Advice

[MikeDaly1970]

Hi Guys,

So got bloods done, haemocrat .52
Testosterone 605.

But, suffering pressure headaches, and facial pain

I know it's the haemocrat being at .52

Last October it was at .52 and had pressure headaches, my endo took 1 unit blood and all headaches etc stopped, all good

Been taking 50mg twice a week since then, and now in the past week my haemocrat is back again at .52

My endo so busy he cant see me for a few weeks so I paid privately to have another 1 unit drawn, and headaches etc stopped.

Problem is my endo and my doctor both said I've to reduce my testosterone to keep my haemocrat from rising, my endo wants to lower my testosterone so my results come in around 350 ngdl

I'm trying to fight against this, as at 605 I'm feeling great except for the pressure headaches.

My doc said try the gel patches and use every day and get a steadier numbers, and that may keep haemocrat from rising, based on that

I'm thinking maybe inject 14mg every day see does that help with lowering haemocrat.

Thing is I can see my doc and endo eventually saying no more to drawing 1 unit of blood every 3 months to lower haemocrat, my doc says at .52 I'm looking for trouble of a heart attack or blood clots and stroke

What would you guys do in my position

Thanks guys

Mike

 

[Systemlord]

Been taking 50mg twice a week since then, and now in the past week my haemocrat is back again at .52

Seems like you would do better oral T, Jatenzo or Kyzatrex. The half-life is similar to gels only you don't have to worry about absorption issues or transferring Test to children. The clinical trials showing only a very small percentage of men experienced erythrocytosis.

The recommended starting dosage for Jatenzo is 237 mg twice daily, and 200 mg for Kyzatrex. With Jatenzo, I would show peak levels around 989 ng/dL and trough levels 12 hours later 289 ng/dL. This rapid fluctuation in hormones is why hematocrit and hemoglobin are better controlled on oral T.

You’ll also see higher DHT levels versus injections and higher FT levels versus topical gels. The higher DHT levels may also net you a higher sense of well-being.

As far you endo wanting your TT level at 350 ng/dL, you would qualify for TRT at that level. It’s alarming that he’s not even focusing on the FT. Clearly this endo isn’t a good fit to manage anyone’s TRT.

SAGE Journals: Your gateway to world-class research journals

Subscription and open access journals from SAGE Publishing, the world's leading independent academic publisher.

journals.sagepub.com

 

[Systemlord]

Thread 'Oral TU offers a safe and effective long-term treatment option for men with hypogonadism'

Nov 10, 2022

Two-Year Analysis of a New Oral Testosterone Undecanoate (TU) Formulation in Hypogonadal Men: Efficacy, Impact on Psychosexual Function, and Safety (2022)
Stanton Honig, MD, Marc Gittelman, MD, Jed Kaminetsky, MD, Christina Wang, MD, John K. Amory, MD, Nestor Rohowsky, MA, Robert E. Dudley, Ph.D., B. Woun Seo, Ph.D, Jay Newmark, MD, and Ronald Swerdloff, MD


ABSTRACT

Background: Long-term data evaluating the efficacy and safety of oral testosterone undecanoate (oral TU; JATENZO) in adult hypogonadal men provides important information for healthcare professionals who...

• madman
• hypogonadism; oral t; jatenzo
• Replies: 6
• Forum: Testosterone and Men's Health Articles

• 

Thread 'My Experience On Jatenzo (Oral TRT) Log'

Jun 16, 2021

I wanted to start a thread detailing my personal experience with Jatenzo (oral TRT) which is remarkable in how quickly it has shown results when compared with injections. The first week on Jatenzo was very pleasant unlike my experience after dosing changes on injections, all with minimal swings and I felt things stabilize on day 7 which is where things felt consistent.

The first few days on Jatenzo my glucose levels were the lowest, then over the next two and a half weeks I would see glucose levels fluctuate wildly and at the end of week three a return to those same lower fasting and...

• Systemlord
• jatenzo oral testosterone
• Replies: 374
• Forum: Testosterone Basics & Questions

• 

 

[Seagal]

Hi Guys,

So got bloods done, haemocrat .52
Testosterone 605.

But, suffering pressure headaches, and facial pain

I know it's the haemocrat being at .52

Was your blood pressure increased?

Last October it was at .52 and had pressure headaches, my endo took 1 unit blood and all headaches etc stopped, all good

Been taking 50mg twice a week since then, and now in the past week my haemocrat is back again at .52

My endo so busy he cant see me for a few weeks so I paid privately to have another 1 unit drawn, and headaches etc stopped.

Problem is my endo and my doctor both said I've to reduce my testosterone to keep my haemocrat from rising, my endo wants to lower my testosterone so my results come in around 350 ngdl

I'm trying to fight against this, as at 605 I'm feeling great except for the pressure headaches.

My doc said try the gel patches and use every day and get a steadier numbers, and that may keep haemocrat from rising, based on that

I'm thinking maybe inject 14mg every day see does that help with lowering haemocrat.

Thing is I can see my doc and endo eventually saying no more to drawing 1 unit of blood every 3 months to lower haemocrat, my doc says at .52 I'm looking for trouble of a heart attack or blood clots and stroke

What would you guys do in my position

Thanks guys

Mike

 

[Systemlord]

my doc says at .52 I'm looking for trouble of a heart attack or blood clots and stroke

Your doctor is flat out wrong and is operating outside his scope of medicine. The Traverse trial squashed the myth of testosterone related heart attack, blood clots, and strokes. The FDA is removing the black label warning from testosterone products.

Thread 'FDA issues class-wide labeling changes for testosterone products'

Feb 28, 2025

FDA issues class-wide labeling changes for testosterone products

FDA issues class-wide labeling changes for testosterone products

www.fda.gov

[2/28/2025] Today, FDA informed sponsors of testosterone products about new labeling changes following the agency’s review of the findings from the Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE) clinical trial External Link Disclaimer and the results from required postmarket ambulatory blood pressure (ABPM) studies.

Led by the...

• madman
• hypogonadism; t-therapy; cvd; fda
• Replies: 3
• Forum: Testosterone and Men's Health Articles

• 

Marius Pharmaceuticals Helps Drive FDA’s Landmark Testosterone Label Update, Removing Black Box Warning

RALEIGH, N.C., March 03, 2025 (GLOBE NEWSWIRE) -- Marius Pharmaceuticals, is pleased to announce that the U.S. Food and Drug Administration (FDA) has...

www.globenewswire.com

 

[MikeDaly1970]

Seems like you would do better oral T, Jatenzo or Kyzatrex. The half-life is similar to gels only you don't have to worry about absorption issues or transferring Test to children. The clinical trials showing only a very small percentage of men experienced erythrocytosis.

The recommended starting dosage for Jatenzo is 237 mg twice daily, and 200 mg for Kyzatrex. With Jatenzo, I would show peak levels around 989 ng/dL and trough levels 12 hours later 289 ng/dL. This rapid fluctuation in hormones is why hematocrit and hemoglobin are better controlled on oral T.

You’ll also see higher DHT levels versus injections and higher FT levels versus topical gels. The higher DHT levels may also net you a higher sense of well-being.

As far you endo wanting your TT level at 350 ng/dL, you would qualify for TRT at that level. It’s alarming that he’s not even focusing on the FT. Clearly this endo isn’t a good fit to manage anyone’s TRT.

SAGE Journals: Your gateway to world-class research journals

Subscription and open access journals from SAGE Publishing, the world's leading independent academic publisher.

journals.sagepub.com

I cant get oral T in Ireland

All we have available is, Nebido (was on it years, horrible up an downs) Test E and Test C, and gels that's it.....

Should I inject daily, would it help keep haemocrat normal

 

[MikeDaly1970]

Was your blood pressure increased?

He never mentioned elevated blood pressure, although besides facial headaches etc, at times my breathing is heavy

 

[MikeDaly1970]

Your doctor is flat out wrong and is operating outside his scope of medicine. The Traverse trial squashed the myth of testosterone related heart attack, blood clots, and strokes. The FDA is removing the black label warning from testosterone products.

Thread 'FDA issues class-wide labeling changes for testosterone products'

Feb 28, 2025

FDA issues class-wide labeling changes for testosterone products

FDA issues class-wide labeling changes for testosterone products

www.fda.gov

[2/28/2025] Today, FDA informed sponsors of testosterone products about new labeling changes following the agency’s review of the findings from the Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE) clinical trial External Link Disclaimer and the results from required postmarket ambulatory blood pressure (ABPM) studies.

Led by the...

• madman
• hypogonadism; t-therapy; cvd; fda
• Replies: 3
• Forum: Testosterone and Men's Health Articles

• 

Marius Pharmaceuticals Helps Drive FDA’s Landmark Testosterone Label Update, Removing Black Box Warning

RALEIGH, N.C., March 03, 2025 (GLOBE NEWSWIRE) -- Marius Pharmaceuticals, is pleased to announce that the U.S. Food and Drug Administration (FDA) has...

www.globenewswire.com

maybe I explained incorrect, my doc is not blaming testosterone for possible causing heart attack or stroke or clots, hes saying my continued haemocrat of .52 could cause those issues

 

[MikeDaly1970]

I cant get oral T in Ireland

All we have available is, Nebido (was on it years, horrible up an downs) Test E and Test C, and gels that's it.....

Should I inject daily, would it help keep haemocrat normal

Seems like you would do better oral T, Jatenzo or Kyzatrex. The half-life is similar to gels only you don't have to worry about absorption issues or transferring Test to children. The clinical trials showing only a very small percentage of men experienced erythrocytosis.

The recommended starting dosage for Jatenzo is 237 mg twice daily, and 200 mg for Kyzatrex. With Jatenzo, I would show peak levels around 989 ng/dL and trough levels 12 hours later 289 ng/dL. This rapid fluctuation in hormones is why hematocrit and hemoglobin are better controlled on oral T.

You’ll also see higher DHT levels versus injections and higher FT levels versus topical gels. The higher DHT levels may also net you a higher sense of well-being.

As far you endo wanting your TT level at 350 ng/dL, you would qualify for TRT at that level. It’s alarming that he’s not even focusing on the FT. Clearly this endo isn’t a good fit to manage anyone’s TRT.

SAGE Journals: Your gateway to world-class research journals

Subscription and open access journals from SAGE Publishing, the world's leading independent academic publisher.

journals.sagepub.com

Could you explain the FT and how he should be focusing on that, could that be a cause of the .52 haemocrat and my pressure headaches

 

[Systemlord]

But, suffering pressure headaches, and facial pain

maybe I explained incorrect, my doc is not blaming testosterone for possible causing heart attack or stroke or clots, hes saying my continued haemocrat of .52 could cause those issues

You misunderstand, I'm saying high hematocrit doesn't cause those issues. There are medical conditions, diseases that leads to high hematocrit (sleep apnea, polycythemia vera, COPD) and it's the disease NOT the high hematocrit that causes those issues.

These diseases starve the body of oxygen forcing the body to raise the hematocrit/hemoglobin -> oxygen.

 

[MikeDaly1970]

You misunderstand, I'm saying high hematocrit doesn't cause those issues.

Ok cool thanks

 

[Systemlord]

Glenn Cunningham, the doctor that wrote the guidelines for hematocrit. Dr. Abraham Morgantaler, asked him both on stage and in person where did you come up with hematocrit 54% cut off? His answer was we actually don't have much data to say anything but we had to pick a number and it seemed like a reasonable number.

 

[Systemlord]

Could you explain the FT and how he should be focusing on that, could that be a cause of the .52 haemocrat and my pressure headaches

Testosterone increases red blood cells, same as if you lived at high elevation. So basically if you go from sea level to Boulder, Colorado, the first thing that’s going happen is your testosterone is going to increase (above 4000 ft) and your hematocrit and hemoglobin are going to go up.

If you live at higher altitude, you have higher testosterone compared to at sea level.

Could you explain the FT and how he should be focusing on that

Thje FT or free testosterone is the unbound active portion of testosterone exerting its affects on tissues. The total testosterone doesn’t define testosterone deficiency, and therefore cannot define treatment, success or failure.

So your doctor targeting a total testosterone value is misguided.

 

[Seagal]

He never mentioned elevated blood pressure, although besides facial headaches etc, at times my breathing is heavy

You didn't have these issue with nebido?
I think to recall your initial posts here. Wonder if you would just have done fine with once per week injections of nebido.

 

[MikeDaly1970]

You didn't have these issue with nebido?
I think to recall your initial posts here. Wonder if you would just have done fine with once per week injections of nebido.

No I didnt have this issue with nebido, but can I do once per week injections with nebido? Apparently it's all in one shot and lasts 8 to 10 weeks.


Also, I noticed my haemocrat was a healthy .46 just over 6 weeks ago in January, can it go from .46 to .52 in such a short time, I strictly stick to 50mg testosterone twice a week , maybe it's a dehydration thing ????

To answer my original post, do u think me injecting testosterone 14mg a day will be better at keeping my haemocrat low ??

 

[Seagal]

No I didnt have this issue with nebido, but can I do once per week injections with nebido? Apparently it's all in one shot and lasts 8 to 10 weeks.

One can inject e.g. 125mg of TU per week which results theoretically in the same hormone fluctuation as ED TC injections.

Also, I noticed my haemocrat was a healthy .46 just over 6 weeks ago in January, can it go from .46 to .52 in such a short time, I strictly stick to 50mg testosterone twice a week , maybe it's a dehydration thing ????

To answer my original post, do u think me injecting testosterone 14mg a day will be better at keeping my haemocrat low ??

Yes

 

[seppuku]

No I didnt have this issue with nebido, but can I do once per week injections with nebido? Apparently it's all in one shot and lasts 8 to 10 weeks.


Also, I noticed my haemocrat was a healthy .46 just over 6 weeks ago in January, can it go from .46 to .52 in such a short time, I strictly stick to 50mg testosterone twice a week , maybe it's a dehydration thing ????

To answer my original post, do u think me injecting testosterone 14mg a day will be better at keeping my haemocrat low ??

I was getting hct readings like yours, until i realised i hadn't drank enough fluids before blood tests (as i didn't want to be bursting for the loo on the way to the hospital). I was regularly getting hct readings of 0.51 (51%), but after drinking more before going, readings now come back much lower (last one was 0.43, or 43%). Are you drinking enough fluids? And yes, injecting less frequently apparently can help by reducing the peaks and troughs although i'd try just upping fluids first when you get these headaches and see if that stops them.

 

[Melody68]

Some men do well on lower doses of T; I'm one of them. I'm 69; have been on T about a year and I've experimented with dosages of 60mg/wk to 84mg/wk. I inject every four days and currently am taking 9.5 mg/day or 66.5 mg/wk. At the higher dose, my hematocrit also reached 52 . . . and I had a TIA in December. Who knows if the two were related? But . . . it compelled me to reduce my dose. My T numbers still look healthy, but I'd encourage you to judge more by how you feel. True, I felt "better" at the higher dose, but I'm still feeling pretty well at the lower one; and my hematocrit and hemoglobin have come down. My PSA, which was higher at 4.4 will also hopefully come down.

Remember, it's all a compromise. If I were you I'd gradually reduce my dose and try to find that healthy sweet spot. Be prepared for some negative impact until your body catches up with things. When I reduced my morning wood and erection quality temporarily suffered, but things caught up to normal a month or month and a half later. Be wise and best of luck.

 

[Systemlord]

Also, I noticed my haemocrat was a healthy .46 just over 6 weeks ago in January, can it go from .46 to .52 in such a short time, I strictly stick to 50mg testosterone twice a week , maybe it's a dehydration thing ????

To answer my original post, do u think me injecting testosterone 14mg a day will be better at keeping my haemocrat low ??

I'm looking for trouble of a heart attack or blood clots and stroke

I can see your problem. You lack basic understanding of hematocrit and how it one of the benefits of TRT. Even slightly over the range is considered healthy, but somehow you convinced yourself it's unsafe.

I have labs showing my hematocrit change 4% (55->51%) in a few hours, because I had diarrhea that morning and became dehydrated quickly, but also hydrated a few hours later and labs were drawn a second time.

 

[Systemlord]

Thread 'Does a high hematocrit change your blood's clotting profile? High altitude vs TRT.'

Aug 13, 2024

Does having a high hematocrit mean your blood is more likely to clot? This study looks at a city where people with the highest hematocrit in the world live and work.

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• Systemlord
• high hematocrit
• Replies: 33
• Forum: Testosterone Side Effect Management

Thread 'Stroke-Related Mortality at Different Altitudes: A 17-Year Nationwide Population-Based Analysis From Ecuador.'

Jan 6, 2023

Living at higher elevation with higher hematocrit may decrease cardiovascular risk!

Stroke-Related Mortality at Different Altitudes: A 17-Year Nationwide Population-Based Analysis From Ecuador - PMC

Introduction: Worldwide, more than 5.7% of the population reside above 1,500 m of elevation. It has been hypothesized that acute short-term hypoxia exposure could increase the risk of developing a stroke. Studies assessing the effect of altitude on ...

www.ncbi.nlm.nih.gov

PubMed Central Image Viewer.

• Systemlord
• erythrocytosis; trt
• Replies: 5
• Forum: Testosterone Side Effect Management

• 

Conclusion: This is the first epidemiological study that aims to elucidate the association between stroke and altitude using four different elevation ranges. Our findings suggest that living at higher elevations offers a reduction or the risk of dying due to stroke as well as a reduction in the probability of being admitted to the hospital. Nevertheless, this protective factor has a stronger effect between 2,000 and 3,500 m.