Total Testosterone vs Free Testosterone and how they relate to Hematocrit

Worthy

New Member
I've been on testosterone cypionate for about a year. For the first half of the year, I was on 150 mg/wk divided into two doses a week. I did these Intramuscular. For the last 6 months, I've stayed at the same dosage, but switched to SubQ injections. With the SubQ injections, I'm on a protocol of 3 times a week (monday, wednesday, and friday). I recently got my blood work back and am concerned with my hematocrit numbers. Below are the important numbers between my 6 months ago blood draw and the most recent.

6 Months Ago
RBC: 5.1
Hemoglobin: 15.4
Hematocrit: 47.2
Total Testosterone: 644 (because of the twice a week schedule, had somewhat of an actual trough level when blood was taken)
Free Testosterone: 22.5
Estradiol, sensitive: 21.1

Most Recent
RBC: 5.0
Hemoglobin: 14.9
Hematocrit: 43.5
Total Testosterone: 811 (Higher partially due to no longer having a trough with injections every other day)
Free Testosterone: 16.6
Estradiol, sensitive: 38.3

So my question is whether I should be concerned about a drop in the hematocrit? Could this indicate some type of internal bleeding? I've never donated blood since I've been on TRT. As you can see, my free testosterone is actually lower. Could this be the reason for the decrease or does total testosterone effect that more? Furthermore, I made sure I was very hydrated before this blood draw, something I didn't take into account at the 6 month ago blood draw. As you can see, my RBC and Hemoglobin didn't fluctuate nearly as much. What would cause the hematocrit to drop more than these? How much can hematocrit levels fluctuate from day to day? Thanks
 

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Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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