.

My red blood cell count, hemoglobin and hematocrit are high

See attached screenshots.

I'm taking 18mg daily (.09mL) of testosterone cypionate due to low SHBG.

My DHEA is also low.

I do smoke cigarettes. Yes I'm an asshole.

Taking 10mg of Cialis daily and still have random ED problems of weak erections which were better for a while when I lowered my cypionate dosage.

Any thoughts how to handle?

Need to post labs that include TT, FT, and estradiol before jumping to any conclusions.

Even though you are only injecting 18 mg T daily (126 mg/week) seeing as you have low SHBG your FT level may still be too high!

Again the only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

As you should very well know from being on the forum long enough:

When using exogenous T RBCs/hemoglobin/hematocrit will increase within the 1st month and can take up to 9-12 months to reach peak levels.

T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).

Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.

Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.

3–18% with transdermal administration and up to 44% with injection.

In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.

Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.

As again running very high TT/FT levels will have a stronger impact on driving up HCT.

Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.

Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.

How high an FT level you are running is critical.

It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.

Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.

If you are struggling with such blood markers then in most cases finding the lowest FT level you can run while still maintaining the beneficial effects may very well be the solution.

Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.

Mind you some are lucky and never have an issue or levels tend to stabilize over time.

Others will continue to struggle until the cows come home.

Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!

 

[Another Great Day]

Guys...

Just got test results back.

My iron saturation and ferritin are low.

My red blood cell count, hemoglobin and hematocrit are high

See attached screenshots.

I'm taking 18mg daily (.09mL) of testosterone cypionate due to low SHBG.

My DHEA is also low.

I do smoke cigarettes. Yes I'm an asshole.

Taking 10mg of Cialis daily and still have random ED problems of weak erections which were better for a while when I lowered my cypionate dosage.

Any thoughts how to handle?

Some people want to smoke, that does mean your an A-hole. These are my thoughts from others experiences: My friend used Chantix and had terrible crazy nightmares. He was then prescribed Zyban (the generic name is Bupropion, which is also Wellbutrin) This should begin three weeks prior to slowly cutting back on smokes. Make a list or Excel spreadsheet cut back 1-2 smokes per day or week, depending on how much a person smokes and stick with the plan. My buddy started smoking when he was 14 years of age and with this method quit at the age of 52. As mentioned below - its the chemicals that are most harmful in the smokes.

 

[TRTinNY]

I have a friend that tried to quit smoking and saw firsthand how difficult and debilitating it can be. He wasn't able to deal with the withdrawal systems and will never be able to quit.

I didn't see where this dose has your Total and Free T levels, so it's difficult to advise. Do to having low SHBG, you should be able to get away with a lower Total T and still have sufficient Free T.

So my testosterone total about 3 hours before i injected .09mL of test cyp is 425 with a reference range of 250-100 ng/dL.

My free test is 113.9 with a reference range of 35.0-155.0 pg/mL

Hopefully this helps some more with the questions that were asked

 

[TRTinNY]

Here is the rest of the results. Still waiting on Estradiol Ultrasensitive to come back

 

[TRTinNY]

Anyone have any thoughts on this?

 

[madman]

Anyone have any thoughts on this?

You are only hitting a TT 425 ng/dL on daily injections and your FT level is just above the mean due to your low SHBG 12 nmol/L.

Unfortunately, you would most likely fair better bumping up your FT some but the downfall would be driving up your RBCs/hemoglobin/hematocrit further as it is already very high.

As you know smoking can have a negative impact on hematocrit.

Do you suffer from sleep apnea?

Top it all off that not only did you crash your ferritin/iron but your pregnenolone, DHEA, and Vit D are low.

Prolactin and cortisol on the bottom-end.

 

[TRTinNY]

You are only hitting a TT 425 ng/dL on daily injections and your FT level is just above the mean due to your low SHBG 12 nmol/L.

Unfortunately, you would most likely fair better bumping up your FT some but the downfall would be driving up your RBCs/hemoglobin/hematocrit further as it is already very high.

As you know smoking can have a negative impact on hematocrit.

Do you suffer from sleep apnea?

Top it all off that not only did you crash your ferritin/iron but your pregnenolone, DHEA, and Vit D are low.

Prolactin and cortisol on the bottom-end.

I might have a bit of sleep apnea. I do smoke.

My iron has been low for a long while. I have not donated blood in a year.

What do you suggest I do at this point bc I'm at a bit of a loss?

 

[madman]

I might have a bit of sleep apnea. I do smoke.

My iron has been low for a long while. I have not donated blood in a year.

What do you suggest I do at this point bc I'm at a bit of a loss?

Need to address sleep apnea/smoking.

May need to look into seeking out a hematologist to look into things deeper.

Natesto may be a good option as it should have minimal impact on RBCs/hemoglobin/hematocrit.

Supplementation Preg/Prog, DHEA, Vit D.