Overweight TRT Considerations

[woundcarping]

Well, got my partial 6-week blood results back, and the blood is indeed thickening:
View attachment 27360

It's possible that it's an elevated level from dehydration. I have such a hard time with it on these GLP1s. This is on 120mg test cyp split shots, 4x 30mg per week. Yet to see what the hormone side looks like, but wanted to see what success folks have had lowering hematocrit without donating. I really don't want to get into that rebound cycle.

EDIT: Hematocrit was 46.6 previously, for context.

My hematocrit was fine at 120mg, but when I went to 180mg it went up to 56% in 8 weeks. I dropped my dose to 150mg and donated, dropping it to 52%. This coming week or the week after I'll test again as my 3-4 week post donation hematocrit checkup. TRT labs again in July for my ~8 weeks on the 150mg dose.


There's not a lot of practical and consistent ways to control hematocrit when on TRT aside from dose adjustments. Hydration is important but that's more of a baseline requirement.

 

[quicksilver80]

I hear it will hurt more than help if the underlying issues arent the right ones. Primary or secondary hypogonadism. Gotta find that out first. Then you can potentially avoid trt and doing something like enclo instead.

 

[Airborne Daddy]

My hematocrit was fine at 120mg, but when I went to 180mg it went up to 56% in 8 weeks. I dropped my dose to 150mg and donated, dropping it to 52%. This coming week or the week after I'll test again as my 3-4 week post donation hematocrit checkup. TRT labs again in July for my ~8 weeks on the 150mg dose.


There's not a lot of practical and consistent ways to control hematocrit when on TRT aside from dose adjustments. Hydration is important but that's more of a baseline requirement.

Hydration, vasodilator (5 or 10mg cialis will work) and an appt for donating power reds (double reds) is the way.

 

[Such1943]

Cialis can definitely get you pumps in the gym taken an hour before, personally for me it was a huge difference compared to just watting enough carbs before my work out and the day before, also straight water to drink during work out with dextrose put in. I felt did more for me then Cialis.

I've implemented 5mg Cialis a day a few weeks back for vascularity and blood pressure. I'm going to keep it in the rotation.

 

[woundcarping]

... an appt for donating power reds (double reds) is the way.

Gotta meet their requirements, which I don't.

 

[Mood]

Gotta meet their requirements, which I don't.

Feel ya on that but you can always donate whole blood, just have to do it twice as often. I monitor my hct and generally only need to donate whole blood maybe 2 to 3 times per year (you can donate whole blood about 6 times per year, if needed).

 

[rmhla]

Feel ya on that but you can always donate whole blood, just have to do it twice as often. I monitor my hct and generally only need to donate whole blood maybe 2 to 3 times per year (you can donate whole blood about 6 times per year, if needed).

Its great we can. In Canada if your hematocrit is to high they turn you away. Its crazy so then your stick going to your Dr to ask for a phlebotomy (basically they just discard your blood) which to me is crazy because its proven you can still use that blood for plasma.

 

[Mood]

Its great we can. In Canada if your hematocrit is to high they turn you away. Its crazy so then your stick going to your Dr to ask for a phlebotomy (basically they just discard your blood) which to me is crazy because its proven you can still use that blood for plasma.

They do in the US too (they base it on hemo), but it's gotta be super high. I think for the Red Cross it's has to be lower than 20. With the rule of 3, that would put your hct at close to 60. Hopefully you've taken care of it before it gets to that point.

 

[rmhla]

They do in the US too (they base it on hemo), but it's gotta be super high. I think for the Red Cross it's has to be lower than 20. With the rule of 3, that would put your hct at close to 60. Hopefully you've taken care of it before it gets to that point.

Personally used to be 54.. im fine now using Red Cross. Also weight is proper and eatting health plays big role.

They know me well now also where I visit so its not a big hassle.
You really just need answer yes/no to all the onslot of questions or you very quickly get turned away.

Anyways I personally think you should be able to donate blood even of your hematocrit is high. Why? Well going through a Dr for example on Canada takes 3 to 6 months get an appointment each time... unless using a walk in clinic but never had any luck there.
Family Dr takes forever for appointments

 

[Mood]

Personally used to be 54.. im fine now using Red Cross. Also weight is proper and eatting health plays big role.

They know me well now also where I visit so its not a big hassle.
You really just need answer yes/no to all the onslot of questions or you very quickly get turned away.

Anyways I personally think you should be able to donate blood even of your hematocrit is high. Why? Well going through a Dr for example on Canada takes 3 to 6 months get an appointment each time... unless using a walk in clinic but never had any luck there.
Family Dr takes forever for appointments

Don't disagree, but there could be a concern that something is wrong if your hct is too high and donating can stress the body which could be exasperated if your body is already working harder to push thicker blood. There could also be a concern that it could harm a recipient depending on the underlying cause.

While your high hct may be from trt, if someone had polycythemia vera it could be dangerous to recipients, so its safer to just not allow it. I have an at-home hemo meter so I can monitor my levels and schedule donations if I get a few higher readings before it gets too high.

 

[msyntakz]

So, here are the Testosterone levels, 120mg weekly for 6 weeks, split into 4 doses SubQ:

And the blood again, just for reference:

Versus my blood baseline:


Hoping the jump will level off, because I would really like to increase my dose. I know @woundcarping said he had a jump in hematocrit from 120mg to 180mg (I think), and I would expect an increase as well, but hopefully nothing crazy.

Again, I think I was only drinking about 1/3 of the water I should have been drinking. Tracking now, and it was pretty bad, so that may be part of it, because of the increased GLP1 dose.

Sleep is good, focus is decent, overall improvements going in the right direction. Nothing earth-shattering, but I don't expect that this early. Hence why I want to up the dose and keep going.

Also, sleep trackers do not flag any snoring or sleep apnea related issues, so I don't think hemo is due to that.

OK, that's my update.

 

[woundcarping]

...Hoping the jump will level off, because I would really like to increase my dose. I know @woundcarping said he had a jump in hematocrit from 120mg to 180mg (I think), and I would expect an increase as well, but hopefully nothing crazy...

Yep, went from 120mg to 180mg, hematocrit went from 47% to 56%. I dropped the dose to 150mg, donated a unit, 3 days later hematocrit was 52%. 3 weeks after donation (draw was yesterday) hematocrit came in at 50.5%.

My reticulocytes are normal.
RBC is lower but solid.
Hemoglobin is solid.
MCV is normal.
Ferritin went up.
Iron Sat went up.
Serum Iron is normal
TIBC is normal.

I stopped creatine a week earlier, so it's possible that has my plasma levels expanded a bit. Next planned bloodwork is next month for my 8 week labs at 150mg.

...Again, I think I was only drinking about 1/3 of the water I should have been drinking. Tracking now, and it was pretty bad, so that may be part of it, because of the increased GLP1 dose...

If your hydration is transiently fucked, there's no point in doing labs for hematocrit. Last Thursday I stacked .25mg of Sema on my Reta and overshot my suppression to the point I pushed my biweekly Reta dose back a day.

I put some extra effort in Tuesday to make sure I drank a "normal" amount of water. Yesterday before my draw I drank my customary 1L of water to start the morning off... same protocol before my DEXA scans which can be later in the day but also fasted.

I didn't run my labs until I got over the Sema and got my hydration back to ~baseline the day before. Another way you can transiently fornicate your hematocrit labs is to "pound water" before the draw... unless you're making numbers to keep someone else happy (like the Rx Dr). In general I want to know my consistent baseline to make decisions.



It sounds like you're on the right path!

 

[TacoLifter420]

Hydration and daily cardio are huge factors that can impact your Hematocrit. I live at sea level, weight 190lbs and drink 150 ounces of water a day, half with electrolytes added. This keeps mine between 46-49. If I get a blood draw before I'm properly hydrated for the day I've seen 52 and 53.

 

[msyntakz]

Hydration and daily cardio are huge factors that can impact your Hematocrit. I live at sea level, weight 190lbs and drink 150 ounces of water a day, half with electrolytes added. This keeps mine between 46-49. If I get a blood draw before I'm properly hydrated for the day I've seen 52 and 53.

Wow, I appreciate the numbers on the differences you see. That's a big fluctuation. I am aiming for 3/4 to 1 gallon per day (96-128oz). Probably should just go for the steady whole gallon at least. I'm not a small person, 6'4" and 290 now.

I didn't run my labs until I got over the Sema and got my hydration back to ~baseline the day before. Another way you can transiently fornicate your hematocrit labs is to "pound water" before the draw... unless you're making numbers to keep someone else happy (like the Rx Dr). In general I want to know my consistent baseline to make decisions.

Yeah this is all key to keep in mind, and I will be aiming for consistent baselines as well, moving forward. Now that I am tracking, much more doable.

 

[sfkid]

So, here are the Testosterone levels, 120mg weekly for 6 weeks, split into 4 doses SubQ:
View attachment 27860
And the blood again, just for reference:
View attachment 27861
Versus my blood baseline:
View attachment 27863

Hoping the jump will level off, because I would really like to increase my dose. I know @woundcarping said he had a jump in hematocrit from 120mg to 180mg (I think), and I would expect an increase as well, but hopefully nothing crazy.

Again, I think I was only drinking about 1/3 of the water I should have been drinking. Tracking now, and it was pretty bad, so that may be part of it, because of the increased GLP1 dose.

Sleep is good, focus is decent, overall improvements going in the right direction. Nothing earth-shattering, but I don't expect that this early. Hence why I want to up the dose and keep going.

Also, sleep trackers do not flag any snoring or sleep apnea related issues, so I don't think hemo is due to that.

OK, that's my update.

I dropped from 180gm to 120mg and my hema went from 50 to 53. I started doing some research to understand better.
It seems theres lots of mis-info or just mis-understanding about hema levels that probably need updating, but Im no doctor.
People living at high altitudes have consistent high hema levels and they never worry or do forced donations.
Here is good video with a doc whos hema levels run constantly ay 54.

View: https://www.youtube.com/watch?v=RJrSI6dQPXE

 

[Foggy-Hollow]

Post in thread 'Testosterone.'
https://glp1forum.com/threads/testosterone.19488/post-200615

 

[woundcarping]

...I am aiming for 3/4 to 1 gallon per day (96-128oz). Probably should just go for the steady whole gallon at least...

From a psych perspective, a baseline should be relatively achievable and repeatable, without much effort. Saying 96-128oz, then a whole gallon "at least" isn't an internally consistent statement.

There are times when I need to drink multiple gallons doing highly physical long days of work in the summer... thankfully those days are (hopefully) in the past. There have been days where I drank over 2 gallons at work, didn't use the bathroom for over 12 hours, and when I did it looked like apple juice. That's literally exceptional for myself as well as the overwhelming majority of the population.

As a practical minimum on a sedentary, inside day I should drink ~2L (4-16.9oz water bottles, for example). Thirst can be a reliable guide although GLP and life can make thirst drive less obvious. Urine color is an excellent marker to judge hydration, not because it's particularly accurate, but it's super easy for dudes. Consistently clear without a reason isn't better than a slight tint. Apple juice is bad.

Hydration absolutely doesn't come from just water. Water is fine, but so is pretty much anything else aside from alcohol. Most drinks are 85+% water, low calorie drinks are mid to high 90% water.

Tying back in to the psych perspective, setting up hard pass/fail rules of only drinking water is considerably more difficult over time than realistic guidelines based on observable metrics and understanding hydration needs. If you want to nerd out, get a refractometer and measure the specific gravity of your urine. That can help calibrate your tint observations with measured data.


None of this talks about electrolytes, which matter, but are less of a concern for the average person than marketing would admit.

 

[TacoLifter420]

Wow, I appreciate the numbers on the differences you see. That's a big fluctuation. I am aiming for 3/4 to 1 gallon per day (96-128oz). Probably should just go for the steady whole gallon at least. I'm not a small person, 6'4" and 290 now.



Yeah this is all key to keep in mind, and I will be aiming for consistent baselines as well, moving forward. Now that I am tracking, much more doable.

For context I should note i'm taking 200mg of test c a week with everyday injections. I use to go for blood draws as early as I could because for the other test they were fasted. Now I just wait to eat and go around noon so I can hydrate up.

 

[TacoLifter420]

I've always followed at least half your weight in ounces. So you're 290, 145oz and then adjust for activity level.