Hematocrit and TRT. How to have balance.

[AnotherPersonOnTRT]

Yes, I went all the way from 100 weekly and changed to eod. Down to 16eod.
Hematocrit was stable around 75 maybe 80 a week or eod. But hemoglobin keeps going to 17,6. I donate every 6 month and now moved lower to 16mg EOD. I enjoy nice libido when I stop my hcg (500 eod) which last for a week or two maybe 3 !!! I also see the point of changing protocols it does increase libido and all that.I was actually playing around a bit but not with high variation I may do that and also stop hcg every 3 weeks ! To get this libido.

Hey man. Wouldn’t mind chatting with you more. Do you use ******** messenger, Reddit or and other platform to chat??

 

[M.J]

Hey man. Wouldn’t mind chatting with you more. Do you use ******** messenger, Reddit or and other platform to chat??

Sorry, its better to use this website, I can go back to discussions much easier here.

 

[Seagal]

Suppression of Iron-Regulatory Hepcidin by Vitamin D - PMC

The antibacterial protein hepcidin regulates the absorption, tissue distribution, and extracellular concentration of iron by suppressing ferroportin-mediated export of cellular iron. In CKD, elevated hepcidin and vitamin D deficiency are associated ...

www.ncbi.nlm.nih.gov

 

[Seagal]

Association between sex steroid hormones and hematocrit in a nationally representative sample of men - PubMed

Low or high hematocrit levels are associated with increased morbidity and mortality, mediated via anemia or thromboembolic events, respectively. It is therefore important to identify factors that influence hematocrit. Although androgens are known to stimulate hematopoietic cells, it is unknown...

pubmed.ncbi.nlm.nih.gov

The relationship between sex hormone-binding globulin (SHBG) and hematocrit was complex, with both low (P < .001) and high (P = .01) SHBG levels associated with lower hematocrit in men aged ≥ 20 years and only high (P = .01) SHBG levels in men aged ≥ 50 years. The odds ratio (OR) of high vs normal hematocrit increased as total estradiol (OR, 2.84; P trend = .04) and free estradiol (OR, 2.23; P trend = .09) levels increased.

 

[SkyWarn]

As you know BigTex I’m on Jatenzo at 237 mg twice daily and approaching my evening dosage, I feel the same as I did 2 hours after taking my morning dosage.

My levels vary wildly, 1052 ng/dL four hours and 289 ng/dL at 12 hours.

I feel more fluctuations on injections.

Is Jatenzo hard on the liver like other orals are supposed to be?

 

[Systemlord]

Is Jatenzo hard on the liver like other orals are supposed to be?

No, Jatenzo bypasses the liver on the first pass.

 

[Keepfit1]

Thank you, vince. What do you think about less frequent doses for hematocrit control based on suppression of hepcidin and EPO?

I suspect daily micro dosing is best for most things inc Hct

 

[Keepfit1]

If you’re prone to rapid red cell production and high hematocrit, dosage or frequency change will have zero effect in lowering hematocrit. I’ve been on as low as 80 mg to as high as 200 mg a week. Injecting from every day, to once a week. Hematocrit always stays in the 55-56 range. But unlike you I’ve never had a side effect, and my blood pressure stays low normal.

My dose makes a big difference to how high Hct is

 

[Keepfit1]

I was able to control my HCT, once I went to daily injection. I've not donated blood for, I'm guessing 4 plus years. After donating every 8 weeks for 2 years. I may have stabilize my HCT, because of longevity? Or daily injections? Or maybe a combination of both?

what dose type of T are you on

 

[Vince]

what dose type of T are you on

16 mg of testosterone cypionate daily, 500 iu of hcg twice weekly and no AI.
Pregnenolone 10 mg and 25 mg of DHEA.

 

[Keepfit1]

16 mg of testosterone cypionate daily, 500 iu of hcg twice weekly and no AI.
Pregnenolone 10 mg and 25 mg of DHEA.

thats approx the amount of T I am on but still seem to get Hct rising a bit, when I was on 70mg Androgel only Hct didnt move but since adding 4.3mg of Cyp per day its edging up I think

 

[madman]

I suspect daily micro dosing is best for most things inc Hct

This is not a given as many are still caught up on running high/absurdly high FT levels.

Critical point here:

*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

I am on week 5-6 anxiety comes and goes

Free test - 15.39 The Free T will be higher at trough 2x weekly.

www.excelmale.com

 

[Ribeye]

This is not a given as many are still caught up on running high/absurdly high FT levels.

Critical point here:

*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

I am on week 5-6 anxiety comes and goes

Free test - 15.39 The Free T will be higher at trough 2x weekly.

www.excelmale.com

I hope everyone takes this issue seriously. My HCT and hemoglobin were both running high, HCT 55-56% and hemoglobin 17.6-17.7 and I decreased the dosing of T cream by 20% which lowered total to about 900. Still up there, and I still get the benefits. However, with lower dosing and blood donations every two months, it got the initial HCT and Hemoglobin down to high normal ranges while being able to back off the blood donations to every 12 weeks or less often. I was getting low iron markers on CBC, which was a concern by my docs. I felt fine, however. So add in iron supplements in a multi vitamin, and my CBC shows improvement in those markers as well. What was of most concern for me, as I donated blood, my BP would come down to low 120's systolic 68-70 diastolic. As my HCT and hemoglobin increased BP went up to as high as 145 systolic and 88 diastolic, prior to giving blood again. NOT GOOD. I am of the belief based on the data, that increased BP because it's everyday all day, over the longer term, is more risk and potentially more damaging than the risk of a clot, unless you have additional risk of clotting like abnormal high platelets counts. Even without the risk of a clot, long standing hypertension causes so many bad things. Heart failure often being the worst, because it leads directly to so many other problems, like increased risk of heart attacks, strokes, kidney disease, ED and more. When the data is discussed for increased risk of stroke, and clots with high HCT and Hemoglobin, it is rare to see a study that controls for the risk of high BP. So, we don't know, it seems if part the risk assigned to those markers is all high HCT and hemoglobin or contributed to significantly by high BP. And nearly all who have higher HCT and hemoglobin from T therapy will have high BP because your heart has to work harder to push thickened blood and increased blood volume thru the same amount of "piping" (your blood vessels) in your body.

 

[Gman86]

I hope everyone takes this issue seriously. My HCT and hemoglobin were both running high, HCT 55-56% and hemoglobin 17.6-17.7 and I decreased the dosing of T cream by 20% which lowered total to about 900. Still up there, and I still get the benefits. However, with lower dosing and blood donations every two months, it got the initial HCT and Hemoglobin down to high normal ranges while being able to back off the blood donations to every 12 weeks or less often. I was getting low iron markers on CBC, which was a concern by my docs. I felt fine, however. So add in iron supplements in a multi vitamin, and my CBC shows improvement in those markers as well. What was of most concern for me, as I donated blood, my BP would come down to low 120's systolic 68-70 diastolic. As my HCT and hemoglobin increased BP went up to as high as 145 systolic and 88 diastolic, prior to giving blood again. NOT GOOD. I am of the belief based on the data, that increased BP because it's everyday all day, over the longer term, is more risk and potentially more damaging than the risk of a clot, unless you have additional risk of clotting like abnormal high platelets counts. Even without the risk of a clot, long standing hypertension causes so many bad things. Heart failure often being the worst, because it leads directly to so many other problems, like increased risk of heart attacks, strokes, kidney disease, ED and more. When the data is discussed for increased risk of stroke, and clots with high HCT and Hemoglobin, it is rare to see a study that controls for the risk of high BP. So, we don't know, it seems if part the risk assigned to those markers is all high HCT and hemoglobin or contributed to significantly by high BP. And nearly all who have higher HCT and hemoglobin from T therapy will have high BP because your heart has to work harder to push thickened blood and increased blood volume thru the same amount of "piping" (your blood vessels) in your body.

Man, it’s so frustrating to see guys still battling the whole high HCT/ HGB and low iron thing. I’m not trying to come down on u specifically. Ur one of very many that are still caught up in this ridiculousness, and struggle with an issue that literally could not be easier to fix. Hct and HGB are just measurements of ur hydration status basically. They obv measure how many RBC’s and oxygen carrying proteins that u have in ur blood compared to the total volume of blood, but being properly hydrated can lower both measurements drastically. Not many people are actually properly hydrated. You could drink 2 gallons of water per day and still be dehydrated. All someone in ur situation has to do is learn how to properly hydrate ur cells, which will lower ur HCT and HGB levels into a healthy range, as well as lower ur BP into a healthy range. And then stop donating blood and let ur iron levels come back up. It’s honest to god that simple. I’ll link the best vid on how to properly hydrate urself that I’ve ever come across, and I’ll also link a vid talking about how slightly higher BP levels than we’re used to are most likely still very healthy. And this info is coming from a doctor

so there’s ur solution, and the solution almost every guy out there on HRT that struggles with the whole high HGB/ HCT levels, and low iron levels due to donating blood too often can implement. Now what will u, and most guys in ur situation actually do? Not watch either vid, and continue to not fully understand how to properly hydrate their cells and their body, and continue to be in a constant state of whether they should lower their dose, donate blood, and/ or take an iron supplement, or even get off of HRT all together possibly. But hopefully there’s at least a few guys here that are smart enough to implement this extremely easy and effective solution. It’s just really tough seeing guys struggle with this issue, when it’s honestly one of the easiest issues to remedy. Another thing I highly recommend for BP is magnesium. Everyone should be taking it, but definitely anyone with BP issues should take it. There’s many other easy ways to lower BP, but taking magnesium, properly hydrating urself, and using the correct forms of salt can do the trick for most people

 

[madman]

I hope everyone takes this issue seriously. My HCT and hemoglobin were both running high, HCT 55-56% and hemoglobin 17.6-17.7 and I decreased the dosing of T cream by 20% which lowered total to about 900. Still up there, and I still get the benefits. However, with lower dosing and blood donations every two months, it got the initial HCT and Hemoglobin down to high normal ranges while being able to back off the blood donations to every 12 weeks or less often. I was getting low iron markers on CBC, which was a concern by my docs. I felt fine, however. So add in iron supplements in a multi vitamin, and my CBC shows improvement in those markers as well. What was of most concern for me, as I donated blood, my BP would come down to low 120's systolic 68-70 diastolic. As my HCT and hemoglobin increased BP went up to as high as 145 systolic and 88 diastolic, prior to giving blood again. NOT GOOD. I am of the belief based on the data, that increased BP because it's everyday all day, over the longer term, is more risk and potentially more damaging than the risk of a clot, unless you have additional risk of clotting like abnormal high platelets counts. Even without the risk of a clot, long standing hypertension causes so many bad things. Heart failure often being the worst, because it leads directly to so many other problems, like increased risk of heart attacks, strokes, kidney disease, ED and more. When the data is discussed for increased risk of stroke, and clots with high HCT and Hemoglobin, it is rare to see a study that controls for the risk of high BP. So, we don't know, it seems if part the risk assigned to those markers is all high HCT and hemoglobin or contributed to significantly by high BP. And nearly all who have higher HCT and hemoglobin from T therapy will have high BP because your heart has to work harder to push thickened blood and increased blood volume thru the same amount of "piping" (your blood vessels) in your body.

As you should very well know being properly hydrated is key when it comes to testing hematocrit.

Being in a dehydrated state will skew your results.

If you are one who struggles with sides running a >52% HCT then get it under control.

Many may tend to jump the gun and donate once hematocrit gets just above 50% even if they still feel good and overall blood markers are healthy.

Definitely would not let it get too high!


post #3/10

Testosterone Therapy and erythrocytosis

Testosterone Therapy and Men’s Health – Demystifying the Hype with Science to Provide Cutting-Edge Treatment for Your Patients (2021) Summary 25:10-43:34 (Endocrine Society 2018 Guidelines) https://t4leducation.com/video/other-risks-with-testosterone-therapy-and-how-to-manage-them/

www.excelmale.com

*The clinical significance of a hematocrit >54% is unknown

*Although it is not yet clear what upper limit of hematocrit level is clinically desirable, dose adjustments may be necessary to keep hematocrit below 52–54%

 

[Deleted member 43589]

@Gman86 Thank you for that video about BP. I had a very good physician who for years said 140/80 is normal BP and especially good for a guy who was my size. He said any lower than that and I could have dizzy spells. All of the sudden it was changed from 140/80 to <120/80 and of course I am suddenly a candidate for every BP medication know to man. The mention of big pharma sure makes sense.

Hypertension

Access evidence-based guidelines for managing high blood pressure in adults, developed by the Eighth Joint National Committee (JNC-8) and endorsed by the AAFP.

www.aafp.org

I got my HCT down to 50% (was 59%)
1. stopping test cyp
2. starting TU
3. eating grapefruit
4. dumping blood

 

[Systemlord]

All of the sudden it was changed from 140/80 to <120/80 and of course I am suddenly a candidate for every BP medication know to man.

When I started taking 5 mg daily Cialis, my blood pressure dropped from 135/75 ->100/57 which occurred after only 10-12 days, suddenly I feel much better, more energy, stamina and not dizzy.

 

[Gman86]

When I started taking 5 mg daily Cialis, my blood pressure dropped from 135/75 ->100/57 which occurred after only 10-12 days, suddenly I feel much better, more energy, stamina and not dizzy.

So u felt dizzy when ur BP waa around 135/75, and the dizziness went away once u got ur BP down to around 100/57?

 

[Gman86]

@Gman86 Thank you for that video about BP. I had a very good physician who for years said 140/80 is normal BP and especially good for a guy who was my size. He said any lower than that and I could have dizzy spells. All of the sudden it was changed from 140/80 to <120/80 and of course I am suddenly a candidate for every BP medication know to man. The mention of big pharma sure makes sense.

Hypertension

Access evidence-based guidelines for managing high blood pressure in adults, developed by the Eighth Joint National Committee (JNC-8) and endorsed by the AAFP.

www.aafp.org

I got my HCT down to 50% (was 59%)
1. stopping test cyp
2. starting TU
3. eating grapefruit
4. dumping blood

Wow, that’s awesome. 9 percentage points is a huge drop, good job. I assume TU is testosterone undecanoate. So switching to a much longer ester helped drop HCT huh? How u feeling on the testosterone undecanoate compared to test cyp?

 

[Systemlord]

So u felt dizzy when ur BP waa around 135/75, and the dizziness went away once u got ur BP down to around 100/57?

No, I was never dizzy, I was saying I never felt dizzy with BP on the low end.