Testosterone levels and haemoctrit

Hi guys

I posted before about my doc starting me on too high a dose, which was .8ml week 160mg....
My haemocrat went high to 0.56 and I was suffering extremely bad pressure headaches and facial pain.

I reduced my T, and for the past 6 weeks I have been taking only .2ml (40mg) x twice week, total 80 mg weekly.

So that's 40mg every 3.5 days

I did 2 blood tests this week,

2 days after I injected, my peak? T was 695 ng/dl
My haemocrat was .54

And on the morning before my next injection, trough? T was 608 ng/dl
My haemocrat was .50

my problem is...... I am still getting pressure headaches?

Is this unusual, considering that I'm only dosing 40mg x twice week and haemoctrit is coming in at .54 peak .50 trough....

Is it also unusual that haemocrat is so high on a weekly dose of 80mg?

Should I donate to get haemoctric down more so the pressure headaches subside

Also, was hoping to increase T from 80mg weekly to 100mg week, as numbers aren't really good are they, particularly that I do feel ok in myself (besides the headaches) but my erections are poor.

Prior to starting Test Cyponiate, i was on Nebido for few years, and my erections when Test is peak erections were 100%

But, if I was to increase test from 80mg week to 100mg, I'm only gonna suffer more intense pressure headaches aren't I as my haemoctric will be higher......

Should it be between .54 and .50 weekly on 80mg?

Or does it seem somethings not quite right here.

I drink about 3 litres or more water a day.

Thanks for any help guys, these pressure headaches really get me down, I wouldn't mind pain anywhere in the body I'd handle it but when it's your face... man......

Personally I would donate blood and draw labs again about 3 days after blood donation, on one of your most trough test days. Donating red blood does wonders for mine within a day or 2. I do it 3 times a year.

MikeDaly1970 said:

And on the morning before my next injection, trough? T was 608 ng/dl
My haemocrat was .50

Click to expand...

MikeDaly1970 said:

Should I donate to get haemoctric down more so the pressure headaches subside

Click to expand...

This is not a long term solution. Nip this in the bud, lower your dosage. Your body is telling you that your hormone levels are too high. Don't get trapped into thinking more T is better.

Lower your dosage 20 mg, so 30 mg twice weekly. If these symptoms persist, or you don't feel good, you might consider the oral testosterone route as these delivery method has the least impact on hematocrit.

Injections effects hematocrit more than any other TRT option.

MikeDaly1970 said:

But, if I was to increase test from 80mg week to 100mg, I'm only gonna suffer more intense pressure headaches aren't I as my haemoctric will be higher......

Click to expand...

Hematocrit isn't the only blood marker to increase on TRT.

So many variables for each human, right? But for many males I would argue 80mg per week offers very little benefit and may even be detrimental in that it's only acting as a natty suppressor, and nothing more. Donating blood a few times a year has many other health benefits for most humans, besides being proven to lower hematocrit especially for steroid users. This is an old tried and trued method.

Before lowering your dose or going to an oral as suggested by Systemlord I would check every single other thing you can think of. For one and first thing I'd say is how is your sleep? Do you snore? If you have unchecked heavy snoring or legit sleep apnea (which TRT and/or steroids can bring on for many) that could be the cause of both issues. Fix your sleep fix many many sides and drastically improve your overall health and the ripple effect it has in other areas too. I strap the CPAP nightly even after I lost weight and got into great shape (through the help of TRT) I still have to use it. Grab a free snoring app on your mobile phone, plug your phone in at night and runt he app and check your data for a few nights. If the app says you snore badly, get it looked into. Could be a life changer and a life saver. Again, this is one variable probably want to explore, but there are so many others depending on the human being.

Here's another way to look at it, lets say you're taking daily Cialis for ED, you get symptoms and the correct thing to do is lower the dosage.

The approach to TRT is no different, only men treat it differently. We have a member that spent 12 years to figure out his low libido and ED was resolved on 50 mg once weekly. Years early he was on 60 mg weekly. so close to his optimal dose.

It would be a hard sell to say this member isn't benefiting from treatment. Response to hormones is more than just about the absolute hormonal value, men have different types of androgen receptors, receptor density, sensitivity levels at the receptor as well as the ability for tissues to respond.

I agree. That said, my personal beliefs (my own wisdom) leads me to believe men who are truly hypogonadal don't benefit that much from 60mg or 80mg of test per week. I would say more don't benefit from that small amount (over time) than those that would or do. In other words the person you note that took 12 years to figure out 50mg was his sweet spot vs 60 mg is more of the exception than the norm. Not a hard sell at all really. My "own wisdom" also leads me to believe anyone on TRT with hematocrit levels that are high coupled with possible hematocrit or bp related headaches would almost certainly benefit in multiple different aspects of overall health, to indeed donate blood. To say "lower your dose or go to orals" when they asked if they should at least see what blood donation might offer, just doesn't sit well with me. For the record I'm new around here but have read man of your posts Systemlord, and agree with a lot of what you say and can tell you know what your talking about for the most part. Not trying to start a fight, just stating where I'm coming from, and that I think your note about blood donation not being something to try is off base. Cheers!

MikeDaly1970 said:

Hi guys

I posted before about my doc starting me on too high a dose, which was .8ml week 160mg....
My haemocrat went high to 0.56 and I was suffering extremely bad pressure headaches and facial pain.

I reduced my T, and for the past 6 weeks I have been taking only .2ml (40mg) x twice week, total 80 mg weekly.

So that's 40mg every 3.5 days

I did 2 blood tests this week,

2 days after I injected, my peak? T was 695 ng/dl
My haemocrat was .54

And on the morning before my next injection, trough? T was 608 ng/dl
My haemocrat was .50

my problem is...... I am still getting pressure headaches?

Is this unusual, considering that I'm only dosing 40mg x twice week and haemoctrit is coming in at .54 peak .50 trough....

Is it also unusual that haemocrat is so high on a weekly dose of 80mg?

Should I donate to get haemoctric down more so the pressure headaches subside

Also, was hoping to increase T from 80mg weekly to 100mg week, as numbers aren't really good are they, particularly that I do feel ok in myself (besides the headaches) but my erections are poor.

Prior to starting Test Cyponiate, i was on Nebido for few years, and my erections when Test is peak erections were 100%

But, if I was to increase test from 80mg week to 100mg, I'm only gonna suffer more intense pressure headaches aren't I as my haemoctric will be higher......

Should it be between .54 and .50 weekly on 80mg?

Or does it seem somethings not quite right here.

I drink about 3 litres or more water a day.

Thanks for any help guys, these pressure headaches really get me down, I wouldn't mind pain anywhere in the body I'd handle it but when it's your face... man......

Click to expand...

What was your hematocrit while on nebido?
I would try daily injections, e.g 10mg, and then increase dose if necessary, or reduce dose if BP is high, headache continue etc.

MikeDaly1970 said:

Hi guys

I posted before about my doc starting me on too high a dose, which was .8ml week 160mg....
My haemocrat went high to 0.56 and I was suffering extremely bad pressure headaches and facial pain.

I reduced my T, and for the past 6 weeks I have been taking only .2ml (40mg) x twice week, total 80 mg weekly.

So that's 40mg every 3.5 days

I did 2 blood tests this week,

2 days after I injected, my peak? T was 695 ng/dl
My haemocrat was .54

And on the morning before my next injection, trough? T was 608 ng/dl
My haemocrat was .50

my problem is...... I am still getting pressure headaches?

Is this unusual, considering that I'm only dosing 40mg x twice week and haemoctrit is coming in at .54 peak .50 trough....

Is it also unusual that haemocrat is so high on a weekly dose of 80mg?

Should I donate to get haemoctric down more so the pressure headaches subside

Also, was hoping to increase T from 80mg weekly to 100mg week, as numbers aren't really good are they, particularly that I do feel ok in myself (besides the headaches) but my erections are poor.

Prior to starting Test Cyponiate, i was on Nebido for few years, and my erections when Test is peak erections were 100%

But, if I was to increase test from 80mg week to 100mg, I'm only gonna suffer more intense pressure headaches aren't I as my haemoctric will be higher......

Should it be between .54 and .50 weekly on 80mg?

Or does it seem somethings not quite right here.

I drink about 3 litres or more water a day.

Thanks for any help guys, these pressure headaches really get me down, I wouldn't mind pain anywhere in the body I'd handle it but when it's your face... man......

Click to expand...

Maybe your not giving it enough time, I noticed it took about 4 months on a lower dose of T to show in Hct. Red cells have a 120 day life allegedly,

BadLeroyBrown said:

... But for many males I would argue 80mg per week offers very little benefit and may even be detrimental in that it's only acting as a natty suppressor, and nothing more. ...

Click to expand...

I would argue against this. The 8 mg of testosterone per day represents more than a very large majority of men would make naturally at their best. For someone like me who does well on 4.4 mg per day, taking double this is nothing but trouble.

@MikeDaly1970, Do you recall what your Nebido protocol was? Do you have any idea about your SHBG level? It does seem likely you're getting more testosterone than is good for you. Unfortunately the more-is-better thinking about testosterone is prevalent and misguided.

Hi all, I'm a full blood panel done next week, so will wait on that...

As for blood donation, I am going to try that just to reduce pvc, and also reduce test per week from 80mg down to 60 and see how I go, whilst also doing it daily at about 9mg per day....

Will update thereafter

Thanks all

Cataceous said:

I would argue against this. The 8 mg of testosterone per day represents more than a very large majority of men would make naturally at their best. For someone like me who does well on 4.4 mg per day, taking double this is nothing but trouble.

@MikeDaly1970, Do you recall what your Nebido protocol was? Do you have any idea about your SHBG level? It does seem likely you're getting more testosterone than is good for you. Unfortunately the more-is-better thinking about testosterone is prevalent and misguided.

Click to expand...

You say you take 4.4mg a day, so that's 30mg approximately a week yes?

Whats your numbers at

And are erections good on that daily dose

Thanks

Cataceous said:

I would argue against this. The 8 mg of testosterone per day represents more than a very large majority of men would make naturally at their best. For someone like me who does well on 4.4 mg per day, taking double this is nothing but trouble.

@MikeDaly1970, Do you recall what your Nebido protocol was? Do you have any idea about your SHBG level? It does seem likely you're getting more testosterone than is good for you. Unfortunately the more-is-better thinking about testosterone is prevalent and misguided.

Click to expand...

That sounds like you only take 4.4mg T per day and nothing else to support the hormonal cascade, is that true?

Maybe we should define on a sticky note what is meant by "more-is-better thinking". I don't want or need to pick a fight. I think it's reasonable to start with the average normal dose corresponding to age. If one has T labs from before having potentially T related health problems, I would take these values as individual priors. For me the "more-is-better thinking" in short means: a person is doing well, has recovered from T deficiency related health problems and now thinks: hey, maybe more is even better. Or even worse, right from the start, instead of starting low and slowly increasing a potentially suboptimal dose; I just take what my bros say works best for them.
Please fill in the nuances.

Cataceous said:

I would argue against this. The 8 mg of testosterone per day represents more than a very large majority of men would make naturally at their best. For someone like me who does well on 4.4 mg per day, taking double this is nothing but trouble.

@MikeDaly1970, Do you recall what your Nebido protocol was? Do you have any idea about your SHBG level? It does seem likely you're getting more testosterone than is good for you. Unfortunately the more-is-better thinking about testosterone is prevalent and misguided.

Click to expand...

But does it not depend a lot on what SHBG , a guy has

MikeDaly1970 said:

You say you take 4.4mg a day, so that's 30mg approximately a week yes?

Whats your numbers at

And are erections good on that daily dose
...

Click to expand...

When I say 4.4 mg per day I am referring to pure testosterone. The equivalent in testosterone cypionate is 44 mg per week. However, my testosterone comes as daily injections of a blend of testosterone propionate and testosterone enanthate. The resulting diurnal variation in testosterone probably does let me use less testosterone than if I used only enanthate or cypionate. I suspect that daily peak testosterone correlates better with some benefits of testosterone than average or trough levels.

Most recent lab work gave total testosterone as 810 ng/dL. I believe this was about 6 hours post-injection. SHBG is in the low 40s nMol/L. Erection quality is good.

I asked about your SHBG because free testosterone is more important than total. If you have low SHBG then total testosterone is artificially lower, even though free testosterone can be good or even high.

Keepfit1 said:

But does it not depend a lot on what SHBG , a guy has

Click to expand...

Generally no, because SHBG does not drive free testosterone; it drives total testosterone. The testosterone dose is what drives free testosterone. That said, high or low levels of SHBG probably have the potential to cause problems that are independent of the free testosterone level in serum.

Seagal said:

That sounds like you only take 4.4mg T per day and nothing else to support the hormonal cascade, is that true?

Click to expand...

No, the overall protocol is more complex, and includes things like gonadorelin, enclomiphene, DHEA, and progesterone. The former two in particular stimulate some endogenous LH and FSH production.

Seagal said:

... I think it's reasonable to start with the average normal dose corresponding to age. ...

Click to expand...

A normal interpretation of this is that you'd be taking a dose that yields normal testosterone for your age. But in this case the dose would be pretty small given that peak production in healthy individuals in their 20s-30s is around 6-7 mg/day. I'm not advocating this. I argue in favor of aiming for the same levels as healthy young guys, with total testosterone averaging 600-700, adjusting for SHBG of course. However, it is also not unreasonable to argue that this has the potential to be too much for aging bodies.

Seagal said:

... For me the "more-is-better thinking" in short means: a person is doing well, has recovered from T deficiency related health problems and now thinks: hey, maybe more is even better. Or even worse, right from the start, instead of starting low and slowly increasing a potentially suboptimal dose; I just take what my bros say works best for them.
Please fill in the nuances.

Click to expand...

It is the former to which I have no objections. If you have experienced a wide range in testosterone levels in the normal range over many months then experiment if you like. The latter scenario is what I have problems with. You don't know a priori what an optimal dose is. I could have avoided a lot of unpleasantness if the doctor had me titrate up from 4 mg T per day instead of down from 10 mg. Zyosted represents the pragmatic approach. You start at 75 mg TE per week. If things are good you stay there. If levels are excessive or you have symptoms then you drop to 50 mg TE/week. If levels are low and you have corresponding symptoms then you raise to 100 mg TE/week.

Cataceous said:

No, the overall protocol is more complex, and includes things like gonadorelin, enclomiphene, DHEA, and progesterone. The former two in particular stimulate some endogenous LH and FSH production.

A normal interpretation of this is that you'd be taking a dose that yields normal testosterone for your age. But in this case the dose would be pretty small given that peak production in healthy individuals in their 20s-30s is around 6-7 mg/day. I'm not advocating this. I argue in favor of aiming for the same levels as healthy young guys, with total testosterone averaging 600-700, adjusting for SHBG of course. However, it is also not unreasonable to argue that this has the potential to be too much for aging bodies.

It is the former to which I have no objections. If you have experienced a wide range in testosterone levels in the normal range over many months then experiment if you like. The latter scenario is what I have problems with. You don't know a priori what an optimal dose is. I could have avoided a lot of unpleasantness if the doctor had me titrate up from 4 mg T per day instead of down from 10 mg. Zyosted represents the pragmatic approach. You start at 75 mg TE per week. If things are good you stay there. If levels are excessive or you have symptoms then you drop to 50 mg TE/week. If levels are low and you have corresponding symptoms then you raise to 100 mg TE/week.

Click to expand...

Please correct me if I understood it wrong. Are you indirectly saying you would keep a patient strictly within the healthy young range even though there are still symptoms?

That's totally fine if that's your opinion or professional experience. It's about clarification of the meaning of the "more-is-better thinking". Then I would understand it as the "more than the young healthy upper range is better thinking".

Seagal said:

Please correct me if I understood it wrong. Are you indirectly saying you would keep a patient strictly within the healthy young range even though there are still symptoms?

That's totally fine if that's your opinion or professional experience. It's about clarification of the meaning of the "more-is-better thinking". Then I would understand it as the "more than the young healthy upper range is better thinking".

Click to expand...

To further explain, "more-is-better thinking" encompasses treating testosterone differently than any other hormone. In general we recognize that having hormones outside of their normal ranges is problematic, with U-shaped curves for mortality, etc. In contrast, testosterone seems to get a free pass because of its association with muscles and masculinity. It's been relatively uncommon for you to hear a guy say, "My libido isn't where it should be so I think I'll supplement with estradiol to put my levels over the top-of-range."

I've always been skeptical of this argument about still having symptoms in spite of robust testosterone levels. Which symptoms? Testosterone is just one component of health; there are many other potential causes of continued difficulties, not least of which is the disruption caused by exogenous testosterone. It's better to try to understand the reason. You can point to cases where a guy says certain symptoms resolved at higher dosing, but I can do the same for lower dosing.

Cataceous said:

To further explain, "more-is-better thinking" encompasses treating testosterone differently than any other hormone. In general we recognize that having hormones outside of their normal ranges is problematic, with U-shaped curves for mortality, etc. In contrast, testosterone seems to get a free pass because of its association with muscles and masculinity. It's been relatively uncommon for you to hear a guy say, "My libido isn't where it should be so I think I'll supplement with estradiol to put my levels over the top-of-range."

I've always been skeptical of this argument about still having symptoms in spite of robust testosterone levels. Which symptoms? Testosterone is just one component of health; there are many other potential causes of continued difficulties, not least of which is the disruption caused by exogenous testosterone. It's better to try to understand the reason. You can point to cases where a guy says certain symptoms resolved at higher dosing, but I can do the same for lower dosing.

Click to expand...

That's fair enough. I really appreciate how you formulated that.
May I assume that you and @madman are in line?
There is no more need for obscene language, referring to that explanation should be sufficient.

Seagal said:

...
May I assume that you and @madman are in line?
...

Click to expand...

I tend to be more conservative with respect to ideas about dosing, but I think we align on general principles.

Seagal said:

It's about clarification of the meaning of the "more-is-better thinking".

Click to expand...

On these forums you have so many people reporting side effects of being on T and asking for advice. For almost all of them you will see labs where they are running at top of range or above top of range of "normal" T/free T levels. It is extremely difficult (in some cases impossible) to convince these people to try lowering their T dose to alleviate their unwanted side effects.

On the other side, you have tons of people that started T because they felt like garbage and they are not seeing the benefits of exogenous T yet. Even if their labs are showing them at high end or above the top of "normal" range for T/free T, it is extremely easy for them to be willing to increase their dose of T.

Most people (including myself) think well more T = more muscles and more health, less T = less muscles and less health. So they will want to exhaust all other options before lowering their T dose.

Almost everyone is willing to increase their T dose to see if it makes them feel better. Very few are willing to try lowering their T dose to see if it makes them feel better.