First labs after 2.5 months on TRT

[gon3r]

Hey everyone,

So I've been on 200mg/wk (100mg twice a week) for 2.5 months. Part of the starting protocol also has me on .25mg of Anastrazul 3x week.

So far all my previous symptoms are solved for. Only side effect of TRT is an elevated blood pressure sporadically throughout the day. I'll wake in the morning to 100/55, but later in the day it will sometimes go as high as 155/106. I've been monitoring it a few times a day and there is no direct pattern that I can identify for the elevated BP.

I spoke with Endo about the results below and we currently feel the elevated BP is due to elevated Hematrocrit and Hemoglobin levels. Current plan is to lower dose down to 150mg/wk (taken once a week) and re-check in 10 weeks. He also advised I could give blood if I so chose. Of course that will skew the results if the labs come back lower in 10 weeks for H&H levels (was it the lower dose or the blood donation). He also advised I stop Anastrazal and DHEA supplement.

I wanted to hear your feedback as I value your opinions and you have all helped me so much to this point.

Thanks!

[SEOINAGE]

I don't think I would want to lower my dose, I don't know when the test was taken but those test and free test numbers are pretty dang nice.

[bass]

you need to donate as often as they allow, it should be part of TRT. don't wait too long, if your hemoglobin gets too high blood drives will reject you then you have to get a script for blood letting. its normal for BP to go higher toward the end of the day, but yours is a tad high. take a baby aspirin every night until you give blood, it might help with BP.

[kelkel]

Exactly what Bass said. Make giving blood a habit. Don't do it the day before your BW is done but do it. It's a healthy thing to do for you and society. Drink more water along with the aspirin too. Why would you stop the anastrazole? So the doc can watch your E level rise and T subsequently fall? Makes no sense to me. Is that a sensitive assay for your estrogen? If not it's useless. And start supplementing with vit D3. It will lower your shbg which in turn will raise your free T level. Most people are low.

Welcome to the forum! Stick around and learn. You'll like this place.

[gon3r]

SEOINAGE - Blood work was done the the morning I was due for my next shot (I shoot 2x/week and had blood drawn just before injecting). I hear you on the T numbers being where I want them, but in my mind it isn't worth the elevated blood pressure as that can kill me if I'm looking to be on TRT for the rest of my life (only 33yrs old now).

Bass - thanks, I'm going to look into this. I just now got to the point where I don't pass out for blood work. The thought of donating kills me, but I'll get used to it as well. How long is the donating session?

Kelkel - The endo said they rarely put people on Anastrazal unless they are showing signs of gyno. I'm currently taking 50,000IU of D per week.

I'm just trying to find out the most healthy combination here as my pre-T symptoms are all gone not that I'm injecting, but I have this elevated blood pressure and high Hemocratit and Hemoglobin that I need to get sorted.

[steroid.com 1]

Your DHEA-S level is ideal so why stop supplementation?

Follow this below link and see the work presented by Dr. Neil Rouzier at a recent A4M TRT conference on DHEA and see what he presented at optimal DHEA-S serum levels...you are right there!

http://forums.steroid.com/showthread...ou+should+know

More and more TRT Doc's want to see men's DHEA-S levels near 600 for all the reasons listed here.

You might want to forward this to your Doc and reconsider.

BTW, E2 at 44 pg/ml would be too high for me personally...keep an eye on it as it's out of the ideal range recommended by many.

[EZ E]

Agree with everyone here, the blood work looks good but E2 could be a bit lower. Might want to try Anastrozole at .25 4x/week but definitely don't drop it or lower the dose.

[gon3r]

EZ E - You think my hematocrit and hemoglobin numbers look good? What about my high blood pressure?

[EZ E]

I was referring to the numbers that are mainly affected by your current protocol, no need to bust my balls. Your hematocrit is going to be high on just about any TRT dosage, give blood-already been covered. Your blood pressure has more to do with genetics, diet, etc.. than your TRT dosage imo.

[gon3r]

Sorry, came across wrong. I wasn't busting your balls at all, just asking if you'd be worried if those were your numbers.

Thanks for the help EZ E and to everyone else as well. I made an appt to donate Whole Blood in the morning.

[LevMyshkin]

They started you 200 mg/week? Dang! I started at 100 mg/week and they slowly brought me up in 10 mg increments until my resting test level was where they wanted it after 5 weeks. (I.e., up me to 110 mg for five weeks, redraw, evaluate, up me to 120 for five weeks, redraw, evaluate, etc.) Even now, I'm only at 140 mg/week and one week post-shot I'm sitting around 440 total test. If you're over 800, your test level is spiking WAY high 36-48 hours post-shot.

If your doc is suggesting dropping you to 150 mg/week, but you don't want to lower your dose, you might ask him if you can just have a 100 mg shot twice per week. That'd at least even out the roller coaster of your testosterone spikes and valleys. Personally, though, I think they might have started you on too high a dosage. A resting 800+ test level is necessarily bad, but remember that your spikes are going well above that.

[Technologist]

Hey everyone,

So I've been on 200mg/wk (100mg twice a week) for 2.5 months. Part of the starting protocol also has me on .25mg of Anastrazul 3x week.

So far all my previous symptoms are solved for. Only side effect of TRT is an elevated blood pressure sporadically throughout the day. I'll wake in the morning to 100/55, but later in the day it will sometimes go as high as 155/106. I've been monitoring it a few times a day and there is no direct pattern that I can identify for the elevated BP.

I spoke with Endo about the results below and we currently feel the elevated BP is due to elevated Hematrocrit and Hemoglobin levels. Current plan is to lower dose down to 150mg/wk (taken once a week) and re-check in 10 weeks. He also advised I could give blood if I so chose. Of course that will skew the results if the labs come back lower in 10 weeks for H&H levels (was it the lower dose or the blood donation). He also advised I stop Anastrazal and DHEA supplement.

I wanted to hear your feedback as I value your opinions and you have all helped me so much to this point.

Thanks!

Donate blood ASAP! Blood thickness changes from linear to exponential once Hematocrit and Hemoglobin climb too high. Your blood pressure change is a strong indicator. Slight dehydration could end up killing you if you're levels get any higher.

Realistically you'll only knock your Hemoglobin down about 1 point per pint of blood and because it will rise between donations you're going to need to donate at least 2-3 times to get your levels normal. For me I drop about 5-6% per donation on Hematocrit and Hemoglobin per 500ml of blood but I'm 268 pounds.

With Hematocrit and Hemoglobin climbing that fast after 2.5 months you're going to need to donate blood at least once a month. Red Cross every 8 weeks and find a private hospital that needs donations. Just don't mention one to the other or the Test use and space them out at least 10-14 days so they cant see the needle mark from the blood draw. Once you get past >18 on the hemoglobin many hospitals won't take your blood. Blood pressure is usually higher in the morning. You're 106 diastolic pressure is above the cut off of 100 to donate. Take an aspirin a day for now but hold off for two days before donation. The aspirin will help prevent a heart attack or stroke and may help your blood pressure stay lower. Stay hydrated and drink extra water for now! Also you might be getting brain fog as the capillaries in your brain are very tight with almost no holes and thick blood will diminish Cognitive function. Actually brain fog and high blood pressure are two very common first symptoms of elevated Hematocrit and Hemoglobin levels.

Also you can take Glycerol/glycerin to dilute your blood. It might help drop your blood pressure. Glycerol is marketed as a dietary aid for "hyperhydrating" the body by increasing blood volume and helping to delay dehydration. It will also allow you to hopefully sneak past the blood pressure cuff test without going over 100. The half life of aspirin is just hours but aspirin irreversibly disrupts platelet function by inhibiting cyclooxygenase-1 (COX1), and hence normal hemostasis. The resulting platelets are unable to produce new cyclooxygenase because they have no DNA. Normal platelet function will not return until the use of aspirin has ceased and enough of the affected platelets have been replaced by new ones, which can take over a week. In effect, the aspirin helps keep your blood flowing properly even days after taking it.

If the nurse is ill trained like >80% of them and all red crosses have improper table/chair heights. She will not know how to properly use a Sphygmomanometer. If you're tall and have a long torso your readings will probably be 10-15 points high as she will set your arm low on the table while your heart could be 9" above that. Think about it. Is your heart behind your Sternum or is it in your stomach? If your arm is below your heart the readings will be high.



Quote about high Hematocrit and Hemoglobin:

"Although much of the clinical and public health focus has been on anemia or the low end of the hemoglobin distribution, there are also problems at the high end. The most notable consequence is increased blood viscosity. The relation between hemoglobin and blood viscosity is linear when the hematocrit is <0.50 (equivalent to a hemoglobin value of 160 g/L). Above this hemoglobin concentration, the relation becomes exponential—a small increase in hemoglobin or hematocrit results in a large increase in viscosity (18). Once hemoglobin concentrations reach ≥ 180 g/L, the blood viscosity reaches a level that impairs microcirculation and an inadequate amount of oxygen is transported to tissues, similar to the situation with severe anemia. This is often manifested as peripheral cyanosis and impaired mental function resulting from compromised cerebral blood circulation (21). Additionally, because of the poor blood flow, the risk of thromboembolism increases substantially (21). A study of individuals with chronic mountain sickness (or polycythemia), which is due to a combination of high altitude residency and poor pulmonary function, showed that long-term survival with a hemoglobin >200 g/L is not possible (21)."

[Technologist]

I double checked your blood tests. Don't stop the Anastrozole but stop the DHEA and avoid any iron supplements.

Most likely if you stay as 200mg per week you'll be forced to donate blood or do a phlebotomy every 2-4 weeks (for life) just to keep your Hematrocrit and Hemoglobin levels in check. At 150mg's per week you might get by on once every month or even every 8 weeks.

[steroid.com 1]

I double checked your blood tests. Don't stop the Anastrozole but stop the DHEA and avoid any iron supplements.

Most likely if you stay as 200mg per week you'll be forced to donate blood or do a phlebotomy every 2-4 weeks (for life) just to keep your Hematrocrit and Hemoglobin levels in check. At 150mg's per week you might get by on once every month or even every 8 weeks.

^^^^Are you a licensed Physician?

[gon3r]

Went today to donate blood and they said my hematocrit is now at 61, up from the 53 it was at when tested two weeks back. BP was fine at 130/76, but they wouldn't let me donate due to high hematocrit.

I went back to Endo to get a prescrip for 'therapeutic phlebotomy'. Hopefully I'll be able to go in tomorrow and get started as I'm starting to get real nervous this TRT is starting to do some damage.

[rob30023]

Hey everyone,

So I've been on 200mg/wk (100mg twice a week) for 2.5 months. Part of the starting protocol also has me on .25mg of Anastrazul 3x week.

So far all my previous symptoms are solved for. Only side effect of TRT is an elevated blood pressure sporadically throughout the day. I'll wake in the morning to 100/55, but later in the day it will sometimes go as high as 155/106. I've been monitoring it a few times a day and there is no direct pattern that I can identify for the elevated BP.

I spoke with Endo about the results below and we currently feel the elevated BP is due to elevated Hematrocrit and Hemoglobin levels. Current plan is to lower dose down to 150mg/wk (taken once a week) and re-check in 10 weeks. He also advised I could give blood if I so chose. Of course that will skew the results if the labs come back lower in 10 weeks for H&H levels (was it the lower dose or the blood donation). He also advised I stop Anastrazal and DHEA supplement.

I wanted to hear your feedback as I value your opinions and you have all helped me so much to this point.

Thanks!

I have had the same issue with BP going up/down, and also had high hemoglobin levels. Has the donations helped. I was given that advice but have not done so yet.

[gon3r]

Haven't been able to donate yet, was denied today because Hematocrit was 61 which is way to high. I go tomorrow to start 'theraputic phlebotomy' so we'll see how quickly that lowers it.

[Technologist]

Went today to donate blood and they said my hematocrit is now at 61, up from the 53 it was at when tested two weeks back. BP was fine at 130/76, but they wouldn't let me donate due to high hematocrit.

I went back to Endo to get a prescrip for 'therapeutic phlebotomy'. Hopefully I'll be able to go in tomorrow and get started as I'm starting to get real nervous this TRT is starting to do some damage.

At this point you have TRT induced polycythemia.

Some of the important symptoms include: Easy bruising, easy bleeding, blood clot formation (potentially leading to heart attacks, strokes, blood clots in the lungs [pulmonary embolism], bone and joint pain (hip pain or rib pain),
Headache, high blood pressure, itching, itching after taking a shower or bath, fatigue, dizziness and abdominal pain. Neuropathy (numbness, tingling, and/or pain, especially in the hands and feet) and brain fog.


You need to forcibly up your fluid intake many times a day for now.

At 61% Hematocrit and high hemoglobin it's actually counter productive. Athletes dope to reach levels "Below" your level around (50%) and if they overdue it hampers performance. Your blood is way too thick right now and could kill if not corrected.

I know many on this forum would die to be on 200mg's per week TRT but it's just going to give you endless phlebotomy problems. Simply missing not getting a blood donation for 2-3 months could be a killer.

On the therapeutic phlebotomy you'll probably need at least 2-3 pints (weekly or every two weeks) taken to get your levels in the normal range. After that you'll be good for the blood donations if your TRT is brought down to 150mg week or less.

Most blood donation centers don't check Hematocrit only Hemoglobin. Some red crosses do if they have a centrifuge to test Hematocrit. Find a Red cross "mobile unit" and ask if they test Hematocrit.
The Red cross cutoff is higher at <19 for Hemoglobin. Some hospitals will still allow you to donate if you are on TRT by a doctors prescription and have high hemoglobin. Hoag Hospital in Newport Beach is one example.

[Technologist]

Deleted my double post.

[gon3r]

Thanks Technologist, i think that sums it up nicely.

I start the therapeutic phlebotomy today and have already lowered my dose from 200mg/wk to 150mg/wk. I'm due for another round of blood in 10 weeks, so I hope to see some good news then.

Thanks again!

[EZ E]

If you can get your hemoglobin down you can donate whole blood every 8 weeks.

[bp2000]

At this point you have TRT induced polycythemia.

Some of the important symptoms include: Easy bruising, easy bleeding, blood clot formation (potentially leading to heart attacks, strokes, blood clots in the lungs [pulmonary embolism], bone and joint pain (hip pain or rib pain),
Headache, high blood pressure, itching, itching after taking a shower or bath, fatigue, dizziness and abdominal pain. Neuropathy (numbness, tingling, and/or pain, especially in the hands and feet) and brain fog.


You need to forcibly up your fluid intake many times a day for now.

At 61% Hematocrit and high hemoglobin it's actually counter productive. Athletes dope to reach levels "Below" your level around (50%) and if they overdue it hampers performance. Your blood is way too thick right now and could kill if not corrected.

I know many on this forum would die to be on 200mg's per week TRT but it's just going to give you endless phlebotomy problems. Simply missing not getting a blood donation for 2-3 months could be a killer.

On the therapeutic phlebotomy you'll probably need at least 2-3 pints (weekly or every two weeks) taken to get your levels in the normal range. After that you'll be good for the blood donations if your TRT is brought down to 150mg week or less.

Most blood donation centers don't check Hematocrit only Hemoglobin. Some red crosses do if they have a centrifuge to test Hematocrit. Find a Red cross "mobile unit" and ask if they test Hematocrit.
The Red cross cutoff is higher at <19 for Hemoglobin. Some hospitals will still allow you to donate if you are on TRT by a doctors prescription and have high hemoglobin. Hoag Hospital in Newport Beach is one example.

Ive heard cyclist go to 60%. If it hampered their performance why would they go that high? Mine is 46% already not on trt. Just curious

[Technologist]

If you can get your hemoglobin down you can donate whole blood every 8 weeks.

You can donate more then that if you know how to.

Let's say your 250 pounds and your Hemoglobin is 18.8 and your hematocrit is 55. It might take you 3-4 donations to get them down to 16 and 46.

The Redcross mobile blood drives without a centrifuge usually only checks Hemoglobin. In my area So. CA No blood facility I've been to pre checks for Hematocrit. Not even the Redcross main donation building. Never let any other clinic know that you're donating to more them one location. Give each donation enough time so they can't see the mark from the previous donation.

Always record your Hemoglobin on the pre test and when you're <16 you can stop donating.

If you're a little high on hemoglobin you can take glycerol to help add volume to your blood and drop hemoglobin and hematocrit.


Some Independents (Hospitals that need blood for their patients) will allow higher Hemoglobin >19 and allow donation if you're on TRT on a doctors order. Just ask them anonymously by phone.

Example:

1. Redcross week 1
2. Independent hospital week 3
3. Independent hospital week 5
4. Independent hospital week 7
5. Redcross week 9

Most centers now draw 480ml to 500ml and call it a pint.

1 pint = 473.176 ml

[Technologist]

Ive heard cyclist go to 60%. If it hampered their performance why would they go that high? Mine is 46% already not on trt. Just curious

Riders who naturally have a hematocrit above 50% would be barred by the UCI.
books.google.com/books?id=7MZu1ZTZL_kC&pg=PA266&lpg=PA266&dq=hemato crit+cyclists+uci&source=bl&ots=_VMhxQAKGQ&sig=RM7 YkEBDEoHG_DXYGZRJNoWt6RA&hl=en#v=onepage&q=hematoc rit%20cyclists%20uci&f=false

I have charts and on both on and off season cyclists and off season the riders are only around 40% but climb closer to 50% on season. They almost all dope but once you hit a threshold your efficiency drops. Horses and dogs drop off at rest at above 40% while humans can go higher.

The weird thing is that "at rest" a much lower hematocrit is more efficient but with higher cardiac output you can increase hematocrit but any higher and output drops dramatically.
www2.research.uky.edu/pimser/p12mso/PASS/Meeting%20Documents/Summer%20June%202012/High%20School%20Blood%20Doping.pdf


Runners typically have LOWER than normal hematocrit levels because of increased blood plasma. Distance runners have increased RBC levels but it is outpaced by increased blood plasma thus the decrease in hematocrit. This is why the international cycling federation has set the hematocrit limit to 50% when normal levels for men can commonly reach 52%. So, if you have a hematocrit of 50% as a teenager before you start running you can expect it to drop 2-3% or so over the course of your training.

[gon3r]

donated 500ml yesterday. When they checked my Hematocrit, before the withdrawal with finger prick, it was only 56. Confusing since the day before with the same test it was 61. Had it been 56 at first I could have donated, now my blood is thrown away.

Oh well, I feel better so I'm pleased. I'll wait a week and then get finger pricked again to see where Hematocrit is at.

Thanks!

[Technologist]

donated 500ml yesterday. When they checked my Hematocrit, before the withdrawal with finger prick, it was only 56. Confusing since the day before with the same test it was 61. Had it been 56 at first I could have donated, now my blood is thrown away.

Oh well, I feel better so I'm pleased. I'll wait a week and then get finger pricked again to see where Hematocrit is at.

Thanks!

Awesome, The raise and drop is common based on hydration, testing errors and machine calibration. The higher the Hematocrit the more hydration can effect it. Personally I would have some Controlled labs Glycergrow on hand to increase blood volume (dilution) slightly before (Redcross) donations.

This one donation alone will probably keep your blood pressure from jumping up as much but you still need 1-2 more blood lettings. It will look something like this

I estimated your Hemoglobin and Hematocrit will drop about 7% per 500ml. I drop only about 6% but I'm 268 lbs and pretty solid.

56 - 7% = 52.08

Climbs back up slightly during the next week

53 - 7% = 49.29

Climbs back up slightly during the next week

50 - 7% = 46.5%

Hopefully this level will allow a full 8 weeks before (the climb is a problem) and the next donation and it can go to a blood center.

Cut and paste this link below and understand that when hematocrit rises to 60 blood viscosity can become as great as 10 times that of water and you'll have a decreased oxygen delivery. You'll need to knock it down to about 46% as it will creep up over time.

en.wikipedia.org/wiki/Blood_viscosity

What was your Hemoglobin?

Now find a blood donation center and donate again as soon as the blood draw mark on your arm is gone. Redcross first! Then private hospital and repeat. Usually it takes a week or more to heal up.
You could claim the mark is simply from a routine blood check but the Phlebotomist will spot it and may ask. They look for other needle marks on every draw.

Congress is trying to push a new law to allow repeat donations after 48 hours in disasters and a guy with High RBC, hemoglobin and hematocrit will actually feel better within a few days of a double donation.
msnbc.msn.com/id/43974739/ns/health-health_care/t/super-blood-donors-could-be-tapped-disaster/

[Technologist]

BTW: This is extremely common and most guys doing higher levels of Test (even 150mg's per week will do it) on this forum have the same problem. Most never check their blood and have no idea why they feel great on the first half of their cycle then end up with brain fog (Impaired Mental Function, dysfunctional cognition, dizziness, and mental confusion) numb arms when sleeping, exhaustion, high blood pressure and a host of other problems like . They get off the cycle thinking they are going to die (true) and then their hematocrit and hemoglobin slowly drops and within x months those symptoms reside as their hematocrit and hemoglobin drop back into the healthy ranges again. Then they do it all over again. The real fix was simply to donate sufficient blood to maintain the hematocrit below 46% long term. The pro's could probably run a one man blood bank with the blood they must dump every month or they use stuff chemicals to suppress Hgb and Hct.

[gon3r]

Thanks so much Technologist for all your help on this. My plan is to go back to the same bank late next week and ask for a finger prick to check Hematocrit. Depending on that number I'll report back here and decide next steps.

Thanks again!

[gon3r]

I wanted to post an update to this. After dropping down from 200mg to 150mg per week and going in for one pint theraputic draw, two weeks later my Hematocrit had dropped down to 45 from a high of 61.

I have not gone back in for any more blood draws, but have stayed at the 150mg per week and will retest hematocrit one a couple more weeks.

Thanks all for the help!

[Bushyhead]

Interesting. The is the first I have read about the need to donate blood. I wonder if donating blood before beginning TRT would be beneficial

[TennTarheel]

I learn something new every day! This some great info! I knew lots of endurance athletes used EPO but I wasn't sure what all was involved with the blood letting and what not. It's really interesting stuff