Maximus uses Selective Estrogen Receptor Modulators (SERMs) as part of its testosterone optimization protocols. Studies show "SERMs did not elevate the hemoglobin level or the hematocrit."1 Specifically, "no erythrocytosis occurred in men taking Enclomiphene"; average Hermatocrit was 46.9% at 12 months, which is well under the threshold of 50% that would be of clinical concern or 54% requiring phlebotomy.2 Thus, Maximus' SERM-based protocol offers a key advantage over injectable Testosterone Replacement Therapy (TRT). References:
Awouters M, Vanderschueren D, Antonio L. Aromatase inhibitors and selective estrogen receptor modulators: Unconventional therapies for functional hypogonadism? Andrologia. 2020;8(6):1590-1597. https://onlinelibrary.wiley.com/doi/full/10.1111/andr.12725
Pastuszak AW, Wiehle RD, Fontenot G, Podolski J, Lipshultz LI. Mp76-07 comparison of the effects of oral enclomiphene citrate and topical testosterone gels treatment on serum hormones, erythrocytosis, lipids, and prostate specific antigen. Journal of Urology. 2016;195(4S). https://www.auajournals.org/doi/full/10.1016/j.juro.2016.02.1858