Hello, been on trt for 6 yrs now started with gel, then pellets and now injections once a week. Everything has been fairly well so far until now. I’m 56 yrs old and in good physical shape work out with weights 6 days a week and have a pretty decent diet. My hematocrit level is increasing now slowly and my doctor is deceasing my dosage. I’m at .375 ml weekly. Not feeling as good anymore can you guys please give me so advise as to what I should do? Thank you...
New here and need help
- Thread starter kaipo
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Systemlord
Member
Your doctor should know well enough the answer to your problems is splitting up the dose twice weekly or EOD, this will lower hematocrit easily without sacrificing good T levels which is exactly what I believe your doctor has done. Once weekly protocol is hardly optimal and drove my hematocrit up as well, most of us members here went private to seek competent care.
Most sickcare doctors are inept to manage TRT protocols.
We need to see some labs, your doctor should be using Total T, Free T, SHBG and E2 sensitive to balance out your levels.
Please describe dosing in mgs, not ml.
Most sickcare doctors are inept to manage TRT protocols.
We need to see some labs, your doctor should be using Total T, Free T, SHBG and E2 sensitive to balance out your levels.
Please describe dosing in mgs, not ml.
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Systemlord
Member
That would depend on more than one factor, SHBG and E2 sensitive would be a deciding factor in my recommendation.
Where does your SHBG sit?
Typical starting dosages for twice weekly is 50mg twice weekly, 20-25mg EOD.
I do 20mg EOD, my SHBG is on the lower end.
Systemlord
Member
A twice weekly protocol will be optimal, 50-60mg is a good starting point. You may need less or more, but your dosage will be close to 100mg weekly.
I hope you're using 27-29 gauge insulin syringe to inject T in shoulders and quads.
Systemlord
Member
Is that pre-TRT or on 100mg weekly? Also when were these labs taken in relation to your injection?
CoastWatcher
Moderator
Was your estradiol measured with the sensitive test, LC,MS/MS? Always draw blood just prior to injection, if you're going to test in the morning of an injection a few hours delay isn't going to pose any problems.
Time to consider a new doctor. Your doctor should know that multiple, smaller injections are far more successful than one single weekly injection. He's in the dark.
Time to consider a new doctor. Your doctor should know that multiple, smaller injections are far more successful than one single weekly injection. He's in the dark.
Systemlord
Member
I have a 100mg vials and a 200mg vials, so if I draw .5 from either it would be either 50mg or 100mg. It doesn't sound like you doctor has any ideal what he's doing, he's only keeping your levels in range and not really optimizing your levels, typical of sick care doctors.
I want to feel my absolute best and had to seek a private doctor, my endo was satisfied with a trough of 440, right at the cut off point for cardiovascular disease!
Anastrozole has a two-day half life. So you're probably crashing estradiol for a few days and then letting it rebound unchecked for the remainder of the two weeks.
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1- increase injecting frequency - may help lessen increase in HCT
2- consider sub Q injections- may help lessen increase in HCT
3- get genetic testing for coagulation - so you know what you are dealing with. Meaning that if you have no issues you may be able to let HCT go a little higher
4- get tested for sleep apnea - if you have SA, you may be able to reduce the effect of test on HCT by controling SA
5 - if you take an ACE inhibitor for blood pressure, consider switching to Losartan. It may elp lower HCT
6- Donate blood without tanking ferritin levels
2- consider sub Q injections- may help lessen increase in HCT
3- get genetic testing for coagulation - so you know what you are dealing with. Meaning that if you have no issues you may be able to let HCT go a little higher
4- get tested for sleep apnea - if you have SA, you may be able to reduce the effect of test on HCT by controling SA
5 - if you take an ACE inhibitor for blood pressure, consider switching to Losartan. It may elp lower HCT
6- Donate blood without tanking ferritin levels
Thank you for you help. What would you suggest my dosage be?
Thank you for your help, will increasing frequency increase test level? What is sub Q injections? I will check on the SA. I was on lisinopril and just changed to losartan and I plan on donating blood once more before my next lab. When do you suggest I do my lab work in relations to donating blood? Thanks again!
Systemlord
Member
I think 50mg twice weekly is fine, but I'm uncertain if you even need an AI, I doubt you need 1mg as it's little much. Lean guys usually don't need AI's, obese men tend to need micro doses once or twice weekly until weight is dropped.
If in the US Defy Medical is an option, a telemedicine clinic with experienced doctors who know exactly what to do.
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