My Dilemma

[BigTex]

My doctor has put in an order for a blood dump, should I go or lower the dose slightly.

September blood tests
RED BLOOD CELL COUNT 5.66 Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 16.8 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 50.4 H Reference Range: 38.5-50.0
PLATELET COUNT 281 Reference Range: 140-400 Thousand/uL

TESTOSTERONE, TOTAL, MALES (ADULT), IA 783 Reference Range: 250-827 ng/dL
ESTRADIOL - 24 Reference Range: < OR = 39 pg/mL

December blood tests
RED BLOOD CELL COUNT 6.11 H Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 16.6 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 51.9 H Reference Range: 38.5-50.0 %
PLATELET COUNT 291 Reference Range: 140-400 Thousand/uL

TESTOSTERONE, TOTAL, MALES (ADULT), IA 883 H Reference Range: 250-827 ng/dL
ESTRADIOL 68 H Reference Range: < OR = 39 pg/mL

How do I feel? The same as I did in September. I did stop the anastrozole in September. I was taking 1/2mg the day after my injection. Since there is absolutely no literature on using 55mg testosterone undecanoate sub-q every 5 days it has been a huge guessing game.

My blood testosterone levels peaked a long time ago since I started this over a year ago, I am now consistent from injection to injection.. I tested the day before the next injection each time, yet the testosterone levels rose 100 points from September.

Most likely dropping the AI and the increase in serum testosterone levels could have increased the E2 and most likely the HCT 1.5%. A blood dump would probably drop this to ~48.9% but does that solve the problem? 51.9% is far from the >54% cut off. I a going to go back to 1/2mg of anastrozole after the injection.

Should should I not worry about it? Should I do the dump? Or should I drop the dose from 55mg/5days to 50mg/5 days? I am certainly not worried about having slightly high testosterone. I have not dumped blood in about a year and my iron levels are good.

 

[MDavidW76]

I’d drink a gallon and a half of water with liquid IV or some other electrolytes in it, then I’d do another blood test.

My current hematocrit level is 52. It gets flagged as high. I’m 2500’ above sea level, honestly pretty damn lazy, eat garbage (it’s Christmas :shrug, and I don’t drink enough water daily.

I’m not red like a lobster, that for me happens when I’m at 56 and dehydrated.

If you do a pump and dump you’ll probably rebound to the same or a higher level. If you do visit the vampires, donate. I do a power red or double red and it’s alright, and it not dumped down the drain, it goes to folks who need that blood badly.

If you’re looking to have everything in the made up “95% of the non obese males up to 39 years old and are just peachy” range then yeah, drop your dose a bit, but then you wait 40 days for homeostasis, before doing another blood test that will probably say the same thing…

 

[Charliebizz]

I personally wouldnt change a thing. I’ve come up slightly high before only to drop back down next draw. Like mdavid said. Hydration status can have a lot to do with it

 

[MDavidW76]

I personally wouldnt change a thing. I’ve come up slightly high before only to drop back down next draw. Like mdavid said. Hydration status can have a lot to do with it

I know my answer looks crass but a lot of medical folks will absolutely flip out at numbers that show a minimal out of range, I was flagged as “High Critical” when another reading was 50.1… Math is not their strong point, and on top of that, platelets and RBC were low in range… I was dehydrated to the point I needed two bags of saline, so of course it was a messed up reading… I shake my head at some of the lab folks and medical “professionals” sometimes

 

[Charliebizz]

These are my labs a few months apart. First picture I was in a lower dose and had slightly lower t levels then the second picture.

 

[MDavidW76]

5.82 vs 5.80, 50.2 vs 50…
Obviously you survived

 

[Charliebizz]

5.82 vs 5.80, 50.2 vs 50…
Obviously you survived

Exactly. If I was @BigTex i wouldn’t touch a damn thing.

 

[testiculus]

My doctor has put in an order for a blood dump, should I go or lower the dose slightly.

September blood tests
RED BLOOD CELL COUNT 5.66 Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 16.8 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 50.4 H Reference Range: 38.5-50.0
PLATELET COUNT 281 Reference Range: 140-400 Thousand/uL

TESTOSTERONE, TOTAL, MALES (ADULT), IA 783 Reference Range: 250-827 ng/dL
ESTRADIOL - 24 Reference Range: < OR = 39 pg/mL

December blood tests
RED BLOOD CELL COUNT 6.11 H Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 16.6 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 51.9 H Reference Range: 38.5-50.0 %
PLATELET COUNT 291 Reference Range: 140-400 Thousand/uL

TESTOSTERONE, TOTAL, MALES (ADULT), IA 883 H Reference Range: 250-827 ng/dL
ESTRADIOL 68 H Reference Range: < OR = 39 pg/mL

How do I feel? The same as I did in September. I did stop the anastrozole in September. I was taking 1/2mg the day after my injection. Since there is absolutely no literature on using 55mg testosterone undecanoate sub-q every 5 days it has been a huge guessing game.

My blood testosterone levels peaked a long time ago since I started this over a year ago, I am now consistent from injection to injection.. I tested the day before the next injection each time, yet the testosterone levels rose 100 points from September.

Most likely dropping the AI and the increase in serum testosterone levels could have increased the E2 and most likely the HCT 1.5%. A blood dump would probably drop this to ~48.9% but does that solve the problem? 51.9% is far from the >54% cut off. I a going to go back to 1/2mg of anastrozole after the injection.

Should should I not worry about it? Should I do the dump? Or should I drop the dose from 55mg/5days to 50mg/5 days? I am certainly not worried about having slightly high testosterone. I have not dumped blood in about a year and my iron levels are good.

I wouldn't base the decision to use anastrozole on an increasing hematocrit. If you're having high estrogen symptoms, then yes. Also nothing says you have to take 1/2 mg. Take only how ever much you need to eliminate symptoms. 1/4 mg or less might be all you need.

On hematocrit, if the trend holds you'll reach ~54% after 6-7 months from Sept (more data points would give you a more accurate estimate, but you get the idea). At that point you definitely would need to donate. So if you're okay dropping a unit of blood twice a year, stay at the current dose. If not, then drop the dose or add something else to suppress RBC generation. Either way at 51.9% and no symptoms it's not an urgent situation, but long term high blood viscosity leads to increased risk of adverse events.

 

[Vince]

My doctor has put in an order for a blood dump, should I go or lower the dose slightly.

September blood tests
RED BLOOD CELL COUNT 5.66 Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 16.8 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 50.4 H Reference Range: 38.5-50.0
PLATELET COUNT 281 Reference Range: 140-400 Thousand/uL

TESTOSTERONE, TOTAL, MALES (ADULT), IA 783 Reference Range: 250-827 ng/dL
ESTRADIOL - 24 Reference Range: < OR = 39 pg/mL

December blood tests
RED BLOOD CELL COUNT 6.11 H Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 16.6 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 51.9 H Reference Range: 38.5-50.0 %
PLATELET COUNT 291 Reference Range: 140-400 Thousand/uL

TESTOSTERONE, TOTAL, MALES (ADULT), IA 883 H Reference Range: 250-827 ng/dL
ESTRADIOL 68 H Reference Range: < OR = 39 pg/mL

How do I feel? The same as I did in September. I did stop the anastrozole in September. I was taking 1/2mg the day after my injection. Since there is absolutely no literature on using 55mg testosterone undecanoate sub-q every 5 days it has been a huge guessing game.

My blood testosterone levels peaked a long time ago since I started this over a year ago, I am now consistent from injection to injection.. I tested the day before the next injection each time, yet the testosterone levels rose 100 points from September.

Most likely dropping the AI and the increase in serum testosterone levels could have increased the E2 and most likely the HCT 1.5%. A blood dump would probably drop this to ~48.9% but does that solve the problem? 51.9% is far from the >54% cut off. I a going to go back to 1/2mg of anastrozole after the injection.

Should should I not worry about it? Should I do the dump? Or should I drop the dose from 55mg/5days to 50mg/5 days? I am certainly not worried about having slightly high testosterone. I have not dumped blood in about a year and my iron levels are good.

If it was me I would just do the blood donation. That way you know they will except it.

 

[Gman86]

I’m so confused, why would u lower ur dose or donate blood? Ur Rbc’s and HCT are slightly above the top of the range, which is completely fine, imo. I wouldnt donate strictly to lower those levels. They’re perfectly fine and healthy, again imo.

I wouldn’t lower ur test dose either. Or take an ai, if ur feeling pretty good. Ur test and E2 levels are both great. So as long as ur feeling pretty good, I see zero reason to lower ur dose.

If ur worried about ur RBC and HCT levels, which again I wouldn’t be at all if I were u, I would simply just pour a big glass of water about an hour or two prior to getting ur labs done, put some sea salt in it, preferably Celtic sea salt, and/ or an electrolyte mix, chug it down, and retest ur RBC, HCT and HGB levels. I guarantee u’ll see all those numbers come down a decent amount. And then once u see those levels come back lower on ur labs, just try to stay as hydrated as possible everyday to keep ur levels slightly lower on a daily basis. Key to hydration, imo, is drinking as much water with extra electrolytes in it as possible. I personally just keep it simple and add Celtic sea salt and some magnesium chloride liquid to any water that I drink. Recently been adding some cream of tartar to my morning glass of water to get some extra potassium in

 

[Sly]

I’m so confused, why would u lower ur dose or donate blood? Ur Rbc’s and HCT are slightly above the top of the range, which is completely fine, imo. I wouldnt donate strictly to lower those levels. They’re perfectly fine and healthy, again imo.

I wouldn’t lower ur test dose either. Or take an ai, if ur feeling pretty good. Ur test and E2 levels are both great. So as long as ur feeling pretty good, I see zero reason to lower ur dose.

If ur worried about ur RBC and HCT levels, which again I wouldn’t be at all if I were u, I would simply just pour a big glass of water about an hour or two prior to getting ur labs done, put some sea salt in it, preferably Celtic sea salt, and/ or an electrolyte mix, and retest ur RBC, HCT and HGB levels. I guarantee u’ll see all those numbers come down a decent amount. And then once u see those levels come back lower on ur labs, just try to stay as hydrated as possible everyday to keep ur levels slightly lower on a daily basis. Key to hydration, imo, is drinking as much water with extra electrolytes in it as possible. I personally just keep it simple and add Celtic sea salt and some magnesium chloride liquid to any water that I drink. Recently been adding some cream of tartar to my morning glass of water to get some extra potassium in

I agree totally with Gman86.

 

[TLR]

I wouldn’t do it…..

 

[FunkOdyssey]

I would not reduce T nor would I donate blood. I'd wait and see what happens with the next set of labs.

 

[BigTex]

WOW! Thank you guys for this solid advice. This is exactly what I was feeling and you guy made me feel much more confident in my decision. My doctor wanted me in September to dump blood with a 50.4 HCT and I did not go. I like the guy because he always let's me know i am in charge, he just makes suggestions.

He suggested I do 1mg anastrozole the day before and the day after my injection. I opted to do a 1/2mg the day after and that only lasted a maybe 4 weeks. He listens to what I say and values my opinions, plus he has no problems writing me a script for what ever I want. He had no problem with the 883 test level so that is good. I feel better with higher levels and am able to maintain muscle mass. So I am not wanting to change this at all by dropping the dose. As long as I am below the 54% mark. I am good with it. @Gman86, I'll go with your advice and use the water, electrolytes and sea salt before the next test. Also going to make sure I eat grapefruit once a day.

Again, I do appreciate all of the input you guys gave.

 

[Sly]

Strenuous exercise within 48 hours of the test can raise HCT also, not to mention PSA levels.

 

[BigTex]

@Sly I was wondering about that very thing but just never got around to searching it. I have been really pushing the intensity of my workouts in the past few months. and did legs the day before testing. I know with high intensity exercise blood parameters increased immediately after acute high-intensity but I am not sure how long before they return to baseline.

 

[Sly]

@Sly I was wondering about that very thing but just never got around to searching it. I have been really pushing the intensity of my workouts in the past few months. and did legs the day before testing. I know with high intensity exercise blood parameters increased immediately after acute high-intensity but I am not sure how long before they return to baseline.

@BigTex, through personal experience and talking with my doctor and several phlebotomists is where I arrived at the 48hour window. Although it doesn’t always hold true, I’ve experienced it myself through donations and also tested a few times using a home testing kit. Now, I error on the side of caution. My protocol before a blood test is to abstain from working out and sex for 48 hours before the test and drink a couple gallons of water throughout the day on the day of the test.

 

[BigTex]

@Sly I was wondering about that very thing but just never got around to searching it. I have been really pushing the intensity of my workouts in the past few months. and did legs the day before testing. I do understand that strenuous exercise can effect blood parameters but I am not sure how long it take for them to go back to baseline.

 

[Gman86]

WOW! Thank you guys for this solid advice. This is exactly what I was feeling and you guy made me feel much more confident in my decision. My doctor wanted me in September to dump blood with a 50.4 HCT and I did not go. I like the guy because he always let's me know i am in charge, he just makes suggestions.

He suggested I do 1mg anastrozole the day before and the day after my injection. I opted to do a 1/2mg the day after and that only lasted a maybe 4 weeks. He listens to what I say and values my opinions, plus he has no problems writing me a script for what ever I want. He had no problem with the 883 test level so that is good. I feel better with higher levels and am able to maintain muscle mass. So I am not wanting to change this at all by dropping the dose. As long as I am below the 54% mark. I am good with it. @Gman86, I'll go with your advice and use the water, electrolytes and sea salt before the next test. Also going to make sure I eat grapefruit once a day.

Again, I do appreciate all of the input you guys gave.

Ya do it man. Ever since I started hydrating this way, and making sure I always down a ton of electrolyte infused water an hour or two prior to my labs, my hct levels have stayed in a nice range, despite my total androgens going up quite a bit. It definitely makes a big difference. And obv it’s pointless to just hydrate prior to one set of labs to make them look good. Key is to try and hydrate that way throughout the day, everyday.

 

[testiculus]

I would caution anyone against trying to lower their hematocrit, just for labwork. You really want to know what your day to day hematocrit is. If you chug 2 gallons of water everyday, that's fine, but don't change things for the labwork. Being at 52 for a few hours when in reality your at 55 everyday isn't a good thing. Higher hematocrit means higher blood viscosity which means higher risk of adverse events. How high is too high is subject for debate because that's a question of how much risk is too much risk? It's a judgement call. But make your judgement call based on your everyday number, not a manipulated one.

In BigTex's case, his physician is recommending a blood donation because he feels that a hematocrit of 51.9 is too much risk, knowing his history and potential to have very high hematocrit numbers if he changes his behaviour.