Systemlord
Member
The Free T will be higher at trough 2x weekly.
I am on week 5-6 anxiety comes and goes
- Thread starter Chris9150
- Start date
madman
Super Moderator
Smart move.
Much better than upping your dose.
As you can see you were hitting a descent trough TT of almost 700 ng/dL which would have your FT at a healthy level.
Keep in mind these are trough levels (7 days post-injection) and your peak (8-12 hrs post-injection/during the first few days) TT, FT, and estradiol levels will be much higher.
Always post the lab/assays used/reference ranges.
Again it is always best to test using the most accurate assays TT/estradiol (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration).
Although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.
Seeing as you are splitting your weekly dose of 100 mg T into twice-weekly injections (50 mg T every 3.5 days) you will end up hitting a high-end trough let alone blood levels will be more stable throughout the week.
Make sure to wait 4-6 weeks for blood levels to stabilize before getting blood work done.
You left out some important blood markers such as CBC which includes RBCs/hemoglobin/hematocrit.
Wishing you all the best!
Keep us posted.
My NP wanted to to switch to every 6 days inject 100mg but I asked if I could try this first. How long do I need to stay in this? Under my old once a week I was still having like one or two bad days mood wise. Usually around the 24-48 hours post injection. But not all the time. Would have random anxiety sometimes.
Also when you say much higher like how high?
madman
Super Moderator
Androgen therapy and erythrocytosis
*‘Erythrocytosis’ is formally defined as a hematocrit 25% higher than expected for an individual's height and weight [39]. The term ‘polycythemia’ is often used interchangeably but refers to any hematological cell excess rather than erythrocytes specifically. Erythrocytosis is suspected when hemoglobin is above 185 g/L or the hematocrit greater than 52% in a man, or above 165 g/L and 48% respectively, in a woman [40]. In men on testosterone therapy, the Endocrine Society defines erythrocytosis as hematocrit greater than 54%
*Erythrocytosis confers an increased blood viscosity and concerns arise from the potential increased risk of thromboembolic events including myocardial infarction and cerebrovascular accidents.
Management of Erythrocytosis in Men Receiving TRT
Management of Erythrocytosis in Men Receiving Testosterone Therapy: Clinical Consultation Guide (2022) Pranjal Agrawal, Sajya M. Singh, Taylor Kohn 1. Introduction Testosterone deficiency, previously known as male hypogonadism, affects approximately 25% of all men, with a prevalence that...
www.excelmale.com
Regarding those struggling with high hematocrit here is my reply from another thread:
As you can see your RBCs/hemoglobin/hematocrit is elevated which is a common side-effect when using exogenous T, especially when running higher FT levels let alone peak--->trough levels can have a significant impact.
When using exogenous T RBCs, hemoglobin and hematocrit will increase within the 1st month and can take anywhere from 9-12 months to reach peak levels.
T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).
Other factors such as sleep apnea, smoking, asthma, COPD can have a negative impact on hematocrit.
Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.
3–18% with transdermal administration and up to 44% with injection.
In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.
Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.
As again running very high TT/FT levels will have a stronger impact on driving up HCT.
Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.
Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.
How high an FT level you are running is critical.
It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.
Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.
If you are struggling with such blood markers then in most cases finding the lowest FT level you can run while still maintaining the beneficial effects may very well be the solution.
Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.
Mind you some are lucky and never have an issue or levels tend to stabilize over time.
Others will continue to struggle until the cows come home.
Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!
madman
Super Moderator
You just started your new protocol and although you are keeping your weekly T dose the same since you are splitting up your dose and injecting more frequently you will need to wait for blood levels to stabilize (4-6 weeks) before getting blood work done.
As we want to see where such a dose of 50 mg T injected twice weekly (every 3.5 days) has your trough TT, FT, and estradiol level let alone RBCs/hemoglobin/hematocrit.
Even then if you are hitting a good FT level then I would still give it a few months to gauge how you truly feel overall regarding relief/improvement of low-t symptoms.
Again keep in mind that the first 4-6 weeks mean nothing when looking at the bigger picture as hormones will be in flux during the weeks leading up until blood levels have stabilized.
It is common to experience ups/downs during the transition as the body is trying to adjust.
Once blood levels have stabilized it will take time for the body to adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall.
Every protocol needs to be given 12 weeks before claiming whether it was a success or failure.
6 weeks is nowhere near enough time to gauge how you truly feel on such protocol (dose of T/injection frequency).
This is where many fail!
Patience is key.
Trust me on this one.
It said my numbers were in range. Are you talking about my numbers or the other thread. And thanks.
T
tareload
Guest
Excellent. The terms erythrocytosis and polycythemia should not be used interchangeably. Lazy and confusing people. Just wrong.Androgen therapy and erythrocytosis
*‘Erythrocytosis’ is formally defined as a hematocrit 25% higher than expected for an individual's height and weight [39]. The term ‘polycythemia’ is often used interchangeably but refers to any hematological cell excess rather than erythrocytes specifically. Erythrocytosis is suspected when hemoglobin is above 185 g/L or the hematocrit greater than 52% in a man, or above 165 g/L and 48% respectively, in a woman [40]. In men on testosterone therapy, the Endocrine Society defines erythrocytosis as hematocrit greater than 54%
*Erythrocytosis confers an increased blood viscosity and concerns arise from the potential increased risk of thromboembolic events including myocardial infarction and cerebrovascular accidents.
Management of Erythrocytosis in Men Receiving TRT
Management of Erythrocytosis in Men Receiving Testosterone Therapy: Clinical Consultation Guide (2022) Pranjal Agrawal, Sajya M. Singh, Taylor Kohn 1. Introduction Testosterone deficiency, previously known as male hypogonadism, affects approximately 25% of all men, with a prevalence that...
My reply from a previous thread:
As you can see your RBCs/hemoglobin/hematocrit is elevated which is a common side-effect when using exogenous T, especially when running higher FT levels let alone peak--->trough levels can have a significant impact.
Keep in mind smoking/sleep apnea can also drive up hematocrit.
Regarding those struggling with high hematocrit here is my reply from another thread:
When using exogenous T RBCs/hemoglobin/hematocrit will increase within the 1st month and can take up to 9-12 months to reach peak levels.
T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).
Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.
Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.
3–18% with transdermal administration and up to 44% with injection.
In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.
Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.
As again running very high TT/FT levels will have a stronger impact on driving up HCT.
Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.
Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.
How high an FT level you are running is critical.
It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.
Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.
If you are struggling with such blood markers then in most cases finding the lowest FT level you can run while still maintaining the beneficial effects may very well be the solution.
Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.
Mind you some are lucky and never have an issue or levels tend to stabilize over time.
Others will continue to struggle until the cows come home.
Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!
Last edited by a moderator:
WhatSayYou89
Active Member
The one thing I can guarantee will happen every time I swap my dose is anxiety. Up or down.
I just recently finished 8 weeks after lowering my dose and and from week 2 down to I think week 7 the anxiety doesn’t let up.
Just lowered my dose again and on week 2 now and it’s like reliving a nightmare all over again.
One truly has to be dedicated to trial and error & willing to go through hell many times over if the rent aren’t one of those lucky ones who land on the perfect protocol first try.
I tell you this because sometimes it helps to know others are going through the same thing as you are.
I just recently finished 8 weeks after lowering my dose and and from week 2 down to I think week 7 the anxiety doesn’t let up.
Just lowered my dose again and on week 2 now and it’s like reliving a nightmare all over again.
One truly has to be dedicated to trial and error & willing to go through hell many times over if the rent aren’t one of those lucky ones who land on the perfect protocol first try.
I tell you this because sometimes it helps to know others are going through the same thing as you are.
Same here.
I'm scared of changing my dose now... It fucks with my relationship, work, sleep, etc.
WhatSayYou89
Active Member
It’s kind of like being in a dead end job. You might be in a crappy spot but it’s a crappy spot that you’re use to and change can be scary. Especially when you know the change messes you up for 8 weeks.
Then staying put to long then you’re pissed at yourself for being stuck in that dead end job for so long knowing you should of made the change.
Something I’ve done is start keeping some Xanax just for during this time bc sometimes the anxiety can be overwhelming if it coincides with other stressful situations. Might only use 1 or 2 during that 8 week transition but knowing I have them helps.
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