Marco, I wonder why you are not on TRT. I am sure you have good reasons since you are well researched. Clotting or thrombosis concerns?
Thrombosis is the biggest concern. For all the benefits I could derive from TRT that become more evident daily, it's studies like these that keep me awake at night preventing me from moving forward:
http://www.ncbi.nlm.nih.gov/pubmed/23925401
http://www.jewishhospitalcincinnati.com/cholesterol/Research/naseer-urology.html
http://cat.sagepub.com/content/early/2013/04/23/1076029613485154.abstract
"If the prevalence of major gene thrombophilias in the general population of Caucasians is ~20%, then a signficant percentage of the population is at risk for thrombotic events when given exogenous testosterone, usually deep venous thrombosis-pulmonary embolus-osteonecrosis. The cost of hospitalization (and who can adequately estimate cost of premature death) for these disorders is usually $50,000 +. Assuming that there are 10 hospitalizations per year for DVT-PE-osteonecrosis, total cost ~$500,000, which would pay for 1,000 screenings of men before testosterone, for Factor V Leiden, Prothrombin gene, Factors VIII and XI, and homocysteine. As physicians, above all, we are taught to do no harm. Screening before giving testosterone is not only ethical, but probably cost-effective in preventing otherwise serious morbidity and mortality."
But then, here are some good ones:
http://www.ncbi.nlm.nih.gov/pubmed/8228555
http://www.ncbi.nlm.nih.gov/pubmed/8844628
Conflicting evidence makes the procrastination to take the plunge worse.
http://www.ncbi.nlm.nih.gov/pubmed/18591887
Thus far, we have found no evidence of a clear genetic component to my clotting disorder, but that doesn't mean there isn't one. As I mentioned in another post, I think there may be some as-yet unknown chronic infection/immune system inflammation that is causing a hypercoagulable state so I am looking into this again.
From my research, it appears that T is both pro and antifibrinolytic depending on many factors, dose being one. It seems to be a mediator. I'm sure there are plenty of men on anticoagulants and TRT long term and have had no incidents of clotting.
Other than management of H/H, isn't the REAL problem with TRT and clotting elevated E2????