Considering Moving to Daily Injections

[MarkM]

I am considering changing my injection protocol to ED for E3.5D. I would like some advice or opinions.

My current protocol is:
180 mg Test Cypionate total weekly, 90 mg E3.5D - Monday AM and Thu PM
No HCG
No AI

I feel really dialed in with one exception, I would like to get my Hb and HCT to remain at a constant level where I am not having to deal with blood donations and the constant supplementing of iron to replace what I am losing in the blood donations. I have been on TRT for over 13 years and have always had high Hb and high HCT even when on gels for years.

I know it is more needle sticks but I am okay with that and I know it is a commitment to do it everyday but I did the gels for many years every single day in my past so that is no a concern.

Part of me says "Hey, if the protocol you are on is working for you, why change it". If it weren't for the high HB and HCT I wouldn't be changing a thing. I don't believe I have polycythemia because my WBC, platelets, RDW, MCV, MCH, and MCHC are all mid range with platelets actually lower than mid range. Polycythemia normally raises blood pressure and my blood pressure averages 112/62. I do believe I have erythrocytosis which is basically the elevated RBC, HB, and HCT without the other areas mentioned that can cause blood clotting. Several years ago I went through more rigorous testing on two occasions for polycythemia (bone marrow and erythropoietin) and all turned out normal. That being said, I would still prefer to have lowered RBC, HB, HCT because of the potential extra pressure on the vessels and arteries.

My last blood work results at trough were (LabCorp):

Total Testosterone 1050 Range 264 - 916
Free Testosterone 30.2 Range 7.2 - 24.0
PSA Range 1.1 Range 0.0 - 4.0
Prolactin 8.7 Range 4.0 - 15.2
Estradiol Sensitive 35.3 Range 8.0 - 35.0
SHBG 29.7 Range 19.3 - 76.4
DHEA-s 322.8 Range 49 - 344
DHT 92 Range 30 - 85
Vitamin D 57.3 Range 30 - 100

WBC 6.4 Range 3.4 - 10.8
RBC 6.05 Range 4.14 - 5.80
Hemoglobin 18.1 Range 13.0 - 17.7
Hematocrit 54.3 Range 37.5 - 51.0
MCV 92 Range 79 - 97
MCHC 32.8 Range 32 - 36
RDW 13.1 Range 12.3 - 15.4
Platelet Count 214 Range 150 - 400

Do you think by going to daily injections my RBC, Hb, and HCT will stabilize at a lower level? I'd like to somewhat mirror the hormonal levels I currently have.

What daily dose would you recommend that I move to? I was thinking 22 mg per day which is 154 mg per week. This is a reduction of almost 15%. Is that a large enough reduction?

I appreciate any feedback you might give me.

Thanks

 

[Vince]

I am considering changing my injection protocol to ED for E3.5D. I would like some advice or opinions.

My current protocol is:
180 mg Test Cypionate total weekly, 90 mg E3.5D - Monday AM and Thu PM
No HCG
No AI

I feel really dialed in with one exception, I would like to get my Hb and HCT to remain at a constant level where I am not having to deal with blood donations and the constant supplementing of iron to replace what I am losing in the blood donations. I have been on TRT for over 13 years and have always had high Hb and high HCT even when on gels for years.

I know it is more needle sticks but I am okay with that and I know it is a commitment to do it everyday but I did the gels for many years every single day in my past so that is no a concern.

Part of me says "Hey, if the protocol you are on is working for you, why change it". If it weren't for the high HB and HCT I wouldn't be changing a thing. I don't believe I have polycythemia because my WBC, platelets, RDW, MCV, MCH, and MCHC are all mid range with platelets actually lower than mid range. Polycythemia normally raises blood pressure and my blood pressure averages 112/62. I do believe I have erythrocytosis which is basically the elevated RBC, HB, and HCT without the other areas mentioned that can cause blood clotting. Several years ago I went through more rigorous testing on two occasions for polycythemia (bone marrow and erythropoietin) and all turned out normal. That being said, I would still prefer to have lowered RBC, HB, HCT because of the potential extra pressure on the vessels and arteries.

My last blood work results at trough were (LabCorp):

Total Testosterone 1050 Range 264 - 916
Free Testosterone 30.2 Range 7.2 - 24.0
PSA Range 1.1 Range 0.0 - 4.0
Prolactin 8.7 Range 4.0 - 15.2
Estradiol Sensitive 35.3 Range 8.0 - 35.0
SHBG 29.7 Range 19.3 - 76.4
DHEA-s 322.8 Range 49 - 344
DHT 92 Range 30 - 85
Vitamin D 57.3 Range 30 - 100

WBC 6.4 Range 3.4 - 10.8
RBC 6.05 Range 4.14 - 5.80
Hemoglobin 18.1 Range 13.0 - 17.7
Hematocrit 54.3 Range 37.5 - 51.0
MCV 92 Range 79 - 97
MCHC 32.8 Range 32 - 36
RDW 13.1 Range 12.3 - 15.4
Platelet Count 214 Range 150 - 400

Do you think by going to daily injections my RBC, Hb, and HCT will stabilize at a lower level? I'd like to somewhat mirror the hormonal levels I currently have.

1. What daily dose would you recommend that I move to? I was thinking 22 mg per day which is 154 mg per week. This is a reduction of almost 15%. Is that a large enough reduction?

2. As far as labs in the future, since the peak and trough are much closer together, would I still have labs run prior to my daily injection. Of course I would run labs first thing in the morning but do I go ahead with the injection prior to lab work?

I appreciate any feedback you might give me.

Thanks

I haven't had to donate blood for almost 2 years now, I think overtime your HCT should stabilize but I did go to daily injections.

My protocol is 16 mg of testosterone cypionate daily, 500 iu of HCG twice a week, 25 mg of DHEA and no AI.

testosterone serum 1117 ng/dL range 264 - 916
Free T 30.3 pg/mL range 6.6 - 18.1
DHEA - Sulfate 347.3 range 48.9 - 344.2
Estradiol, Sensitive 29.5 range 8.0 - 35.0
SHBG 48.8 range 19.3 - 76.4
HCT 47.9 range 37.5 - 51.0

 

[MarkM]

I saw your protocol. It seems to be working great for you and one reason why I thought I might try it. My HCT has never stabilized after 13 years.

Do you do your daily injection prior to lab work or after you have labs?

 

[MarkM]

Vince, prior to injecting daily, what type of protocol did you have?

 

[Vince]

My HCT stabilize after I went to daily injection, that's my labs for my 16mg daily injections. Before that I was injecting 20 mg daily, when I get a minute I will post labs from that protocol.

 

[mooseman109]

I just switched to daily about 4 weeks ago. No labs just yet. I am a low dose guy anyway, was 75mg a week, 25 sun, tues, thurs. I am now 10 mg everyday. Libido is up for sure.
My reasoning was same as yours. I also went thru poly and several other myloma testings only to come back with secondary erythrocytosis. Secondary to Test. I know the 3x a week reduced my hct from once a week. I had 2 hematologist tell me to keep my hct under 54 and they were happy. Like you I would like to be lower, but i do not freak out if it gets 53. I tend to stay 52 ish. I am hoping this will get better. I will post results in a few weeks.

 

[MarkM]

Good info Moose, I appreciate it. Me too on the secondary erythrocytosis, secondary to the testosterone. When you do your next set of labs, are you going to run labs before your daily injection or go ahead with your normal daily injection and have labs after?

 

[MarkM]

My HCT stabilize after I went to daily injection, that's my labs for my 16mg daily injections. Before that I was injecting 20 mg daily, when I get a minute I will post labs from that protocol.

Thanks Vince.

Do you do your daily injection prior to lab work or after you have labs?

 

[Vince]

Thanks Vince.

Do you do your daily injection prior to lab work or after you have labs?

I always inject after labs.

 

[Vince]

20mg of testosterone cypionate daily, 500iu of HCG every 3 1/2 days and 25mg of dhea daily'

T serum >1500 range 264-916
FT 39.4 range 6.6-18.1
dhea 228.6 range 48.9-344.2
estradiol 43.7 range 8.0-35.0
shbg 74.9 range 19.4-76.4
HCT 47.9

 

[MarkM]

I always inject after labs.

I thought that would be the case as it is with other protocol's but wasn't sure. Thanks for clarifying that.

 

[Vince Carter]

More than a year of daily hasn't stabilized my HCT/HGB and you know that I've ben cutting the dose repeatedly thru that time.

Something you can think of that generally on this forum get's an unwelcome response is how many other drugs and treatments are resulting in HCT/HGB elevation but those guys aren't being drained like TRT guys...interesting difference.
Some say in that same context it's the platelets that matter, too, polycythemia vera is not what this is and it's being misdiagnosed. Even those living at or adjusted to high altitude, could be a perfectly normal adaptation. Also being mistaken for PCV is an otherwise completely benign condition.

I donate because I think I'm required to to continue my treatment. Otherwise...I'm not sure that I would. I know its placed me in a dangerous Ferritin situation that I haven't been able to overcome in the 56 day window. My Ferritin was 26 two weeks ago. So as Ive discussed with my Nurse they have me in the perpetually dangerous cycle of killing my Ferritin, quite possibly affecting my Thyroid and I just can't escape this cycle they have me in.

 

[MarkM]

@Vince Carter, I am fortunate that in my 13 years of TRT and having high Hb an HCT I have never had a medical practitioner ever threaten to remove me from testosterone because they thought my Hb or HCT were too high. It would always come up in the conversation but I never felt I had to donate. But I recently moved and have a new doctor that gives it much more attention.

After 13 years I don't need a doctor anymore to diagnose my TRT related issues, I basically just want someone to write me my scripts but this new doctor might be a problem. At least I have the lab results from previous polycythemia testing I can provide him and a letter from a doctor stating my condition is erythrocytosis and not polycythemia.

If you were me and wanted to try the daily injections for several months to see if it made a difference in HCT/HB, where would you go with the dosing based on my numbers I provided? What would be your best guess?

 

[mooseman109]

Good info Moose, I appreciate it. Me too on the secondary erythrocytosis, secondary to the testosterone. When you do your next set of labs, are you going to run labs before your daily injection or go ahead with your normal daily injection and have labs after?

Hey Mark,
I will run labs at 7 am, usual time, and then do my injection. So still in the trough, if there is a trough on a daily protocol.
If i was in your shoes Inwoild look to go to 18-20 mg/ day.

 

[Vince Carter]

@Vince Carter, I am fortunate that in my 13 years of TRT and having high Hb an HCT I have never had a medical practitioner ever threaten to remove me from testosterone because they thought my Hb or HCT were too high. It would always come up in the conversation but I never felt I had to donate. But I recently moved and have a new doctor that gives it much more attention.

After 13 years I don't need a doctor anymore to diagnose my TRT related issues, I basically just want someone to write me my scripts but this new doctor might be a problem. At least I have the lab results from previous polycythemia testing I can provide him and a letter from a doctor stating my condition is erythrocytosis and not polycythemia.

If you were me and wanted to try the daily injections for several months to see if it made a difference in HCT/HB, where would you go with the dosing based on my numbers I provided? What would be your best guess?

\
OK yes I was looking for Erythrocytosis...Id suggest 16mg/D as that seems, for me, to be where I'm getting my Free T to the lab range, I've been under @ 12 and 14mg/D

 

[MarkM]

@Vince Carter, I saw in an older thread that you were at 26 mg and 28 mg ED? Did that put your E2 too high?

 

[Vince Carter]

one those doses yes, I was at one point twice the lab range on Free E, 40/50/60 as much as 88 at one time LC/MS/MS. I methodically cut my Cyp dosing from 28/24/20/18 and so forth trying to control E but was still required to use an AI. I have a long thread on it, possibly the one you saw.

 

[xqfq]

I’m wondering, have you also looked into sleep apnea? I know it can make hematocrit increases more prominent.

 

[manz]

I don't know if is true or not because i don't find any study about this, but in my country all doctors say that donate regulary make raise hct, ,and they prescribe it only in very dangerous case, as over 54/55 of hct level.