Test levels DROPPED after RAISING dose

[SH3P]

Been on TRT for almost a year and a half. Have tried different dosages and schedules, and found that everyday injections subcutaneously keeps my CBC in-check. However, I wasn't where I wanted to be at 70mg/week, and went back up to 100mg/week.

70mg week: 569 ng/dL total, 110 pg/mL free.

100mg week: 559 ng/dL total, 100 pg/mL free.

(Reference range: Total: 250-1100 ng/dL, Free: 35.0-155.0 pg/mL)

These tests were 16 weeks apart, same schedule. What the hell is up with that? I'm not UGL, so I'd assume the quality of the vial should be about the same as the last. How could I raise my dose 30mg/week and have my numbers DROP?

 

[FunkOdyssey]

How could I raise my dose 30mg/week and have my numbers DROP?

everyday injections subcutaneously

May I suggest injecting into the muscle instead? You may be like many of us, where your subcutaneous tissue is like a black hole that mysteriously makes testosterone disappear.

 

[SH3P]

May I suggest injecting into the muscle instead? You may be like many of us, where your subcutaneous tissue is like a black hole that mysteriously makes testosterone disappear.

Was doing 100mg/week IM split into 2 doses, and my numbers were okay around 750 and 154, but my RBC count, HGB, and HCT were getting up there. Switched to subcutaneous after that, and thinking my levels could be a little lower injecting that way, raised it to 120mg/week. Hit 1000, and 180, but my CBC look really bad (18.8, 57%). Dropped my dose to 70mg and have been trying to titrate back up with everyday injections for about 9 months, but my levels are just not consistent, so I'm at a loss. CBC is acceptable at 100mg/week subq, but my levels are just not where I want them. Kind of at a loss on what to do at this point.

 

[FunkOdyssey]

Was doing 100mg/week IM split into 2 doses, and my numbers were okay around 750 and 154, but my RBC count, HGB, and HCT were getting up there. Switched to subcutaneous after that, and thinking my levels could be a little lower injecting that way, raised it to 120mg/week. Hit 1000, and 180, but my CBC look really bad (18.8, 57%). Dropped my dose to 70mg and have been trying to titrate back up with everyday injections for about 9 months, but my levels are just not consistent, so I'm at a loss. CBC is acceptable at 100mg/week subq, but my levels are just not where I want them. Kind of at a loss on what to do at this point.

I personally find EOD IM with long esters to be a great compromise of stability and side effect management without having to poke yourself every day. I would be surprised if there were any substantial hematocrit difference between daily SC and EOD IM with cypionate at equivalent doses.

Your hematocrit is much higher than it should be given your dosage and levels. I would be looking at other factors besides testosterone here. Hopefully you do not smoke? Any screening for sleep apnea? Do you have an Oura ring or similar way to measure SpO2 while sleeping?

 

[SH3P]

I personally find EOD IM with long esters to be a great compromise of stability and side effect management without having to poke yourself every day. I would be surprised if there were any substantial hematocrit difference between daily SC and EOD IM with cypionate at equivalent doses.

Your hematocrit is much higher than it should be given your dosage and levels. I would be looking at other factors besides testosterone here. Hopefully you do not smoke? Any screening for sleep apnea? Do you have an Oura ring or similar way to measure SpO2 while sleeping?

Did a sleep study, and found out that I have moderate sleep apnea, which I'm treating. CBC has improved, so I believe having untreated OSA was causing an elevation for sure.

Just trying to figure out what to try next. Been a delicate balance between dosages/T levels, and CBC-related stuff. Getting exhausting. I tried everyday IM as well at 70mg/week, and my test levels were about the same as 70mg/week subq, but my HCT/HGB went back up, so I went back to subq.

I guess I could try going back to IM 100mg/week split into 2 doses. I'd start tomorrow, but going to Denver for a week soon, and don't want the elevation to exacerbate any HCT issues that might come with switching back to 2x/week IM.

 

[FunkOdyssey]

Did a sleep study, and found out that I have moderate sleep apnea, which I'm treating. CBC has improved, so I believe having untreated OSA was causing an elevation for sure.

Just trying to figure out what to try next. Been a delicate balance between dosages/T levels, and CBC-related stuff. Getting exhausting. I tried everyday IM as well at 70mg/week, and my test levels were about the same as 70mg/week subq, but my HCT/HGB went back up, so I went back to subq.

I guess I could try going back to IM 100mg/week split into 2 doses. I'd start tomorrow, but going to Denver for a week soon, and don't want the elevation to exacerbate any HCT issues that might come with switching back to 2x/week IM.

I would think E3.5D with IM is going to have peaks large enough to make a significant negative difference. I would not make that move while struggling with hematocrit.

How are you tracking the effectiveness of your OSA treatment? I bet there is room for improvement. This is likely the real driver of your hematocrit here that has prevented you from running effective doses of testosterone.

 

[SH3P]

I would think E3.5D with IM is going to have peaks large enough to make a significant negative difference. I would not make that move while struggling with hematocrit.

How are you tracking the effectiveness of your OSA treatment? I bet there is room for improvement. This is likely the real driver of your hematocrit here that has prevented you from running effective doses of testosterone.

I just compare the number of events or AHI to what my test showed prior to getting a CPAP. I even import the data from the CPAP into an opensource software to look at the chart. My HGB and HCT have improved over time with treatment.

Last CBC showed 17.7 and 52.2%. I'm okay with anything under 18 and 54%. What's wild is that the CBC before this one, when my test levels were slightly higher, showed 17.0 and 50.0%. The difference there is that I stopped being as compliant with my CPAP in between, so the elevation in HGB/HCT seems to be somewhat independent from testosterone levels.

 

[FunkOdyssey]

Last CBC showed 17.7 and 52.2%. I'm okay with anything under 18 and 54%. What's wild is that the CBC before this one, when my test levels were slightly higher, showed 17.0 and 50.0%. The difference there is that I stopped being as compliant with my CPAP in between, so the elevation in HGB/HCT seems to be somewhat independent from testosterone levels.

This is confirmation of what I'm saying here, that OSA is really the larger factor, more so than the testosterone. So, if you want to run more testosterone, attack the OSA harder. And if you want more consistent levels, it is my opinion you'll get that with IM.

 

[SH3P]

This is confirmation of what I'm saying here, that OSA is really the larger factor, more so than the testosterone. So, if you want to run more testosterone, attack the OSA harder. And if you want more consistent levels, it is my opinion you'll get that with IM.

I suppose what I'll do is hit compliance with my CPAP hard and try going IM when I get back from Denver.

The question is how much will a week at elevation impact my RBC count. The bastards hang around so long once they're produced.

 

[SH3P]

Now that I'm looking into it, Rite-Away Pharmacy is who TRT Nation has started using, and there's a possibility they may be under-dosing their test.

 

[Systemlord]

You’re going to drive yourself crazy trying to target a specific lab value on injections. Get another hobby or switch to oral testosterone, which has extremely consistent absorption in the intestines.

 

[SH3P]

You’re going to drive yourself crazy trying to target a specific lab value on injections. Get another hobby or switch to oral testosterone, which has extremely consistent absorption in the intestines.

Been on 1.5 years and have found I feel best between 800-900, with anything over that having diminishing returns. I'm not sure if the "hobby" part was intended as snark, but I don't think it's unreasonable to make sure medication is effective at keeping me where I feel best, which is not mid 500s. Plus, there is a cost aspect there as well, if these vials are under-dosed. From what I've been seeing, QC at compounding pharmacies can be hit-or-miss.

The only numbers I'm "chasing" are RBC count, HGB, and HCT, which is a critical responsibility. That's especially true if you struggle with it, which I do.

 

[Systemlord]

I mentioned the oral testosterone due to your comment about your red blood cell count. Oral testosterone doesn’t affect red blood cells to the same degree as injections. As far as maintaining between 800-900 total testosterone on injections, I wish you luck because total testosterone can change due to isolated changes in SHBG where free testosterone remains unchanged.