I’ve been on TRT since december last year. Started of with 165mg testosterone enanthate + 500iu of HCG a week, split into 2 doses. After getting bloodwork done and seeing high HCT levels, I’ve lowered my dose to 125mg, and increased the frequency to 3 times a week.
However - to my shock, my hematocrit increased from 59 to 64, and my testosterone also didn’t lower - even increased a little bit. And this is about 2 weeks after I’ve donated 500ml of my blood!
I am now starting to dose 100mg per week, injecting a small amount (maybe start SQ instead of IM?) every other day in hopes to bring my HCT down finally. I really don’t want to quit TRT, it has dramatically improved my life quality, energy, motivation + libido. I have no idea why this is happening.
I’ve included both blood work lab results (only added ferritin the second time), and converted some european units to the american standards for good measure.
It’s part of the package. You may level off over time but blood donation semi-regularly can help too.
I personally donate once per quarter, up from 2x per year. It was a pain at first but after reading the health benefits of blood donation itself it’s actually something I would do now regardless.
The place where I donate updates you when your blood is used. No specifics but they’ll ping you that “your blood was used to save a life today at xyz hospital” and it’s cool to see too.
I know this isn’t the answer you’re looking for but if you’re going to drop TRT and the benefits it provides over donation, reframing may be something to consider.
Thanks for your reply. I think you may have misunderstood me – I already donate blood, and I have no intention of stopping TRT. The point I was trying to make is that my hematocrit rose even after my blood donation.
You need one of the three new oral testosterone formulations, Jatenzo, Orlando or Kyzatrex. These testosterone formulations only caused erythrocytosis in a very small minority of men in the clinical trials.
The PK profiles are similar to topical treatments, which don’t affect red blood cells to the same degree as injections which affects red blood cells more than any other delivery method!
The ways to determine a person sensitivity to androgens, a substantial increase in red blood cells from baseline, in the absence of an underlining conditions, such a sleep apnea, these men would do better to lower their dose to a below average dosage of 50-70 mg per week.
Ferritin levels under 100 show increase life expectancy. Excess iron is highly toxic to the body! Life expectancy decreases as the ferritin levels increase beyond 100, and in fact at 500 your life expectancy is 50 to 60 years.
Lots of people travel to to the United States to get the better treatment options. It all depends on how far you’re willing to go to get the best treatment option. Since you don’t reside in the US, you can get a larger supply of medicine.
It’s going to continue to do so. You’re treating the symptom with donations, not the cause (TRT). It’s just part of the ride that needs to be managed, but may level off or slow down in time.
I have not tried the options Systemlord mentioned myself, but maybe a viable alternative.
But wait, why would it continue to do so? It doesn’t make sense that it keeps on rising after lowering my dose, increasing the frequency and donating blood…right? Literally everywhere people are saying those are the things that should help.
You’re leaving out another variable, you went from injecting twice per week to three times per week and lowering the dose, as opposed to just lowering the dose.
So now, if you lower the dose, the hemoglobin and hematocrit will go down.
I think you should go back to twice per week injections and just lower the dose because three times per week really shot up your hematocrit without a dosage increase, showing you that more shot frequency was a mistake!
You’ll have an easier time on twice per week injections managing hematocrit and lowering the dose then you will injecting three times per week and lowering the dose.
I have zero medical chops but my theory is that TRT, regardless of dose, maintains an overall higher steady state of testosterone vs natural ebbs and flows, and this throws off feedback mechanisms. Just like therapeutic doses can alter estradiol in many. Lowering dose to negate the higher circulating levels falls in line as a correlation, but it also negates the purpose to begin with.
I have tried to search for other examples but I have not found any, so before I alter my protocol accordingly…do you know of any other person where they increased frequency and their HCT shot up?
The one protocol that sees the highest red blood cell count is 200 mg every two weeks which hormone levels fluctuate wildly. Sadly this is the standard of care for TRT in 2024!
Newer studies show lower ferritin is preferred and is linked to data of people regularly donating blood versus people with higher end ferritin.
My ferritin is somewhere in the 30 to 40 range on TRT and I feel amazing! Ferritin over 50 dehydrates me and I started gaining muscle mass and muscle tone in two weeks when ferritin drop below this level.
My weight has increase in these two weeks since my last phlebotomy.
