Lowering E2 and HCT - Reduce dose or increase frequency?

[S1W]

A bit of a hypothetical question here, but something I've been curious about. Supposing someone with relatively normal SHBG (mid 20s-mid 30s) is on a T. Cyp. E3.5D injection protocol and has slightly elevated E2 and HCT. TT/FT slightly above range at trough.

For this example, let's say they use 120mg/week (60mg E3.5D).

Which change would likely give better results?

1. Continue E3.5D injections and lower dose to 112mg/week (56mg E3.5D) or 108mg/week (54mg E3.5D).

2. Keep current total weekly dose of 120mg and inject EOD.

I know the short answer is lower dose AND inject more frequently, but I'm interested in hearing if any of you have any experience/insight into tweaking injection frequency vs simply lowering the overall dose.

Thanks!

 

[Vince]

I went straight from twice a week injections to dailies. I felt good before I went to daily injections and still feel good. Once I did go to daily, I didn't have to donate blood any longer. My HCT stabilized, it now stays around 48. I don't know if my HCT stabilized because of longevity or daily injections.

I've never had any estrogen issues and never needed to use an AI. Estradiol, Sensitive 28.5 range 8.0 - 35.0

My current protocol is 18 mg of testosterone cypionate daily and 500 IU of HCG twice a week.

 

[Vince Carter]

I would only reduce the dose I don't see the need for EOD; 112mg. Controlling one or both with this strategy is a rather long shot, worth exploring but with low expectations. I don't see too much need to reduce dosing that puts a guy under the lab range in FT at the trough. But astronomically over the FT lab range is a more likely cause of some of these more common negative sides.

 

[Pringle]

I would only reduce the dose I don't see the need for EOD; 112mg. Controlling one or both with this strategy is a rather long shot, worth exploring but with low expectations. I don't see too much need to reduce dosing that puts a guy under the lab range in FT at the trough. But astronomically over the FT lab range is a more likely cause of some of these more common negative sides.

Agree with this^.....I hoped to lower both with the higher injection frequency. I was able to lower E2, but my HCT still behaved the same way and I had to continue frequent phlebotomy regardless of weekly, E3.5D, or my daily shot protocols. I have been on trt about 2.5 years now and my HCT has yet to stabilize regardless of shot protocol. I am currently monitoring my Free T more closely using the TruT calculator to adjust my dosing to achieve Free T levels at top of range, not over. It Will be interesting to see if this helps with the high HCT.
TruT Free Testosterone Calculator by FPT

 

[bigbobrocks]

Agree with this^.....I hoped to lower both with the higher injection frequency. I was able to lower E2, but my HCT still behaved the same way and I had to continue frequent phlebotomy regardless of weekly, E3.5D, or my daily shot protocols. I have been on trt about 2.5 years now and my HCT has yet to stabilize regardless of shot protocol. I am currently monitoring my Free T more closely using the TruT calculator to adjust my dosing to achieve Free T levels at top of range, not over. It Will be interesting to see if this helps with the high HCT.
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Why not just leave the hct? Hasn't it been proven to be fine now? My doc showed me a study that basically said people mix up two types of conditions to do with high hct and that TRT does not require giving blood frequently.
I can find the study and/or info if you want.

 

[S1W]

Why not just leave the hct? Hasn't it been proven to be fine now? My doc showed me a study that basically said people mix up two types of conditions to do with high hct and that TRT does not require giving blood frequently.
I can find the study and/or info if you want.

I've seen that info. Nothing has been definitively "proven". With some searching on this site, you can also find Dr. Saya's stance on it. This thread is a good place to start:

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I am in the Dr. Saya camp on this one. Sure, if your HCT is high and your BP is spot on perfect, then perhaps no cause for alarm. But if BP is elevated as a result and left unchecked, I believe that will likely result in health problems long-term.

Also from a more practical standpoint, I am not willing to donate blood regularly for the rest of my life. My doctor simply will not refill my rx with HCT above a certain threshold.

 

[Pringle]

Why not just leave the hct? Hasn't it been proven to be fine now? My doc showed me a study that basically said people mix up two types of conditions to do with high hct and that TRT does not require giving blood frequently.
I can find the study and/or info if you want.

I too am a defy patient and side with the doc on this one. I have HBP, a coronary calcium score That shows some early stages of build up, and atherosclerosis is Hereditary in the family. Markers that I am not willing to add additional risk with such little research available.

 

[Vince]

Agree with this^.....I hoped to lower both with the higher injection frequency. I was able to lower E2, but my HCT still behaved the same way and I had to continue frequent phlebotomy regardless of weekly, E3.5D, or my daily shot protocols. I have been on trt about 2.5 years now and my HCT has yet to stabilize regardless of shot protocol. I am currently monitoring my Free T more closely using the TruT calculator to adjust my dosing to achieve Free T levels at top of range, not over. It Will be interesting to see if this helps with the high HCT.
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I copied your free testosterone calculator and started a new thread with it. Just in case other members want to use it.

 

[Gman86]

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Here’s a quick clip about HCT from a TOT doctor’s roundtable the other day.