Struggling with bloodwork consistency. TRT bloodwork included.

[BeardedButcher55]

Started TRT through a clinic and I didn’t have much if any guidance on dose. Was put on 200mg Test Cyp a week and .5mg Arimidex 2x a week. I followed this for about 2 years. Bloodwork numbers were hard to follow because each doctor through the clinic basically just said “everything looks good” but when I looked at my numbers nothing looked good. I felt like starting at 200mg a week was high but found this was the dose all their patients get regardless. (Probably a bad sign). I ultimately dropped down to 160mg.

I decided paying the clinic so much wasn’t worth it so I consulted with my primary doctor who suggested I go through him as my insurance covered it. He’s not an expert but willing to listen to my concerns and work with me to be optimal for how I should be feeling as well as being safe.

Note: I feel like that I definitely convert more to estrogen and have suffered the side effects more so than others.

Current TRT protocol:

-140mg a week of Test Cyp. Single IM dose on Mondays.
-1mg Arimidex on Mondays. 1mg Arimidex or Thursday.
-No processed foods. Low carbohydrate with high fat and moderate protein from meat. High water intake. 7-8 hours of quality sleep every night.
-Blood donations as needed to maintain RBC, hematacrit, etc. Was doing double reds every 6months but switches to full donations as I can do them more often.


Bloodwork timing question: I can’t seem to get my timing right as far as when I should get my blood test.

Bloodwork timing as of the last blood test: TRT injection (140mg) on Monday early morning. Bloodwork test on Thursday early morning.



I was doing 2x a week of a split dose but injections so often was annoying. I do understand it might help level my numbers better and help with estradiol.

 

[WhiteMale]

I have low SHBG and I like my E2 number to mirror my SHBG value. You stated E symptoms and you're still bothered by whatever you're feeling so push it a little lower. I don't think your numbers or dosing is otherwise troubling, keep it simple and just push your E2 a little lower. Ideally you want to time your bloods on Monday morning for your trough and then do your injection, since you're injecting once per week.

 

[BeardedButcher55]

My symptoms are not so bad but I don’t feel amazing like I did before. Sex drive is not particularly high.

 

[Vince]

I would inject 50 mg of testosterone twice a week. And that's it, no ai. See how you feel in about 12 weeks. Also, I would donate blood at least once to keep your HCT in range

 

[BeardedButcher55]

I would inject 50 mg of testosterone twice a week. And that's it, no ai. See how you feel in about 12 weeks. Also, I would donate blood at least once to keep your HCT in range

I was thinking I could lower it and be able to drop AI. When do you suggest the bloodwork to be done as far as injection schedule

 

[Systemlord]

The AI can deceive you into thinking your estrogen is fine, when in reality, serum E2 means very little. Estrogen is converted, made in tissues (50 x higher than serum levels) which can't be measured and this it's where estrogen exerts its effects and you're blocking estrogen inside the tissues.

You can have a magneesium, or potassium deficiency and still have normal serum levels. The tissues is where the magic happens.

Also, depending on the location in the body, the brain converts estrogen at a higher rate than other areas of the body, yet you're blocking estrogen eveningly through the body.

 

[Vince]

I was thinking I could lower it and be able to drop AI. When do you suggest the bloodwork to be done as far as injection schedule

When I change my protocol, I like to wait at least 12 weeks before I get labs. That's how long it takes me to actually feel my results.

 

[madman]

Started TRT through a clinic and I didn’t have much if any guidance on dose. Was put on 200mg Test Cyp a week and .5mg Arimidex 2x a week. I followed this for about 2 years. Bloodwork numbers were hard to follow because each doctor through the clinic basically just said “everything looks good” but when I looked at my numbers nothing looked good. I felt like starting at 200mg a week was high but found this was the dose all their patients get regardless. (Probably a bad sign). I ultimately dropped down to 160mg.

I decided paying the clinic so much wasn’t worth it so I consulted with my primary doctor who suggested I go through him as my insurance covered it. He’s not an expert but willing to listen to my concerns and work with me to be optimal for how I should be feeling as well as being safe.

Note: I feel like that I definitely convert more to estrogen and have suffered the side effects more so than others.

Current TRT protocol:

-140mg a week of Test Cyp. Single IM dose on Mondays.
-1mg Arimidex on Mondays. 1mg Arimidex or Thursday.
-No processed foods. Low carbohydrate with high fat and moderate protein from meat. High water intake. 7-8 hours of quality sleep every night.
-Blood donations as needed to maintain RBC, hematacrit, etc. Was doing double reds every 6months but switches to full donations as I can do them more often.


Bloodwork timing question: I can’t seem to get my timing right as far as when I should get my blood test.

Bloodwork timing as of the last blood test: TRT injection (140mg) on Monday early morning. Bloodwork test on Thursday early morning.



I was doing 2x a week of a split dose but injections so often was annoying. I do understand it might help level my numbers better and help with estradiol.

Most are setting themselves up for failure when dealing with those dime a dozen run of the mill T clinics known for dishing out those ridiculous cookie cutter protocols high dosed T 200 mg once weekly with an AI thrown in to boot!

Jacking you up on T from the get go is a recipe for disaster!

Such dose for the majority will have your FT sky-high let alone many are still hitting a high-end/high trough FT 7 days post-injection.

Overkill here!

Throwing in the AI to manage high estradiol to boot.

Go figure!

Most men on TTh are injecting 100-200 mg whether once weekly or split into more frequent injections as in twice-weekly (every 3.5 days), M/W/F, EOD or daily.

The majority of men can easily hit a healthy let alone high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes there are those outliers who may need the higher-end dose 200 mg but it is far from common as in rare!

The clueless ones are caught up on that more T is better sheep mentality bulls**t.

Blood work should be done at the true trough (lowest point) before your next injection.

You are injecting every Monday morning so blood work needs to be done the following Monday before your next injection.

You tested at the wrong time which was 3 days post-injection but at least you have a snapshot of where your TT and more importantly FT sit earlier in the week!

As you can see 3 days post-injection you are still hitting a very high TT 1150 ng/dL and more importantly very high FT 32.1 ng/dL

Your true peak (within 24 hrs) TT/FT let alone estradiol will be even higher.

Shit kicker here is you have low SHBG and even if you had tested at the true trough (7 days) post-injection you are still going to be hitting a high-end TT and more importantly highish FT!

Imagine how much higher your TT/FT let alone at trough would have been when that clinic had you on that mickey mouse protocol of a whopping 200 mg/week.

No wonder you were struggling with elevated RBCs/hematocrit then and now,

It's a given when running a high trough let alone steady-state FT level!

Getting caught up on that donating too frequently merry go round can easily lead to carshing your iron/ferritin.

You would most likely fare much better injecting more frequently and lowering your weekly dose which would most likely allow you to drop the AI.

As Vince stated you can easily go down to 100 mgT/week split (50 mg) every 3.5 days.

Chances are you will still end up hitting a good trough FT.

Regardless there will always be time to increase your dose slightly or inject more frequently if need be.

As we preach on here it is always best to start low and go slow on a T only protocol.

Much easier going up than coming down trust me on this one.

Patience is key.

Lots of time to increase the dose down the road if need be let alone throw in hCG!

 

[madman]

When I change my protocol, I like to wait at least 12 weeks before I get labs. That's how long it takes me to actually feel my results.

Good advice but labs should still be done at the 6 week mark after starting TTh or tweaking a protocol (increasing/decreasing dose of T or manipulating injection frequency) so we can see where said protocol (dose of T/injection frequency) has your trough TT and more importantly FT, estradiol and SHBG.

Even then the first 6 weeks means nothing when looking at the big picture here as we very well know when starting TTh or tweaking a protocol (dose of T/injection frequency) hormones will be in flux during the weeks leading up until blood levels have stabilized (4-6 weeks TC/TE) and it is common for one to experience ups/downs during the transition as the body is trying too adjust.

What is even more critical here is once blood levels have stabilized it will still take a few more months for the body to adapt to it's new set-point and this is the period where one needs to gauge how they truly fell overall regarding relief/improvement of low-t symptoms and overall well being.

Every protocol needs to be given 12 weeks before claiming whether it was a success or failure.

The ones who tend to have a really bumpy ride are the men overmedicated on T from the get-go as the transition can be rough when lowering your dose as the body has been amped up on T !

Many bail out quick claiming that they do not feel well!

For some it can take many months for the body to adapt to lower/more sensible FT levels!

Many especially the ones hanging out on those so called HRT/men's health forums are overmedicated on T 24 f**king 7!

 

[BeardedButcher55]

Most are setting themselves up for failure when dealing with those dime a dozen run of the mill T clinics known for dishing out those ridiculous cookie cutter protocols high dosed T 200 mg once weekly with an AI thrown in to boot!

Jacking you up on T from the get go is a recipe for disaster!

Such dose for the majority will have your FT sky-high let alone many are still hitting a high-end/high trough FT 7 days post-injection.

Overkill here!

Throwing in the AI to manage high estradiol to boot.

Go figure!

Most men on TTh are injecting 100-200 mg whether once weekly or split into more frequent injections as in twice-weekly (every 3.5 days), M/W/F, EOD or daily.

The majority of men can easily hit a healthy let alone high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes there are those outliers who may need the higher-end dose 200 mg but it is far from common as in rare!

The clueless ones are caught up on that more T is better sheep mentality bulls**t.

Blood work should be done at the true trough (lowest point) before your next injection.

You are injecting every Monday morning so blood work needs to be done the following Monday before your next injection.

You tested at the wrong time which was 3 days post-injection but at least you have a snapshot of where your TT and more importantly FT sit earlier in the week!

As you can see 3 days post-injection you are still hitting a very high TT 1150 ng/dL and more importantly very high FT 32.1 ng/dL

Your true peak (within 24 hrs) TT/FT let alone estradiol will be even higher.

Shit kicker here is you have low SHBG and even if you had tested at the true trough (7 days) post-injection you are still going to be hitting a high-end TT and more importantly highish FT!

Imagine how much higher your TT/FT let alone at trough would have been when that clinic had you on that mickey mouse protocol of a whopping 200 mg/week.

No wonder you were struggling with elevated RBCs/hematocrit then and now,

It's a given when running a high trough let alone steady-state FT level!

Getting caught up on that donating too frequently merry go round can easily lead to carshing your iron/ferritin.

You would most likely fare much better injecting more frequently and lowering your weekly dose which would most likely allow you to drop the AI.

As Vince stated you can easily go down to 100 mgT/week split (50 mg) every 3.5 days.

Chances are you will still end up hitting a good trough FT.

Regardless there will always be time to increase your dose slightly or inject more frequently if need be.

As we preach on here it is always best to start low and go slow on a T only protocol.

Much easier going up than coming down trust me on this one.

Patience is key.

Lots of time to increase the dose down the road if need be let alone throw in hCG!

Thank you. Great info. I’ll give 100 mg a try and redo a blood test after 12 weeks with 2x a week protocol of 50mg 2x a week. I’ll drop the AI and see how I do.

I’m guessing I should still do blood donations till I get my red blood cell count down ?

 

[madman]

Thank you. Great info. I’ll give 100 mg a try and redo a blood test after 12 weeks with 2x a week protocol of 50mg 2x a week. I’ll drop the AI and see how I do.

I’m guessing I should still do blood donations till I get my red blood cell count down ?

If you have no underlying health issues are are not experiencing any negative sides then I see no issue with having a hematocrit 52%.

Keep in mind lowering your FT will bring down your hematocrit over time.

No need to donate but do what you feel is best for you!




Look over my reply in this post!

Post in thread 'High Testosterone on only 80mg/week'

Jun 22, 2024

Based on the comments you made here about a hematocrit of below 54 being safe are you willing to stand liable for giving out this false information if the OP has a stroke or heart attack?

Also please enlighten us on where you attended medical school and where you got your degree in endocrinology?

If you are having to give blood to reduce the hematocrit, you are not on "TRT" you are taking a small steroid cycle and calling it TRT.

As for my advice to the poster, I know personally of two people I have given similar advice to, both had strokes under the age of fifty. One with a...

• madman

• 

Again if one has no underlying health issues and is not experiencing any negative sides most in the know specializing in testosterone therapy would not fret if the patient's hematocrit falls within 50-54%.

Yes some will be more cautious and take measures once hematocrit hits 52%.

Most of the endos are sticklers and hesitate once your hematocrit gets over the top end and prefer to keep patients levels no higher than 50%.

 

[BeardedButcher55]

Well gentlemen, this is eye opening. If I can get away with 100mg a week with no AI I’ll be happy as hell.

Plus having such a low volume of oil I could do Subq injections 2x a week too. If not, I’m fine doing IM if that’s best. I just figured if I’m only injecting 50mg (.25cc) subq could also help keep my levels more stable.

Sounds like this could be a win win for me. Lower estrogen, lower hematocrit, lower BP (even though mine is decent), likely not have to donate blood / blood dump. Feel better as I won’t have such high ups and downs.

Looking forward to this!

 

[BeardedButcher55]

Most are setting themselves up for failure when dealing with those dime a dozen run of the mill T clinics known for dishing out those ridiculous cookie cutter protocols high dosed T 200 mg once weekly with an AI thrown in to boot!

Jacking you up on T from the get go is a recipe for disaster!

Such dose for the majority will have your FT sky-high let alone many are still hitting a high-end/high trough FT 7 days post-injection.

Overkill here!

Throwing in the AI to manage high estradiol to boot.

Go figure!

Most men on TTh are injecting 100-200 mg whether once weekly or split into more frequent injections as in twice-weekly (every 3.5 days), M/W/F, EOD or daily.

The majority of men can easily hit a healthy let alone high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes there are those outliers who may need the higher-end dose 200 mg but it is far from common as in rare!

The clueless ones are caught up on that more T is better sheep mentality bulls**t.

Blood work should be done at the true trough (lowest point) before your next injection.

You are injecting every Monday morning so blood work needs to be done the following Monday before your next injection.

You tested at the wrong time which was 3 days post-injection but at least you have a snapshot of where your TT and more importantly FT sit earlier in the week!

As you can see 3 days post-injection you are still hitting a very high TT 1150 ng/dL and more importantly very high FT 32.1 ng/dL

Your true peak (within 24 hrs) TT/FT let alone estradiol will be even higher.

Shit kicker here is you have low SHBG and even if you had tested at the true trough (7 days) post-injection you are still going to be hitting a high-end TT and more importantly highish FT!

Imagine how much higher your TT/FT let alone at trough would have been when that clinic had you on that mickey mouse protocol of a whopping 200 mg/week.

No wonder you were struggling with elevated RBCs/hematocrit then and now,

It's a given when running a high trough let alone steady-state FT level!

Getting caught up on that donating too frequently merry go round can easily lead to carshing your iron/ferritin.

You would most likely fare much better injecting more frequently and lowering your weekly dose which would most likely allow you to drop the AI.

As Vince stated you can easily go down to 100 mgT/week split (50 mg) every 3.5 days.

Chances are you will still end up hitting a good trough FT.

Regardless there will always be time to increase your dose slightly or inject more frequently if need be.

As we preach on here it is always best to start low and go slow on a T only protocol.

Much easier going up than coming down trust me on this one.

Patience is key.

Lots of time to increase the dose down the road if need be let alone throw in hCG!

As far as HCG. What protocol do you guys recommend? I’m hoping I can go through insurance for it if my doctor says yes.

For now I’ll just stick with the testosterone only but I would like to see how the igf-1 helps after my testosterone is in a good place months down the road. Just planning ahead.

 

[Systemlord]

I’m hoping I can go through insurance for it if my doctor says yes.

Many insurance providers don't cover (hCG) fertility treatments.

 

[BeardedButcher55]

Any suggestions on the easiest way to load a slin pin for sub q? I’m not a fan of poking the bottle then my skin.