T Nation

CBC, HCT, HGB Labs. My Doc Isn't Concerned, Should I Be?

A urologist started me on testosterone replacement in October '19. I take 200mg testosterone cypionate every 2 wks. I have done lab work about every 8 wks. My doctor likes me to do it the day before I am due for an injection. A covering doctor had me do it several days before the injection and several things were high. My regular doc came back and had me do the labs again the day before the injection and some of the numbers had come down. At this point, he does not seem concerned about the labs at all and said I don’t need to get them done again until 12 weeks from now. That seems like quite a while? I am wondering if others are more closely monitored the first few doses and then labs don’t need to be done as often? I am including my CBC here which goes back to '08. I started TRT October of '19. Even though my doc doesn’t seem worried or concerned at all, I am just wondering if I should be??

I’m monitored every 6 months which pretty standard. As far as your protocol goes, you should inject T at least weekly. I was prescribed 200mg every 2-3 and soon learned my doc was clueless.

Basically the doc reads the prescription label and follows it, which is what docs do everyday, only a 2005 clinical study sheds light on the subject of these protocols and it’s not a good outcome for a lot of men. Sadly when they were written nobody knew diddly-squat about TRT.

Nobody who frequents T-Nation on a regular basis injects every 2 weeks.

Docs aren’t concerned until hematocrit gets to 54%, go to a place of high elevation and see everyone very close to 54%.

Hormone levels are measured at trough, their lowest point, make a habit of seeing levels low at trough and you will usually see a return of low-T symptoms or you may not feel your best. I did 75mg weekly for 15 weeks and felt great, but on the 16th week after my body woke up from androgen deprivation I started experiencing horrible symptoms towards the end of the week and now I inject daily.

Thanks! All good information!!

Systemlord is speaking in absolutes.

While it may be true the most guys the frequent T-nation forums don’t inject every 2 weeks, I’d wager that a lot of guys that are perfectly happy do inject e2w. They don’t bother with searching out forum discussions because they’re satisfied.

Hormones being checked at trough is typical but hardly the only way to go. I’ve been checked at both peak & trough during the same injection window. (Overly cautious) And checking a day or 2 early isn’t wrong it’s just different. The idea here is if you’re still “in range” right before you’re next injection, and you still feel well your dose is appropriate. If not perhaps you need to adjust.

Once stable checking every 6 months seems appropriate, when getting dialed in you’d want to check before making adjustments to try to help be a guide. If you’re not going to see the doc for 3 months, then that seems reasonable.

A blanket statement that docs only get worried at 54% hematocrit and above is silly, he can’t speak for every doc, you need to discuss it with yours, maybe he starts getting nervous at 52%, who knows.

I wouldn’t model your dosage protocol on systemlord’s experience, he’s struggled a lot and tends to over respond to a lot of stuff. Be aware of it, but take everyone’s advice with a grain of salt, how I respond, may have zero correlation to how you respond.

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It is true that most men on T-Nation inject T once weekly, some more which is accurate and would be dumb to argue against. I am also correct is saying most men on TRT inject once weekly while some men inject more frequently.

I would advise new members to be weary of taking advice from someone delusional such as yourself who would argue/attack another members advice based off a “feeling” with no real world data to backup your comment.

You are just a delusional person and it seems you are argumentative today, at least you’re consistent. My advice to you is try living in reality for a change.

Silly you say, in an attempt to alleviate sylvan’s concerns about hematocrit I mentioned the guidelines state action is needed when hematocrit reaches 54% and is standard of care for TRT for which doctors tend follow.

If you want to argue about it, I suggest you do it somewhere else and stop acting like a fool.

Stop being so overly dramatic.

I never suggested sylvan to model his protocol to mirror my own, I don’t know where you get these delusions, but bringing up my struggles has nothing to do with anything, it’s a cheap shot to lend your post more credibility from someone with low self confidence and has nothing to do with any of my recommendations and wasn’t appropriate given the scope of my advice to sylvan.

Have you donated blood recently. Should do that a few times a year to keep hct down

If they think the doc knows best then they may believe feeling ok is as good as it gets. Every 2 weeks is not ideal for anyone. Are there some that may not feel like crap on it? Probably but those people would be really pissed to find out they could have been feeling fucking amazing if they only knew the doc didn’t know any better.

I think most GPs, urologists and endocrinologists use every two to three week dosing. Patients are fine and happy with it, however, you don’t know what you don’t know and if they were on weekly dosing they would most likely be happier. Maybe not all, but I think most.

Some doctors will lower the dose or completely discontinue TRT with erythrocytosis. Most TRT doctors will be fine up to a point, usually hct of 54 or 55 is where they draw the line. Some won’t worry about it at all. A hematocrit of 50.3 is fine.

Yes. Talk to anyone getting test injections through their PCP or urologist. I don’t, but I think I could do every other week injections and be fine. I wouldn’t feel as good as with weekly, but it would be doable.

I’d love to get about twenty (or more) guys all on 200mg weekly and draw labs daily for a week. That would be interesting. If I could get them to go for it, I’d pay for the labs.

One of the pluses with daily injections.

This is a population based model, your personal HCT risk relationship might be different, but that’s the best info available.

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Thanks! The answers I am getting on here are very reassuring and much clearer than my doc, who doesn’t seem to have time to explain anything, lol.

I can’t donate blood. My doc is aware of that and hasn’t offered a prescription for the donate and discard blood letting thing.

You need it. Tell him to give it to you or you risk long term heart issues