Please review my latest bloodwork

[Mojo88]

Please take a peek at my latest bloodwork and offer some advice/opinions. I am 70 years old. I self-inject 120mg every 10 days. This latest blood draw was on day 4 after injection. Been doing TRT for about 9 years now, as my testicles can testify by their teeny size.

Went to my doc today (urologist) and he suggested reducing my dosage, as my Hematocrit and Hemoglobin are getting out of range. Honestly, I've been thinking of reducing the dosage anyway, my hands seem colder than usual and I'm getting small headaches, almost suspecting that thicker blood may have something to do with it. But with my T level at 814, it seems like a no-brainer to maybe just cut the dose in half. However, I am no expert on this stuff. I am seeing the doc again next week for cystoscopy (and possible TURP, ugh) and we will discuss T dosage further. I would like to be more educated on subject prior to next appt.

Thanks for any help. Dave F.

 

[Cataceous]

You're averaging 12 mg per day—cypionate?—, which is ok. The injection pattern is the problem. The simplest thing to try is increasing the dose frequency, ideally to at least twice a week. This would be 42 mg every 3.5 days. The problem with injecting every 10 days is that it is two full half-lives, assuming cypionate and typical absorption. This means that peak serum testosterone after injections can be four times higher than pre-injection troughs. Rough estimates from your lab work put the peak at 1,400 ng/dL and the trough at 350. There is some evidence that this kind of variation in levels contributes to hemoglobin and hematocrit problems. With twice-weekly injections the variation in serum levels would be more subdued, possibly with peaks in the 800s and troughs in the 500s. This is much closer to normal physiology.

 

[Mojo88]

Thank you. Yes, I'm using Cypionate, and averaging 12mg per day. Can you perhaps point me to a reference source, perhaps a chart or Excel spreadsheet showing how dosage intervals affect blood levels? I don't understand how I could ever approach the 1,400 ng/dL you estimate.

Thanks, very much

 

[Cataceous]

Play around with this site: SteroidPlotter - Graph your cycle
If you enter your current protocol you'll see that the post-injection release rate is about four times greater than the pre-injection trough:

Now enter the protocol with twice-weekly dosing. You see that peaks and troughs are much closer together:

To roughly estimate your particular serum levels I took your measurement of 814 ng/dL at four days post-injection and knocked off 13% to estimate the value at five days or one half-life post-injection. This is about 700 ng/dL. Now we just need to double this figure to get the peak five days earlier and halve it to get the trough five days later. Bear in mind that these are crude estimates, but they still give a decent idea of what's happening.

 

[Mojo88]

As the old adage goes, a picture is worth a thousand words! Thanks, that's awesome.

 

[Cataceous]

One other thing: if you do go to a higher injection frequency then it's possible you won't feel as good for some weeks. Your body may have come to expect those higher testosterone peaks. But after the adjustment period you should end up feeling as good or better, and hopefully have improved HGB & HCT numbers.

 

[Mojo88]

Well, I'm definitely going to lower the dose a little. I know the doc is gonna want that, plus I want it too. I'd actually like to get off TRT, but not sure if that's feasible or desirable. I'm still working out and lifting some weights, so the T really helps with that.

 

[Systemlord]

Those range for hematocrit aren't correct, the reference ranges seem to differ great as my labs show 50% being at the top end, yet the internationally-recognized top end to the ranges is 54%.

Lab ranges and reference ranges are two different things, so an HCT of 51% is fine and is nothing to be concerned about.

There are many things that can cause cold hands, thyroid problems and iron deficiency being two.