Guys...
Just got test results back.
My iron saturation and ferritin are low.
My red blood cell count, hemoglobin and hematocrit are high
See attached screenshots.
I'm taking 18mg daily (.09mL) of testosterone cypionate due to low SHBG.
My DHEA is also low.
I do smoke cigarettes. Yes I'm an asshole.
Taking 10mg of Cialis daily and still have random ED problems of weak erections which were better for a while when I lowered my cypionate dosage.
Any thoughts how to handle?
Need to post labs that include TT, FT, and estradiol before jumping to any conclusions.
Even though you are only injecting 18 mg T daily (126 mg/week) seeing as you have low SHBG your FT level may still be too high!
Again the only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).
As you should very well know from being on the forum long enough:
When using exogenous T RBCs/hemoglobin/hematocrit will increase within the 1st month and can take up to 9-12 months to reach peak levels.
T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).
Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.
Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.
3–18% with transdermal administration and up to 44% with injection.
In most cases when using injectable T
high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.
Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.
As again running very high TT/FT levels will have a stronger impact on driving up HCT.
Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that
the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.
Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.
How high an FT level you are running is critical.
It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.
Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.
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.
Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.
Mind you some are lucky and never have an issue or levels tend to stabilize over time.
Others will continue to struggle until the cows come home.
Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!
