Testosterone too high after 8 weeks on 200 mg Cypionate / Week!

[RSM]

I am still losing weight and now down to 270 lbs. Only working out 3 times a week but active everyday walking etc.

 

[CSI007]

Congrats on the weight loss!

 

[lcvl]

200mg T a week is def too much for your body. I'd scale down to 150mg. Watch out for those hematocrits and Estradiol values.

 

[Vince]

I use 200mg of T per week, split into two doses.
Why is 200 mg/wk the "upper limit" for TRT?
https://www.excelmale.com/forum/showthread.php?3175-Why-is-200-mg-wk-the-upper-limit-for-TRT

 

[Vince Carter]

200mg T a week is def too much for your body. I'd scale down to 150mg. Watch out for those hematocrits and Estradiol values.

I wouldn't agree here, he's only @ 992 total

 

[Vince Carter]

Looks like a little AI may be needed, perhaps a .25mg twice or three times per week.

That and you need to donate 1 pint of blood, soon.

 

[CoastWatcher]

I'd be curious to know what your SHBG level is, given your higher free testosterone. As Vince Carter noted, you need to address the hematocrit. Finally, there's no need to measure LH while you're on exogenous testosterone - it's going to be suppressed. You'll be receiving excellent care at Defy. Keep us posted.

 

[johndoesmith]

Quick update: I had my levels tested again just before my next injection and will be consulting with Defy.

Below are the results...

So you tested at day of injection, but before injection, correct?

What's your protocol, 200mg E7D or 100mg E3.5D?

How do you feel? I imagine not so great with that E2 level.

Donating blood is a priority for you right now! HCT of 53 is fairly high.

 

[Henry]

I wouldn't agree here, he's only @ 992 total

Yeah, but at 992 total, his E2, RBC's and Hematocrit are all high. Even his hemoglobin is at the upper limit. Now I know everyone is going to say, "get on an AI and start donating blood" but maybe he can drop his TT to the 800's and see if that'll help instead of him having to titrate AI's and deal with the hit on his lipids or donate blood and deal with the iron issues that come with that.

 

[CoastWatcher]

Yeah, but at 992 total, his E2, RBC's and Hematocrit are all high. Even his hemoglobin is at the upper limit. Now I know everyone is going to say, "get on an AI and start donating blood" but maybe he can drop his TT to the 800's and see if that'll help instead of him having to titrate AI's and deal with the hit on his lipids or donate blood and deal with the iron issues that come with that.

I'm all in favour of adjusting protocols in order to avoid an AI, it worked for me with no drop in testosterone levels once stability was achieved. I would, however, donate blood now. There's no good reason to delay addressing the current elevated hematocrit, and excellent reasons for it to be dealt with.

 

[Henry]

I'm all in favour of adjusting protocols in order to avoid an AI, it worked for me with no drop in testosterone levels once stability was achieved. I would, however, donate blood now. There's no good reason to delay addressing the current elevated hematocrit, and excellent reasons for it to be dealt with.

I agree 100%

 

[RSM]

Thank you for all the responses!

I use 200mg of T per week, split into two doses.
Why is 200 mg/wk the "upper limit" for TRT?
https://www.excelmale.com/forum/showthread.php?3175-Why-is-200-mg-wk-the-upper-limit-for-TRT

I do plan on switching to two doses per week instead of once. It will be interesting to see what Defy recommends as far as dosage goes.

Looks like a little AI may be needed, perhaps a .25mg twice or three times per week.

That and you need to donate 1 pint of blood, soon.

I'll look into donating blood. I would not mind skipping AI if my dosage / frequency will be a solution.

I'd be curious to know what your SHBG level is, given your higher free testosterone. As Vince Carter noted, you need to address the hematocrit. Finally, there's no need to measure LH while you're on exogenous testosterone - it's going to be suppressed. You'll be receiving excellent care at Defy. Keep us posted.

Thanks. I will.

So you tested at day of injection, but before injection, correct?

What's your protocol, 200mg E7D or 100mg E3.5D?

How do you feel? I imagine not so great with that E2 level.

Donating blood is a priority for you right now! HCT of 53 is fairly high.

Correct. I had my next injection about 2 hours after the test.

My protocol at the moment is 200mg every 7 days via 25G into my outer quads. I alternate quads every week.

I don't feel too bad with the high E2. Sleep is a little broken but I do get enough. Still getting morning wood and a healthy libido. However sensitivity is down as is expected - but a plus as far as my wife is concerned because it lasts longer - lol!

Yeah, but at 992 total, his E2, RBC's and Hematocrit are all high. Even his hemoglobin is at the upper limit. Now I know everyone is going to say, "get on an AI and start donating blood" but maybe he can drop his TT to the 800's and see if that'll help instead of him having to titrate AI's and deal with the hit on his lipids or donate blood and deal with the iron issues that come with that.

Interesting. Changing to two 100mg injections every 3.5 days vs one 200mg every 7 days would help reduce E2. Would it also lower RBC and Hematocrit levels?

I'm all in favour of adjusting protocols in order to avoid an AI, it worked for me with no drop in testosterone levels once stability was achieved. I would, however, donate blood now. There's no good reason to delay addressing the current elevated hematocrit, and excellent reasons for it to be dealt with.

Sounds good and makes sense. I think the key is I need to change my frequency / dosage and will discuss blood donation with Defy. Thanks for the input!

 

[johndoesmith]

Interesting. Changing to two 100mg injections every 3.5 days vs one 200mg every 7 days would help reduce E2. Would it also lower RBC and Hematocrit levels?

E3.5D injections can very well help reduce E2, and also allow you to maintain a higher trough level.

It will not reduce RBC and HCT. The only way is bloodletting. Or leeches. Might have to go medieval.

 

[Vince]

If you have no symptoms from high levels of E2, it would be nice to avoid AI. So many have trouble with low estradiol, more frequent injections will help lower E2. I agree you need to donate blood.

 

[RSM]

I had my consultation with a P.A. from Defy. Their feedback made a lot of sense to me.

Here's the summary:

• Red Blood Cell Count (RBC) too high for them to prescribe Testosterone.
• They think my RBC is high because of sleep apnea (oxygen deprivation = increased RBC). They suggested getting a sleep study done and either get a CPAP or go for optional surgery to address the sleep apnea. They also think the reason for my low testosterone was the lack of Stage 4 sleep caused by the sleep apnea. This stage of sleep is critical for natural testosterone production.
• Requested that I donate 1 pint blood to immediately bring down RBC by 3 points. They do not recommend getting into the habit of donating blood to reduce RBC because of potential of becoming iron deficient.
• Suggested that I skip the next testosterone injection and then switch to a lower dosage injection every 3.5 days.
• Prescribed me with HCG and an estrogen blocker - to be taken every 3.5 days as well with the option of taking it on the same day as the testosterone injections.
• They thought my cholesterol levels were excellent for my age so no issues there.
• They suggested that I increase my cardio to increase HDL cholesterol levels.
• Recommended that I reduce DHEA to 25 mg for now and perhaps revert back to 50 mg later. ( I am currently taking 50 mg in the mornings.)
• Requested that I get another blood test to check my RBC levels after the blood donation and reduction in testosterone dosage.

I donated blood about a week ago and have not had an injection since 12/17/2016. I still have a little libido left (lol!) but did notice my energy was less intense at the gym and a little anxiety creeping in (work deadlines).

I have one 200 mg / 1cc testosterone vial left and will divide this into 4 dosages (50mg per shot).

I will start injecting 50 mg (0.25 cc) on Sunday (1/1/2017) with the next 50mg injection 3.5 days later for a total of 100 mg per week. I have not yet received the HCG or estrogen blocker and will start incorporating this when I have it.

I have a consultation scheduled with a sleep center in a few days so they can determine the extent of my sleep apnea.

I will probably go for the blood test to check my current RBC levels in about 2 weeks. Or should I go sooner?

 

[Vince Carter]

This is the first time I've heard talk of RBC exclusively...normally it's Hematocrit/HCT that is the subject of discussion and treatment. Also, seems odd, to me, that the PA would steer you away from regular blood donation which is a very VERY common way to deal with this, and iron is easy to deal with, too. I was kind of thinking that as medical staff grew that some medical opinions would vary between staff. I try and stay with Nurse Jill or Dr Saya, Only, for those reasons.

I also am personally vary wary of sleep studies and CPAPs. I've seen a number of people do this and I just don't see them thriving on that method of treatment. Seems like a lot to endure to me personally. I'd never do it.

 

[johndoesmith]

I had my consultation with a P.A. from Defy. Their feedback made a lot of sense to me.

Here's the summary:

• Red Blood Cell Count (RBC) too high for them to prescribe Testosterone.
• They think my RBC is high because of sleep apnea (oxygen deprivation = increased RBC). They suggested getting a sleep study done and either get a CPAP or go for optional surgery to address the sleep apnea. They also think the reason for my low testosterone was the lack of Stage 4 sleep caused by the sleep apnea. This stage of sleep is critical for natural testosterone production.
• Requested that I donate 1 pint blood to immediately bring down RBC by 3 points. They do not recommend getting into the habit of donating blood to reduce RBC because of potential of becoming iron deficient.
• Suggested that I skip the next testosterone injection and then switch to a lower dosage injection every 3.5 days.
• Prescribed me with HCG and an estrogen blocker - to be taken every 3.5 days as well with the option of taking it on the same day as the testosterone injections.
• They thought my cholesterol levels were excellent for my age so no issues there.
• They suggested that I increase my cardio to increase HDL cholesterol levels.
• Recommended that I reduce DHEA to 25 mg for now and perhaps revert back to 50 mg later. ( I am currently taking 50 mg in the mornings.)
• Requested that I get another blood test to check my RBC levels after the blood donation and reduction in testosterone dosage.

I donated blood about a week ago and have not had an injection since 12/17/2016. I still have a little libido left (lol!) but did notice my energy was less intense at the gym and a little anxiety creeping in (work deadlines).

I have one 200 mg / 1cc testosterone vial left and will divide this into 4 dosages (50mg per shot).

I will start injecting 50 mg (0.25 cc) on Sunday (1/1/2017) with the next 50mg injection 3.5 days later for a total of 100 mg per week. I have not yet received the HCG or estrogen blocker and will start incorporating this when I have it.

I have a consultation scheduled with a sleep center in a few days so they can determine the extent of my sleep apnea.

I will probably go for the blood test to check my current RBC levels in about 2 weeks. Or should I go sooner?

Wait, you weren't prescribed testosterone, right? So how are you going to continue taking it? Won't you run out?

Or was defy saying that they can't prescribe testosterone right now, but will once you donate blood and reduce HCT + RBC?

This is the first time I've heard talk of RBC exclusively...normally it's Hematocrit/HCT that is the subject of discussion and treatment. Also, seems odd, to me, that the PA would steer you away from regular blood donation which is a very VERY common way to deal with this, and iron is easy to deal with, too. I was kind of thinking that as medical staff grew that some medical opinions would vary between staff. I try and stay with Nurse Jill or Dr Saya, Only, for those reasons.

I fear you're right, vince, this doesn't sound like a typical Defy response. It somewhat concerns me for the future, but you're right, Nurse Jill is awesome.

OP's whole post struck me as kind of odd. I'm hoping he just misunderstood a few things, which is possible, there's a LOT to go over in that consult.

 

[RSM]

This is the first time I've heard talk of RBC exclusively...normally it's Hematocrit/HCT that is the subject of discussion and treatment. Also, seems odd, to me, that the PA would steer you away from regular blood donation which is a very VERY common way to deal with this, and iron is easy to deal with, too. I was kind of thinking that as medical staff grew that some medical opinions would vary between staff. I try and stay with Nurse Jill or Dr Saya, Only, for those reasons.

I also am personally vary wary of sleep studies and CPAPs. I've seen a number of people do this and I just don't see them thriving on that method of treatment. Seems like a lot to endure to me personally. I'd never do it.

The P.A. recommended an auto adjusting Phillips CPAP which is less bulky and cumbersome. She said that insurance companies will try to get you the cheapest and clunkiest machine and that it would be best to get a better model but it would cost more.

I'll look into it more after my sleep consultation.

 

[RSM]

Wait, you weren't prescribed testosterone, right? So how are you going to continue taking it? Won't you run out?

I can still get this prescribed from my Dr. I figured it made sense to take a break for a week or so and then start the reduced dosage. I have another appointment scheduled with my Dr. early next year and will then determine how to proceed with Testosterone prescriptions.

Or was defy saying that they can't prescribe testosterone right now, but will once you donate blood and reduce HCT + RBC?

Correct. They can prescribe it once my RBC is at an acceptable level. The blood donation and reduced dosage may not even get my levels down low enough - the new blood test will indicate this. As I mentioned above I can get the Testosterone prescribed by my Dr. but I want to be healthy at the same time so hopefully I can get my RBC below 50% if possible.

I fear you're right, vince, this doesn't sound like a typical Defy response. It somewhat concerns me for the future, but you're right, Nurse Jill is awesome.

OP's whole post struck me as kind of odd. I'm hoping he just misunderstood a few things, which is possible, there's a LOT to go over in that consult.

There is no misunderstanding. It is pretty clear to me the correlation between a high RBC and potential blood clots. The P.A. mentioned to me that a 34 year old patient of theirs developed a blood clot on a flight and his RBC count was similar to mine and he was feeling fine prior to this.

 

[RSM]

This is the first time I've heard talk of RBC exclusively...normally it's Hematocrit/HCT that is the subject of discussion and treatment. Also, seems odd, to me, that the PA would steer you away from regular blood donation which is a very VERY common way to deal with this, and iron is easy to deal with, too. I was kind of thinking that as medical staff grew that some medical opinions would vary between staff. I try and stay with Nurse Jill or Dr Saya, Only, for those reasons.

I also am personally vary wary of sleep studies and CPAPs. I've seen a number of people do this and I just don't see them thriving on that method of treatment. Seems like a lot to endure to me personally. I'd never do it.

The P.A. reasoned it is better to deal with the source of the high RBC than resort to regular blood donations. If this source is addressed then regular donations would not be needed.

If a CPAP or surgery is an option and not cumbersome I would be interested in that. Less broken sleep, lower RBC, better recovery. I was at the donation center for over 3 hours waiting because there were a lot of donors ahead of me. I would not want to do that on a regular basis. However if the CPAP is very inconvenient then I'd be willing to put up with 2-3 donations per year.