High HGB/HCT

[GreenMachineX]

The normal ranges depend upon the population that's being tested.

The normal ranges for the people living in the Himalayas is going to be different.

Gotcha. I still don't understand that analogy for people in the Himalayas. I hear it a lot that with H of 55 up there, no big deal. But what about the cyclists in the 90's that died from EPO? Wouldn't the risk of testosterone induced erythrocytosis function more like EPO, if there's a difference on viscosity? Asking for real.

 

[tareload]

Based on what others have said it sounds like the H&H stabilization period is longer than a month after making changes. I don't know enough to even speculate on the linearity of the process.

Fun paper from way back:

RATE OF BLOOD REGENERATION AFTER BLOOD LOSS

THE PHLEBOTOMY of the healthy donor is the simplest approach to the study of blood regeneration, since there is a controlled, known amount of blood loss and no impairment of hemopoiesis from disease. However, the measurement of blood regeneration after a single phlebotomy of 500 ml. is difficult...

jamanetwork.com

 

[GreenMachineX]

Fun paper from way back:

RATE OF BLOOD REGENERATION AFTER BLOOD LOSS

THE PHLEBOTOMY of the healthy donor is the simplest approach to the study of blood regeneration, since there is a controlled, known amount of blood loss and no impairment of hemopoiesis from disease. However, the measurement of blood regeneration after a single phlebotomy of 500 ml. is difficult...

jamanetwork.com

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So, the first couple weeks after a blood donation, in combination with a dosage drop, is the worst time to make any kind of conclusion it seems like. Blood regeneration in the following 3 weeks is enhanced and then begins to slow down, correct? Maybe another 2 weeks and see another CBC before starting any conclusions?

Obviously my suboptimal b12 levels aren't making a difference in erythrocytosis either...oddly enough.

 

[tareload]

Correct, I would not try to extrapolate a linear rate as you do below. I would go see a hematologist if you are concerned about hemochromatosis and reassess your Hb/Hct after 12 weeks. Finding out if you are heterozygous or homozygous carrier for HH may be helpful in the context of TRT.

It looks like I'm gaining 1 point in hematocrit in 2 weeks at this rate. I might just drop to 4mg while I wait for the test levels to come back. Obviously this dose is still enough to promote RBCs erythrocytosis. I'd like to get ahead of it early. I definitely don't feel hypogonadal either.

As always, minimum effective dose on the TRT especially if you are sensitive to androgens. The paper above is exaggerated as many of these subjects were bleed weekly (obviously not advisable). It is instructive nontheless.

 

[GreenMachineX]

Correct, I would not try to extrapolate a linear rate as you do below. I would go see a hematologist if you are concerned about hemochromatosis and reassess your Hb/Hct after 12 weeks. Finding out if you are heterozygous or homozygous carrier for HH may be helpful in the context of TRT.



As always, minimum effective dose on the TRT especially if you are sensitive to androgens. The paper above is exaggerated as many of these subjects were bleed weekly (obviously not advisable). It is instructive nontheless.

I've seen a hematotologist who tested me for genetic polycythemia and it was negative. All good.
But yeah, I'm looking for the minimum effective dose on this daily protocol. It's been great for all blood parameters like HDL, LDL, etc, and best blood pressure in my life, but H and H still going higher than to my liking.

 

[tareload]

FERROKINETICS IN MAN : Medicine

An abstract is unavailable. This article is available as a PDF only.

journals.lww.com

Free access.

 

[GreenMachineX]

FERROKINETICS IN MAN : Medicine

An abstract is unavailable. This article is available as a PDF only.

journals.lww.com

Free access.

This one is above my intelligence level. Can you eli5 please?

 

[tareload]

Later work:

Measurement of Red Cell Lifespan and Aging - PMC

The measurement of red blood cell (RBC) survival has a long history, and a wide variety of methods have been utilized for this purpose. Current methods are of 2 types. First, those that label a representative sample of RBCs of all ages from the ...

www.ncbi.nlm.nih.gov

Human red blood cells (RBC), after differentiating from erythroblasts in the bone marrow, are released into the blood and survive in the circulation for approximately 115 days. In humans and some other species, RBC normally survive in a nonrandom manner. This means that all of the RBC in an age cohort are removed by the reticuloendothelial system at about the same time. In practice there is considerable variation in the lifespan of human RBC. In a normal individual with a mean RBC lifespan of 115 days, this value may vary between 70 and 140 days [1, 2]. Among individuals the mean lifespan varies by approximately ±15% [1]. As discussed below, there are circumstances in which even this relatively small normal variation can be important.

Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c - PMC

Although red blood cell (RBC) life span is a known determinant of percentage hemoglobin A1c (HbA1c), its variation has been considered insufficient to affect clinical decisions in hematologically normal persons. However, an unexplained discordance ...

www.ncbi.nlm.nih.gov

 

[tareload]

This one is above my intelligence level. Can you eli5 please?

Pretty dense summary of iron transport and kinetics in the human body. Your new favorite book at bedtime?

 

[GreenMachineX]

Pretty dense summary of iron transport and kinetics in the human body. Your new favorite book at bedtime

Too much for me.

 

[GreenMachineX]

Based on what others have said it sounds like the H&H stabilization period is longer than a month after making changes. I don't know enough to even speculate on the linearity of the process.

Update: 2 weeks after blood donation and dose drop to 5mg...
Testosterone, Free 105 (35-155) pg/mL
Total Testosterone MS 414 (250-1100) ng/dL
Estradiol Ultrasensitive 15 (<29) pg/mL

Looks I'm on track with 5mg daily so far. It's been a little more than 2 weeks since I've used dhea, might add that back in at 5mg sublingual for a little more e2. Could that e2 level give me low e2 symptoms? I'm also battling a b12 deficiency which isn't helping determining what symptoms are what, and apparently after increasing b12, folate and potassium deficiencies can arise from the b12 using what's available.

Current symptoms: Anxiety is doing pretty well though, as well as sleep. Tinnitus still terrible. Muscles tighten up when using them (hard to describe, but even a jump shot in basketball had my glutes like cramp up for hours). Random muscle twitches a few times per day. Very mild night sweats (just waking up a little sweaty in middle of night, not drenched like menopause women talk about). Mood seems to be ok for the most part, but the fact I'm dealing with this and can't workout due to the muscle cramps gets to me.

 

[Cataceous]

Update: 2 weeks after blood donation and dose drop to 5mg...
Testosterone, Free 105 (35-155) pg/mL
Total Testosterone MS 414 (250-1100) ng/dL
Estradiol Ultrasensitive 15 (<29) pg/mL

Looks I'm on track with 5mg daily so far. It's been a little more than 2 weeks since I've used dhea, might add that back in at 5mg sublingual for a little more e2. Could that e2 level give me low e2 symptoms? ...

These are reasonable numbers considering that your SHBG is on the low side: mid-range free T, E2/T at 0.36% (~0.3-0.6), calculated free E2 of at least 0.45 pg/mL (~0.3-1.3). It's possible that this estradiol level is less than what's optimal for you, but it's not dangerously low. As it's only been two weeks since the dose reduction you could continue to go lower.

 

[GreenMachineX]

These are reasonable numbers considering that your SHBG is on the low side: mid-range free T, E2/T at 0.36% (~0.3-0.6), calculated free E2 of at least 0.45 pg/mL (~0.3-1.3). It's possible that this estradiol level is less than what's optimal for you, but it's not dangerously low.

Gotcha; thanks.

 

[GreenMachineX]

These are reasonable numbers considering that your SHBG is on the low side: mid-range free T, E2/T at 0.36% (~0.3-0.6), calculated free E2 of at least 0.45 pg/mL (~0.3-1.3). It's possible that this estradiol level is less than what's optimal for you, but it's not dangerously low. As it's only been two weeks since the dose reduction you could continue to go lower.

Guess my memory is struggling too as I just came on here to post those Labs up! Anyway...newest symptoms is "jelly legs". Unsure what else to call it, but muscles seem to have lost size or maybe glycogen storage and feel like jelly. Wondering if I did go too low...good thing is had some more labs drawn today though to see if any change. Still likely too early to tell if a problem since it's only a little more than 3 weeks since the dosage change. But, if my levels are even lower, should I bump back up a little to maybe 6mg, instead of letting it bottom out, so to speak?

 

[Cataceous]

Guess my memory is struggling too as I just came on here to post those Labs up! Anyway...newest symptoms is "jelly legs". Unsure what else to call it, but muscles seem to have lost size or maybe glycogen storage and feel like jelly. Wondering if I did go too low...good thing is had some more labs drawn today though to see if any change. Still likely too early to tell if a problem since it's only a little more than 3 weeks since the dosage change. But, if my levels are even lower, should I bump back up a little to maybe 6mg, instead of letting it bottom out, so to speak?

I'd say to stay the course unless free testosterone drops significantly further. How you feel during the transition may not have much bearing on how you will feel after your body has adapted to the new levels. The problem is that the adaptation can take weeks to months. This makes it mentally difficult, but if you keep tweaking the dose then you'll never really know how you would feel in the long run.

 

[GreenMachineX]

I'd say to stay the course unless free testosterone drops significantly further. How you feel during the transition may not have much bearing on how you will feel after your body has adapted to the new levels. The problem is that the adaptation can take weeks to months. This makes it mentally difficult, but if you keep tweaking the dose then you'll never really know how you would feel in the long run.

I hear ya. Thanks.

 

[GreenMachineX]

I'd say to stay the course unless free testosterone drops significantly further. How you feel during the transition may not have much bearing on how you will feel after your body has adapted to the new levels. The problem is that the adaptation can take weeks to months. This makes it mentally difficult, but if you keep tweaking the dose then you'll never really know how you would feel in the long run.

Got partial labs from Wednesday...
Testosterone 766 ng/dL (168-758)

What on earth is happening??? How could it be so much higher 10 days later, at 5mg daily? This is insane. It's not from Quest, and I don't really know the lab as it's a military base lab, but still.

 

[GreenMachineX]

@readalot
Can you take a look at all these lab values and make sense of it? I'm only testing at trough, and my levels are all over the place. How could 5mg last week be 414 ng/dL, and this week 766 ng/dL, with an even lower range?

I can't imagine how high my free T is with that total T...

 

[Systemlord]

What on earth is happening???

I reach steady state on Jatenzo in 7 days, but my Total T levels don't settle for 2 months.

 

[GreenMachineX]

I reach steady state on Jatenzo in 7 days, but my Total T levels don't settle for 2 months.

Well, roughly 6 weeks into 10mg daily I was at 550 total at trough. Then 2-3 weeks later, I was at 664 about 5 hours after injection. So, I don't know exactly where my trough was at that point, but if guess somewhere around there. That was 2 months ago. Since then, I had a month at 7mg, and then 3 weeks at 5mg. 2 weeks into 5mg, my total T was 414. Then about 10 days later, it's up to 766. For the complete picture, everything except the 766 was through quest MS or whatever with a range of 250-1100. The 766 was a different lab, range 168-758 and its not specified MS or whatever. Could it just be a huge error? I don't quite feel the same as when I was on 10mg. Definitely sleeping better, I think slower facial hair growth, less anxiety and less *negative* energy.

Other factors I've changed from the 414 would be dropping DHEA shortly before, dropping Thorne multivitamin for just using Hydroxocobalamin B12 and niacin. I've stopped telmisartan because my blood pressure was dropping too low, but blood pressure yesterday morning was still 120/78. So, now, I wonder what my hct and hgb are doing again if that's accurate. I'm hoping it was just a huge error.

I should also mention my total T on 25mg EOD was 537. 50mg twice per week was also 550 at trough. 5mg daily can't result in higher total T lol. I'm flabbergasted.