Second time on TRT lots of questions?

Pharma
1

So I was put on Xyosted the end of 2021 after having low T between 160’s to 240’s. The Urologist started me with 75mg using Xyosted injector. I still felt like shit after 2 months and he increased me to 100mg a week.

I was feeling better and lost weight but after 9 months I developed very high BP and my cardiologist told me to stop the TRT. The urologist agreed but also said he felt once I had my BP under control it would benefit me. Fast forward to 6 weeks ago and the urologist put me back on TRT using the Xyosted samples he had at the office while I waited on getting approval from insurance to put me on testcypionate. I got the test and needles from a compounding pharmacy on Wed. I call the Dr’s office the next day because the label says 200mg once every 2 weeks. First this is counter to our previous conversations of trying to keep my T levels as level as possible and this would raise my levels significantly right after and probably have lower lows 2 weeks later. There also was no instructions on how and where to inject myself. Instead of setting an appointment to show me I get a call from the Pharmacy! I tell them I am not sure why they are calling and I expected the Dr. should have answered my questions ideally face to face. I am a little miffed because this seems like a recipe for disaster based upon the fact I had a widow maker heart attack at 43 just months after winning the Brazilian Jiu Jitsu No Gi Pan Ams and then how my body reacted to the test the last time I was on it.

I have since found instructions from some wellness clinic on where to inject myself IM. I think I am better off doing it at the least 1x a week vs the prescribed 1x every 2 weeks and probably even better to do it 2x a week. Does this make sense and is it safe to give myself an IM shot 2x a week since the Dr hasn’t called back since I spoke to the pharmacy on Thursday. I am thinking I rotate between my left and right shoulders and butt cheeks to minimize the scar tissue? I also got my first blood test results today since being back on TRT 6 weeks ago. I went from 223 to 461. He didn’t have my free testosterone measured. I am now over the high end of normal on hematocrit going from 48 to 53.2 and RBC from 5.72 to 5.91.

Thanks in advance!

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This is not a problem if blood pressure are under control and there are no negative symptoms. People with comorbid conditions (heart disease) may have problems with thicker blood.

With a secondary erythrocytosis there is an increase in blood volume which enlarges the vascular bed, decreases peripheral resistance and increases cardiac output. Therefore, in a secondary erythrocytosis optimal oxygen transport with increased blood volume occurs at a higher hematocrit value than with a normal blood volume. A moderate increase in hematocrit may be beneficial despite the increased viscosity.

There are over 80 million people that live higher than 2,500 meters and they develop a secondary erythrocytosis. Men in parts of Bolivia for instance have a normal range of HCT from 45-61%. These men are not at an increased risk of thrombotic events nor do they have to undergo phlebotomies to manage their hematocrit.

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