T Nation

Hematocrit Problems. On TRT 5 Years


ong story short, I am a 42 y/o male that went on TRT 5 years ago with a
clinic. Started at 100 mg p/w x1 then over the first few years worked up
to 200mg p/w x1 under their supervision. Felt good and on day 7 of 7
before blood work Total was around 750-800 and free T on their scale was
14-17. Their protocol mostly focused on Free being 15-18 range as the
target and not so much the total T. Have been on .25 arimidex 2x a week
as well so have a good feel for e2 management. At this rate I was
pushing 50+ on Hematocrit so donated blood every two months. They
stopped allowing their patients to self inject and I travel every week
so had to do something else.

Took my last set of labs and went to an internal medicine guy they
referred. He looked at the labs and continued the protocol of 200 mp
test cyp 1x a week for a while then about 2 months ago we did
cholesterol test and wow…my total was 172 but my good HDL was only
20…TRI was 49. Time to lower the dosage and try to get the good HDL
up! I was also pushing the limits on the hemaglobin test at the blood
center so he wanted to cut the dosage down and re-test in 4 months. Went
from 200 mg 1x p/w to 60 mg 2x p/w. Did a blood donation the day before
my blood work so hematocrit should have dropped to high 40’s.

I felt ok the first few weeks but in less than a month (versus 2 months)
and I was already VERY RED, flush and thick breath when I laid down to
past my hematocrit limit in less than a month…did a blood donation
after 4 weeks and then dropped my dose to 50mg 2x a week. That was 3
weeks ago and I am ALREADY back to high hematocrit and going AGAIN
tomorrow for a blood donation then going to test my Ferritin to see how
much I have to work with.

So why would 200mg 1x cause less RBC creation than 50mg 2x a week???
Perplexed and not going back to dr for a few months. Wonder if I should
go to 100 mg 1x versus the 50 mp 2x? Not messing around with high
hematocrit more than I already have. Has anyone else had this same
issue? Not sure why 50% total dosage cut and that weekly dosage split in
two would have these results.

Other info. 6’ 0", 198lbs. Eat healthy, workout 3-4 times a week. Blood
Pressure normally 120s/70s. Have had sleep apnea for years and I do wear
a CPAP to sleep the majority of the time. Normal multi-vitamins, fish
oil, Vitamin E, Vitamin D and Vitamin C daily. Amino Acids pre-workout
and protein post. Use 25g 1" IM injections in glutes. All other normal
blood work comes back in range except RBC and Hematocrit even on
donations every 2 months.


You need to inject T twice a week. Peaks from injecting once a week is part of the problem.
T levels injecting once a week creates T levels that vary greatly. Anastrozole is competitive with T and it would be the wrong amount most of the time.

I have reading for you.

In the 2nd post of the fist topic in this forum, follow these links:

  • advice for new guys — provide more info
  • things that damage your hormones
  • protocol for injections

Post your labs with ranges.

fasting cholesterol
fasting glucose
CBC with hematocrit

Typically, 0.5mg/week anastrozole will not control E2 with 100mg T, let alone 200mg T.

TRT makes snoring worse. 200mg/week makes it more worse.

What other health conditions and meds, Rx or OTC.

Take mini aspirin to help blood flow.
Avoid iron fortified foods and vitamins


No other otc or rx meds. I gave my last set of labs which were while on 200mg 1x per week to doc so dont have them handy. I have actually been pretty dialed in with e2 between 20-30 for the past 4 years on just .25 2x a week of Arimidex. As stated no labs in the last two months yet (doc wanted to wait four months). I am struging to understand why if I cut my total dose in half per week then divided that yp into two 50mg shots per week (as the link / stickie suggests) why is my hematocrit levels going up so rapidly compared to 1x a week with twice the dosage?

Just curious if anyone else has experienced this. Not sure 2x is working for me after 5 years on 1x a week with few issues other than low HDL now.