balancing FT with low shbg and high H&H

[Tylurnt]

Ive been on cream for a good bit now but struggling balancing H&H. its been upwards of 55.9 , and it undeniably makes me feel worse.

My SHBG is 10, and ive been running 650-850 TT for a while. Finally got a protocol dialed in that got me to 603 TT at 5hrs after application but my FT was 250! My protocol is pretty complicated as it took me forever to get it right, i was targeting 550-600 TT thinking it would help H&H but its still 53, and hemo is 18.1 and headaches and fatigue are starting back in.

My protocol is 2 clicks 2x per day of 200mg/ml with a unodose with 5 holes... 20mg scrotum, 80mg leg morning, 10mg scrotum, 90mg leg at night. Before, 10mg scrotum 90mg leg 2x per day got me to 433 TT, a tad low.

Do you think if I wipe away 20mg of leg application and get it down to 500-550 that it will get my FT better in range and help H&H a good bit, or am I screwed with this major erythrocytosis my body seems to go into on TRT ? I feel so much lighter with my HCT below 52

 

[Gibbon]

I feel what you are going through on low dose shots my Hematocrit is over 53. have sleep apena I recently started treating and hope my other hormoned balance out as my urologist has said it affects shbg. Have you checked for sleep apnea.? It seems prudent that all men on TRT check for sleep apnea.

What was you free T at 433 total? You say it is a tad low but based on what? If you had a TT of 400 but your free was between 150 to 200 maybe that is a good level? I say this because when I hit a total of 500 and free of 150 on cream (atrevis) applied once a day on shoulders it worked well. I may go back to trying cream as shots have been rough but I am waiting to see what happens after a few months of treating the sleep apnea. I was a person that snored but was sure I had not sleep apnea but was wrong.

Have you tried just applying once a day in the morning? Madman posted a video of a doctor I think was in the UK that I listened to and he stated you really only need to get your free T and total up to a decent level ONCE per day. Others here like Cat and Madman would have good advice I think. Seems you may be getting two large peaks of a free at 250 which may not be the best protocal.

 

[Tylurnt]

I feel what you are going through on low dose shots my Hematocrit is over 53. have sleep apena I recently started treating and hope my other hormoned balance out as my urologist has said it affects shbg. Have you checked for sleep apnea.? It seems prudent that all men on TRT check for sleep apnea.

What was you free T at 433 total? You say it is a tad low but based on what? If you had a TT of 400 but your free was between 150 to 200 maybe that is a good level? I say this because when I hit a total of 500 and free of 150 on cream (atrevis) applied once a day on shoulders it worked well. I may go back to trying cream as shots have been rough but I am waiting to see what happens after a few months of treating the sleep apnea. I was a person that snored but was sure I had not sleep apnea but was wrong.

Have you tried just applying once a day in the morning? Madman posted a video of a doctor I think was in the UK that I listened to and he stated you really only need to get your free T and total up to a decent level ONCE per day. Others here like Cat and Madman would have good advice I think. Seems you may be getting two large peaks of a free at 250 which may not be the best protocal.

I test for OSA twice and it was very mild, like 1 or 2 points over normal. so I dont think thats it. I do have nasal congestion a lot which could be an issue...but maybe my FT is just too high causing fatigue and my body just doesnt like it? fatigue is my biggest issue.

as far as 433... I didnt test FT at that time. I only held that dose for a week and just didnt feel ir was enough but maybe didnt hold there long enough.

whats weird is, the times I was running 700-800 and lowered my dose substantially, I felt great the first 2-4 days then felt like shit again. So maybe was passing my sweet spot?

 

[Tylurnt]

I feel what you are going through on low dose shots my Hematocrit is over 53. have sleep apena I recently started treating and hope my other hormoned balance out as my urologist has said it affects shbg. Have you checked for sleep apnea.? It seems prudent that all men on TRT check for sleep apnea.

What was you free T at 433 total? You say it is a tad low but based on what? If you had a TT of 400 but your free was between 150 to 200 maybe that is a good level? I say this because when I hit a total of 500 and free of 150 on cream (atrevis) applied once a day on shoulders it worked well. I may go back to trying cream as shots have been rough but I am waiting to see what happens after a few months of treating the sleep apnea. I was a person that snored but was sure I had not sleep apnea but was wrong.

Have you tried just applying once a day in the morning? Madman posted a video of a doctor I think was in the UK that I listened to and he stated you really only need to get your free T and total up to a decent level ONCE per day. Others here like Cat and Madman would have good advice I think. Seems you may be getting two large peaks of a free at 250 which may not be the best protocal.

what do u mean other hormones balanced out that lower shbg?

 

[Gibbon]

Sleep apnea screws with shbg, colesterol, the liver, metabolism, hematocrit, and who knows what else. I have the problem of I cannot keep my injection levels remotely stable like I did at one time. The thought is I treat the sleep apnea and things will settle down. It is either that or I go to creams or daily shots.

 

[Tylurnt]

Sleep apnea screws with shbg, colesterol, the liver, metabolism, hematocrit, and who knows what else. I have the problem of I cannot keep my injection levels remotely stable like I did at one time. The thought is I treat the sleep apnea and things will settle down. It is either that or I go to creams or daily shots.

SpO₂ 95%, nadir 90%, and zero time <90%. we're my results. Very mild... but I also have all the symptoms you listed.. high cholesterol , low shbg and i suspect i have some liver issues but doesnt show up on any labs

 

[Gibbon]

SpO₂ 95%, nadir 90%, and zero time <90%. we're my results. Very mild... but I also have all the symptoms you listed.. high cholesterol , low shbg and i suspect i have some liver issues but doesnt show up on any labs

I was down to 77 and had lots of time below 90 on Sp02. What were your events per hour? I was close to 30 and now less than 2 most nights and even less than 1 per hour a lot of the time. I'm really hoping this helps me overall.

I'm just a random guy on this site but again it seems like pushing your free to 250 twice a day is a lot. Maybe Madman will see this and can post that video about the once a day peak. I would think a free of 150 to 200 once a day would be enough. It would give your body a rest and help hematocrit. Just a thought.

 

[Vince]

Ive been on cream for a good bit now but struggling balancing H&H. its been upwards of 55.9 , and it undeniably makes me feel worse.

My SHBG is 10, and ive been running 650-850 TT for a while. Finally got a protocol dialed in that got me to 603 TT at 5hrs after application but my FT was 250! My protocol is pretty complicated as it took me forever to get it right, i was targeting 550-600 TT thinking it would help H&H but its still 53, and hemo is 18.1 and headaches and fatigue are starting back in.

My protocol is 2 clicks 2x per day of 200mg/ml with a unodose with 5 holes... 20mg scrotum, 80mg leg morning, 10mg scrotum, 90mg leg at night. Before, 10mg scrotum 90mg leg 2x per day got me to 433 TT, a tad low.

Do you think if I wipe away 20mg of leg application and get it down to 500-550 that it will get my FT better in range and help H&H a good bit, or am I screwed with this major erythrocytosis my body seems to go into on TRT ? I feel so much lighter with my HCT below 52

My brother was tired all the time. He is not on TRT. He tried a CPAP machine and it gave him back his life. You may want to give it a try.

 

[Vitamin_C]

That sounds frustrating, especially after all the effort you’ve put into dialing things in. I wouldn’t assume you’re “screwed,” but a forum can’t reliably predict what removing 20 mg of cream would do to your testosterone levels or hematocrit.

Some useful questions for your prescriber: How was the free testosterone measured, what are its units/reference range, and was the blood draw timed appropriately for your cream? “FT 250” is hard to interpret without those details.

The recurrent hematocrit elevation deserves its own discussion, including whether you've evaluated contributors such as sleep apnea or low oxygen. The Endocrine Society uses hematocrit above 54% as a threshold for clinician intervention, and you’ve previously exceeded that.

With headaches and fatigue returning, contacting your prescriber promptly seems more useful than continuing to chase a particular total testosterone number. Those symptoms shouldn’t automatically be attributed to hematocrit alone.