Hemoglobin Still High 6 Weeks After Lowering Dosage to 50mg a Week

Hey guys need some help here… Just went in today to get my results of my last blood work and my hemoglobin is still 18.4 after giving blood about 3 weeks prior which is about where it was last time I had blood work. So it appears that it keeps rising even with the lowered test dosage…
I have been on 50mg of test cypionate a week divided into 2, 25mg injections every 3.5 days subcutaneously in my belly fat for 6 weeks now. I was hoping to have my hemoglobin in the normal range by now especially after giving blood.
So my question is… If I start doing EOD injections will this lower my hemoglobin? Does the more frequent injections effect hemoglobin, or just level out testosterone, and estrogen?
I was hoping to stay with the twice a week injection frequency but I am open to every other day injections if this will help me with my issue.
Thanks in advance…

Why even be on TRT at 50mg a week? I just wrote the same my on another thread.

My hemoglobin was high and my Dr suggested that I lower my dosage until we get my hemoglobin under control. At my previous dosage of 50mg 2x a week my total t was 1300+ off the chart.
At 50mg a week my total T was 581 now at the end of 3.5 days when my blood was drawn.

What’s your free T? My total T was 575 before I started TRT.

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Are you taking supplements? Any iron supplements? If so dont take iron it raises Hemo. I diet rich in iron will do the same. Donate blood again if you can. How do you feel at 100 weekly?

There are a couple of factors to consider

Up to 50% of men develop erythrocytosis, its the most common side effect of TRT. Some men are more susceptible to developing erythrocytosis than others.

There is a correlation between T dose and level of erythrocytosis and a correlation between injection frequency and erythocytosis was also described. I an study, subject receiving twice weekly T developed more often erythrocytosis than subject on once weekly dosing. The authors concluded that rather than the dose, the injection frequency influences the probability of developing erythrocytosis.

There is a guy on excelmale forum who run different protocols over 2 years and his conclusion is in agreement with the above statement (1 weekly it is), But there seems to be also other reports with conflicting outcomes on this and the other forum.

Erythrocytes have a long life span of about 3 to 4 months on average.


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I am not currently taking any supplements… I felt good at 100mg a week but my total t was off the charts and my Dr recommended I lower my dosage. I am currently at 50mg (25mg twice a week) now in hopes to lower my hemoglobin. I feel normal I guess. My levels were under 200 total T before trt so anything is better then that. I am unable to donate blood at the redcross again until December 10th due to they’re policy.

Thank you for the detailed response… Previously I was having estrogen related issues with less frequent injections so I really don’t want to go back to weekly injections. I am leaning towards every day or every other day low dose subcutaneous injections in hopes that the frequency will help me stabilize my levels. I am reading that others in the forums have great success in this protocol. Although I have yet to find out if low more frequent subcutaneous injections daily lower the chance of developing erythrocytosis. I did read the study you linked but it didn’t cover more frequent injections.

I am a bit skeptical when it comes to estrogen control by frequent injections. I have the impression this is based a lot on how people feel but not on real data that linkes frequent injections with lower E2 levels.
With once weekly injection you will have some variability in T and E2, whereas with daily you will essentially have no variability. Its then also a question when blood was drawn in relation to injection.

If you feel better on daily then fair enough. But might not be related to E2 then.
For me daily didnt bring down E2. No effect after 5 weeks whatsoever with same TT levels.

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Like @johann77 said I don’t think more frequent injections “controls” estrogen but it does (for me and others) make TRT less symptomatic. Maybe it’s the fact it keeps levels stable at a somewhat certain level. Kind of like when you start a new protocol and your levels are in flux like the ocean during a storm and you don’t feel as good as when they finally level out and the waves are back to normal bearable size. The more frequent injections are just leveling them out even more like a calm ocean. It took me about 8 weeks on the daily protocol to start feeling better than ever. At week 6 I wasn’t feeling much different but I’m glad I gave it a little little longer.

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Thanks for the response… I have noticed a better well being and less estrogen related side effects going from a once a week to a twice a week injection. My real concern is that my hemoglobin is still over 18 a month after giving blood even at dosing 50mg of test a week for 6 weeks…
My question is… Will a more frequent injection help lower hemoglobin? Or at least maintain it better or level it from spiking back up? I can’t find this answer anywhere. Thanks in advance.


Truthfully I don’t know. I don’t think anyone really knows. It sounds like your body reacts differently than most so it may not apply to you if we did know. The only thing you can do is try. I have a buddy that has been on 250mg for 3 years and just got blood work done and his hemoglobin is the same as yours. He’s lived 3 years like that. You likely aren’t going to die tomorrow.

Try eating a grapefruit every day for several months and see if that makes a significant difference.

No one could know the answer to this question, it is one you will have to find out. My hematocrit and hemoglobin are lower on daily protocols, but that doesn’t mean everyone will have the same experience.

My conclusion is that TRT resets your baseline points for normal Hemoglobin, RBCs and Hematocrit. Regardless of dosage or frequency my hemoglobin always goes up to the mid 18’s, hematocrit 54ish and rbc’s 6.5ish. Even if I donate, the body quickly uses up the ferritin stores to raise up the levels then stabalize there. I can’t say I’ve felt any different with normal or high hematologic values.

For some of us high HGB is just price of admission for TRT. I am 4 years into this journey and have tried all injection frequencies in search of lowering HGB/HCT. regardless of frequency, for me, I still have to phlebotomy 3-4 times a year. My cardiologist just will not allow me to run HGB over 19, nor should I want to. Tried lowering the dose amounts and all symptoms returned that drove me to TRT in the first place. The frequent phlebotomy keeps my Ferritin in the low normal range raising other concerns. “Catch 22” I keep hoping now that I have settled on a steady injection frequency and dosage protocol, where I feel best, homeostasis will occur at some point…but would not bet on it!

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What does your hemoglobin stay at, and how often do you donate now?

OK so I got a new Dr and he has me doing therapeutic phlebotomy weekly until I get my levels under control. The first 2 weeks my numbers didn’t go down from 19. The 3rd week I was at 17.4 and the 4th week I was at 17.1
I am scheduled to go in today to donate and regardless of the outcome I am taking a month off because I felt pretty crappy last week after donating. The Dr said that sometimes it can take up to 6 months to get hemoglobin in check but at that point I feel I’m gonna be drained of all my life force. Thoughts? I’m only about 7 months into this and have had 5 horrible Dr’s that haven’t had a clue about trt. Hoping this Dr knows what they are doing. I’ve settled on subcutaneous injections
With a 29g insulin needle every 24 hours at 20mg per shot. I feel like I’m at a good dosage for energy and libido… Just need to get my hemoglobin in check. Thoughts?

Here are al my numbers. Just to state. I feel no different before and after phlebotomy, I feel exactly the same with normal or high blood markers.
As you can see dosage and frequency means nothing. (80 mg a eeek low 122 mg a week high, every 7, 3.5, 5 and 4 day frequency)
Grey highlights means on TRT, white before TRT.

Thank sharing this… It appears that some of us just experience higher hemoglobin then others while on trt… Apparently I am one of them. I am going to donate today for my 5th week straight and see where this leaves me in a month from today. I am hoping I will be able to get away with donating every 3 months after this. As I said I am fairly new to this process but my Dr seems to think that frequent injections every week will counter act, and correct this issue. I’m hoping for others who have went through this process and got their hemoglobin in check with therapeutic phlebotomy to chime in as well… My trt journey has been an upward battle between Dr’s who don’t know a thing about trt and getting the wrong advice from others. I’m hoping I’m finally on the right track here so I can actually start enjoying my trt, and stop stressing about it. I greatly appreciate your response and invite any suggestions.

I can tell you from what I see blood donation will only make the blood markers go up high even faster. I think the body wants to be at the new set point for all 3 markers.

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