TRT Provider Discontinued my Prescription - HCT/ Ferritin

Hi guys, would appreciate some advice about HCT/ ferritin levels on TRT if possible.

26yo guy on TRT for around 5 years

I used to blast test but would have issues with high HCT and low ferritin (because I would donate blood to mitigate the high HCT). For the past 5 years I have been on approx 125mg test cyp per week and HCT seems to have stayed at acceptable levels of just below 0.5 L/L. Over time, my ferritin levels have got back to acceptable levels (although still on the lower end), while iron is on the higher end of the range.

About 3 months ago I started having my TRT prescribed (was previously self administered) because I wanted to get a proviron prescription as it’s the only thing that seems to help my libido.

Here are some test results directly prior to having it prescribed:

Free test: 0.743 … 0.2 - 0.62 High
Testosterone: 32 … 9 - 29 High
HCT: 0.53 … 0.38 - 0.5 High
Haemoglobin: 174 … 130 - 170 High
Iron: 28 … 5.8 - 34.5
Ferritin: 97 … 30 - 400

So the prescriber started me on:

75mg test cyp per week (I didn’t mind reducing the dose as HCT was a bit high)
25mg proviron per day
750 IU HCG per week

I was due for my 3 month check up/ blood test and to be sure my HCT wouldn’t be too high, I let 200ml blood (I did this about a week before my blood test).

My results came back:

Free test: 0.47 … 0.2 - 0.62
Testosterone: 19.8 … 9 - 29
HCT: 0.57 … 0.38 - 0.5 High
Haemoglobin: 183 … 130 - 170 High
Iron: Not tested
Ferritin: Not tested

The HCT/ Haemoglobin results were a surprise because I had significantly lowered my testosterone dosage and let 200ml blood prior to the test. My prescriber has discontinued my TRT until HCT is back below 0.55.

I’m not too concerned about this because I can easily let more blood, however this is not a sustainable solution for me as letting blood continuously causes low ferritin issues for me.

In the past, even when my iron has been way above range, ferritin has been low.

So my questions are:

  • I can take iron supplements while letting blood to keep iron up but I don’t think this will keep my ferritin at acceptable levels. Is there a way to increase ferritin faster?

  • Could the change in protocol be to blame for such a jump in HCT? My TRT dosage is lower but I am injecting a greater quantity of oil now and the oil is thicker. Do different labs/ oils effect HCT production differently? Perhaps the HCG or Proviron are to blame? I found the following on T-nation about DHT’s effect on HCT:

Thanks for reading, any help appreciated.

Your hematocrit levels aren’t static and will fluctuate. When you decrease your TRT dosage, you can lose intercellular water in your muscles temporarily.

The HCG is defiantly contributing to the increases in hematocrit.

If ferritin is low, dosing three time per day is best. I forget the name but there is a type of iron that goes directly toward ferritin stores.

@systemlord

How will this loss of intracellular water effect HCT levels? If it’s an increase, surely 3 months is too long for a temporary effect to be still showing up.

Very useful info. Will probably discontinue if this is a known effect. Shame because I was enjoying having balls that don’t retreat into my abdomen.

Again, very helpful. Can’t seem to see anything about a type of iron that raises ferritin more on google/ reddit. Any idea where you saw that info?

Dehydration will cause an elevation in hematocrit.

I saw it on YouTube, it’s gonna take me a while to find it cause I wanna try it out myself. When I know what type of iron it is, you’ll know.

I was a bit dehydrated when I did my test actually.

Great, thank you.

I can’t find it. Google can’t find it either.