T Nation

Protocol Adjustment

So, after my hematocrit rose to 54% on 100 mg testosterone (1233 ng/dl peak, 704 ng/dl trough) enanthate once weekly injections , I decided six weeks ago to change my protocol to twice weekly injections, @ 40 mg each. Morning Wood has completely disappeared, libido is pretty low, and actually I have more acne now than before. I will be doing blood tests next week to see where the haematocrit is, and upping my dosage again. Here is my question. What would be more optimal:

50 mg twice a week (100 mg)
60 mg every four days (105 mg)
80 mg every five days (112 mg)

How was your symptoms on 100 once a week?

Wait for the lab results before you decide on any change. It’s pure speculation now.
Symptoms could be from other things.

Are you checking prolactin too?
And thyroid?
And ferritin?
Dont just check hct. Also check for sure total t. Free t. Estradiol

1 Like

Yes all will be checked except estrogen. Doc here in Canada won’t allow it. The problem with the 100 mg once per week was the high hematocrit, and ferritin dropping from 149 in September pre trt to 19 in January. I have no estrogenic side effects at either dose 100 mg or the 80 mg.

I always though acne was a DHT thing and wood and libido was E2 related. Plus it doesn’t help you changed your protocol and your systems are in flux. Like Charles said we need to see bloods.
If HCT is your real issue then you need to cut your weekly dose not come up with daily doses that still get you to ~100. Cut back to 80/wk I don’t care how many times you stick yourself each week it really won’t matter just stick with one protocol and give it time. Like more than 5 weeks.

Read above. New protocol has been on 80 mg a week. For 6 weeks. So everything is stable now. I reduced it by 20 mg and changed frequency from once to twice a week. What I’m saying in the new stable lower protocol I feel nothing.

I read above and understood 100/wk and you can’t control your HCT.
So you have to live with that. Uping your dose from 80 back to 100 will just put you back where you were. Daily EOD E2D will make no difference 100/wk will raise your HCT.

Let see where your bloods are. Maybe your E2 is too high that would explain your loss of wood and libido but not the acne. You would need to test for DHT. Oh yes your doc won’t test E2 you need to find away around that like finding a private doc that will test it. You are not the only canadian on these forums they don’t seem to have this problem maybe they willl offer a suggestion.

Hematocrit even higher on new protocol.

This makes no sense. Changed protocol from 100 mg TE once weekly to 80 mg split every 3.5 days. So lowered the dosage by 20% and injecting twice a week instead of once. Hematocrit went from 54 to 55! Bloods taken 7 weeks after protocol change. Hemoglobin up from 181 to 186. RBC up from 6.57 to 6.92. Am I not giving it enough time to stabilize? I have no negative symptoms and I feel great. Blood pressure low normal. Platelets good 291 range (140-400). What do you guys think?

  1. I would not worry about it.
  2. Make sure you are well hydrated prior to your next test.
  3. If you are worried about it, you can donate blood.
1 Like

I was worried the first time. Now I totally get it. Like in the video. Not worried so much about the number, just curious why it went up on lower and more frequent dosage. Hydration is on point. Around gallon a day. Pee is constantly clear-ish. Waiting for testosterone results to load now. I’m curious if that went up too.

I’ve seen my hematocrit fluctuate plus or minus 3% within the same week on the same protocol, it could just be a normal fluctuation.

Your levels are not static.

The body does react to changes in doses. I wouldn’t be surprised if that’s part of the puzzle. It’s just odd because your taking less more often… totally opposite of what I would of guessed.

They say men with super high HCT feel like they can’t breathe and feel relief when they give blood.

Also keep in mind athletes would die for a HCT of 55 or 56 lol… they used to use epo and sit at 56-58 I believe. That was the goal and I believe the anti doping body had a 56 as the highest level of hct one could have without triggering tests and alarms.

Do you live at elevation?

No. About 550 feet above sea level. Breathing is fine. Blood pressure is low. Very puzzling. I’ll post testosterone levels once they load up online.

Interesting. Are you on any other meds? You should also see if you can find old Blood work. Maybe your naturally high hct. Check with family. Would be an interesting insight.

I love where the doc (I think rouzier) says “they don’t go to mountain villages and tell them Go give blood do they?”

I do have some numbers. I will post. Also I’ll try a CPAP machine soon and report back if I somehow have sleep apnea. Maybe the protocol change isn’t affecting hemoglobin and hematocrit as red blood cells have a 3 month life cycle? I’ve only been on trt 4.5 months. image

Effects on erythropoiesis (process that produces red blood cells) are evident at 3 months, peaking at 9–12 months. Your body will find a new level at 9-12 months.

Another thing to consider is variance in machines and calibration. Recently I had my labs done on a Wednesday for my doc, and went to a phlebotomy on Friday of that same week (so two days apart). The labs at the phlebotomy showed my hematocrit to be 50, and the labs done at DLS for my doc showed my hematocrit to be 54.

That’s a supposed 4 point difference in 2 days. I no longer have great confidence in lab calibrations and consistency.

1 Like

When you did the 100mg 1 x weekly were you doing your blood test on your absolute best trough day (morning of shot day)? If you were near trough I would think that number would be lower than it would be on a nonstop steady state of Testosterone. I think this is happening to me as well and has my doctor freaked out. I went from 1 time weekly to EOD and now my trough days are basically not existent. I no longer crash or feel tired as if the shot is wearing off but I certainly have increased HCT now as well.

Just a thought.

Blood tests always done on trough right before next shot. So testosterone results uploaded and needless to say this protocol change was a complete waste.
Trough at 3.5 days right before next shot of 40 mg is the same as trough at 7! Days on 100 mg. So spending most week at trough levels with even higher hematocrit. Just shows that protocols that look good on paper don’t always translate to real life. Here are trough numbers:
Total T - 554 ng/dl (19.2 nmol (8.4-28.8)
Free T - 13 ng/dl (454 pmol range (196-636)
Free T % 2.36
Estimated SHBG 28 (this is neither high or low right?)

All you need to do is increase the dosage and figure out an protocol that will lower hematocrit. You may just have to deal with higher hematocrit as your body seems to overproduces it. Trough Free T isn’t optimal, it needs to stay high normal.

SHBG is about midrange and is good.

Sleep apnea can cause higher hematocrit, have you had a sleep study done?

I had one years ago and it was inconclusive, they said no. But I’m starting to think I might have slight sleep apnea. I wear a Fenix 5x Plus watch that has an spo2 oxygen sensor and I do notice every night my oxygen level drops a few times. I’m getting a CPAP machine and will be testing it out. Are you saying the Free T is ok for a trough?
I will be trying a middle ground protocol now. 70 mg every 5 days.