NL Journal of Medical and Pharmaceutical Sciences
(ISSN: 3108-0502)

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Subcutaneous Testosterone-GAC and Hematocrit Outcomes

Author(s) : Lisandra Santos del Castillo*.
DOI : 10.71168/NMP.02.03.134

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Abstract

Testosterone replacement therapy (TRT) is an established treatment for male hypogonadism; nevertheless, a significant side effect is erythrocytosis, marked by elevated hemoglobin and hematocrit levels. The elevation in red blood cell mass caused by testosterone is significantly associated with intramuscular (IM) administration, leading to supraphysiologic serum testosterone levels and enhanced stimulation of erythropoiesis. Increased hematocrit is associated with heightened blood viscosity and an augmented risk of thromboembolic and cardiovascular consequences, sometimes necessitating dosage decrease, treatment cessation, or therapeutic phlebotomy. This observational case series evaluates the hematologic consequences of modifying the route and formulation of testosterone delivery. Thirty adult male patients receiving established testosterone replacement therapy (TRT) and displaying elevated hemoglobin and hematocrit levels while on intramuscular (IM) testosterone were switched to subcutaneous (SC) testosterone, compounded with a blend of glutamine, arginine, and L-carnitine (GAC), administered thrice weekly. Following the intervention, hemoglobin and hematocrit levels either declined or remained stable in the majority of patients, with no future increases seen and no need for therapeutic phlebotomy throughout the follow-up period. The results suggest that subcutaneous testosterone therapy, when combined with GAC and delivered via more frequent, lower-dose injections, may mitigate testosterone-induced erythrocytosis while maintaining therapeutic effectiveness. This study promotes the assessment of alternate administration techniques for individuals displaying elevated hematologic indices during testosterone replacement treatment (TRT). Keywords: Testosterone Replacement Therapy (TRT), Subcutaneous Testosterone Administration, Testosterone-Induced Erythrocytosis, Hematocrit Management, Hypogonadism.

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