Polycythemia & B12

[jwh7699]

Sorry, been a little busy.

Yes, I do have Sleep Apnea. I've had it since about 2011, I've used a CPAP pretty faithfully ever since.

B-12 can give you a boost in energy and it's water soluble, so it's not stored long term. Even with being on TRT I've had some fatigue issues, so trying different things to see what helps.

Since I got the Blood Work back I haven't taken the B-12. My breathing seems to be a little better, but it may be placebo affect at the moment.

Last Testosterone Blood Work was May 2017 (I split my dosing twice a week, Wed & Saturday. I went Wed Morning before my shot)
Total T 1112 ng/dl
Free T 25.5 ng/dl
Estradiol-Sensitive 31.6 pg/ml

My Hematocrit increased after being on TRT. I've been on TRT since 2012. I am 41 years old. I've been on HCG 250mg 2 x weekly for about 4 years. Recently I read it can give libido an extra kick with an increase to 500 2 x a week, so I started it 2 months ago and it helps.

I have not used other Hormones before except for HGH. I used it once 8/2014 to 2/2015, while on TRT. 4 iu's Mon - Friday off on Weekends. I had some strength increases, but mostly it was a dud. I am looking to try another round in a few weeks.

The rest of the CBC Blood Work is fairly Normal. My A1C is a little High, I get it done at the local Veteran's Hospital, and they always ask me to do blood when I haven't fasted and already eaten. I have a fasted one scheduled in a month so that one will be the standard.

Cholesterol is a little High. I stopped taking my Cholesterol medicine awhile ago. One Doctor said to stop the other said I should be on it, so probably go back on it at after the fasted blood work in a month.

I pretty much had the Vitamin Levels Checked because of Fatigue issues. I'm aware the High B12 won't cause the High Hematocrit, rather if I should do something about the High B-12 level. I'm gonna stop the B-12 supplement. I'm going to continue with the B-Complex supplement that covers Folate and the other B Vitamins.

Thanks Guys!!!

[Youthful55guy]

Sorry, been a little busy.

Last Testosterone Blood Work was May 2017 (I split my dosing twice a week, Wed & Saturday. I went Wed Morning before my shot)
Total T 1112 ng/dl
Free T 25.5 ng/dl
Estradiol-Sensitive 31.6 pg/ml

My Hematocrit increased after being on TRT. I've been on TRT since 2012. I am 41 years old. I've been on HCG 250mg 2 x weekly for about 4 years. Recently I read it can give libido an extra kick with an increase to 500 2 x a week, so I started it 2 months ago and it helps.

Cholesterol is a little High. I stopped taking my Cholesterol medicine awhile ago. One Doctor said to stop the other said I should be on it, so probably go back on it at after the fasted blood work in a month.

A couple of thoughts:
Both your T and your Free T seem a bit high being it's the nadir sampling of your longest (3/4 day) interval. It would be helpful to see the normal ranges of your labs, but generally it's around 1100 ng/dL for TT and 25 pg/mL for free T. That means you are way above the upper end of the ranges for both throughout the rest of the week. I'd consider dialing it back to a 50 mg dose.

E2 is OK but at the upper end of the typical normal range (~35 pg/mL) for guys using the LC/MS/MS (sensitive) methodology. I would not attempt to change the anastrozole dose unless you converted to the Vodka method, as it's simply impossible to cut those tinny tables accurately beyond 0.25 mg (and even that is tough). Lowering your T dose should also bring your E2 down well within the upper end of the range.

Your dose of HCG is fine. I've seen data published that says 1000 IU/week will increase your T levels about 300 ng/dL above what the exogenous T will do. here's the article, but it's not explicitly stated. You have to tease the numbers out of Figure 2: https://www.ncbi.nlm.nih.gov/pubmed/15713727. I'd consider breaking up the dosing schedule of both your T and your HCG into an E3D protocol, which will give you lower peaks and nadirs, and allow you to do labs at any scheduled injection day. Lower peaks, will mean lower conversion of T to E and DHT and a more stable ride.

If your cholesterol is high (which is a common side-effect of high T), I'd consider going on a low dose of a cholesterol lowering med. I resisted for several years and then finally let my doc put me on the lowest possible dose of Lipitor (atorvastatin, 10 mg). There are no side-effects that I can tell and it keeps my cholesterol and lipids nicely within range.