How long have you been on TTh?
Where did your hematocrit sit pre-TTh?
Keep in mind 160 mg T once weekly is still a fairly high weekly dose.
Most men on TTh are injecting 100-200 mg T/week whether once weekly or split into more frequent injections as in twice-weekly (every 3.5 days), M/W/F, EOD or daily.
Even then most men can easily hit a healthy let alone high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.
As I have stated numerous times on the forum over the years yes there are some outliers who may need the high-end dose 200 mg T/week but it is far from common as in RARE!
Such dose would be OVERKILL for the MAJORITY!
Common starting dose is 100 mg T/week or better yet 50 mg every 3.5 days.
Starting low and going slow on a T-only protocol would be the most sensible move as we want to see how your body reacts to testosterone and where said protocol (dose of T/injection frequency) has your trough TT and more importantly FT, estradiol let alone critical blood markers RBCs, hemoglobin and hematocrit.
There will always be time to increase the dose or throw in hCG if need be!
Much harder coming down than going up trust me on this one.
Also keep in mind that running too high a trough/steady-state FT can be just as bad in many ways as running too low a FT especially when it comes to libido, erectile function and mood!
You are hammering the shit out of your dopamine when running too high a trough/steady-state FT level.
Unfortunately many men are overmedicated from the get-go.
Some may feel great at first only to be let down months in!
On your current dose 160 mg T/week with hCG thrown in to boot you are hitting a high-end trough TT 886 ng/dL which means that your trough FT will most likely be high unless you have highoish/high SHBG and even than if such was the case your trough FT would still be healthy.
Shitkicker here is seeing as your lab results were at the true trough (7 days) post-injection your peak TT and more importantly FT let alone estradiol will be sky high.
Even than we have no idea where your trough FT level truly sits as you never had it tested but chances are it is high seeing as your hematocrit 57% is through the roof.
If you were well hydrated (fluids/electrolytes) before getting labs done and are truly hitting 57% than you most likely had higher-end hematocrit pre-TTh let alone your trough FT is most likely too high!
Do understand that increasing your TT will drive up your FT, estradiol and hematocrit.
54% is the cutoff and you are over that so in order to bring it down not only will you need to lower your weekly dose of T to bring down your trough FT but chances are you may need to address any underlying issues which may also be contributing
If anything you need to find out where your most important blood marker free testosterone truly sits and in order to know such you would need to have it tested using what would be considered the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.
You can easily pay out of pocket and use Nelson's
DiscountedLabs.com to test your TT and more importantly FT using the most accurate assays (LC-MS/MS-ED).
$48.83
If you do not have access to such (highly doubtful) if you reside in the US than you would need to use/rely upon the calculated linear law-of-mass action Vermeulen (cFTV).
You would need to know where your SHBG and Albumin sit in order to calculate your FT mind you one can use the default Albumin 4.3g/dL.
Look over the threads in post #6
FIGURE 2 Management of erythrocytosis (Source: adapted from BSH guidelines 2019).6
Abstract
An absolute erythrocytosis is present when the red cell mass is greater than 125% of the predicted. This is suspected when the hemoglobin or hematocrit is above the normal range. An erythrocytosis can be classified as primary or secondary and congenital or acquired. The commonest primary acquired disorder is polycythemia vera. The diagnostic criteria for PV have evolved over time and this is the main diagnosis managed in hematology clinics. There...
Especially this one!
Introduction Androgens play a crucial role in the development and maintenance of: Male reproductive and sexual functions Body composition Erythropoiesis
www.thebloodproject.com
Introduction
- Androgens play a crucial role in the development and maintenance of:
- Male reproductive and sexual functions
- Body composition
- Erythropoiesis
- Muscle and bone health
- Cognitive function
- Testosterone falls progressively with age and a significant percentage of men over the age of 60 years have serum testosterone levels that are below the lower limits of young...
