Doc: "Your Testosterone is TOO High for Your Age"

Training Over 35 Lifter
1

Hi. Some background-- I’m 52 years old, been training regularly for years (mainly powerlifting, although my numbers are not too impressive). I went for my annual physical recently and asked for my testosterone levels to be tested. It came out to 717. Also my red blood cells came out slightly high. I don’t have the figures in front of me right now, but it was like 5.7 or something like that. Due to the RBC level, my regular doctor sent me to a blood doctor.

During the visit to the blood doctor, the doctor commented that my testosterone was “very high” for someone of my age. He then asked if I was taking any extra testosterone. I told him no. Then he looked down his nose at me, over his glasses, and asked “by that I also mean any supplements, like those herbal things over the counter. Are you SURE you’re not taking anything that would increase your test to these high levels?”. Again I said no (which is the truth).

Now he wants me to get another blood test to check for any bone marrow issues (lukemia?), which he said is very rare since I am not presenting any of the symptoms, and he also wants me to go to a sleep clinic to make sure that I don;t have sleep apnea, which would also cause an increase in RBCs.

Has anyone heard of a connection between “high” testosterone and red blood cell count being high? Any thoughts on this sleep apnea approach? Let’s put aside the fact that I was essentially accused of juicing.

2

Yep, well known. Guys even on TRT doses sometimes have trouble with too many red blood cells. Guys who cycle / blast routinely deal with thick blood due to excess red blood cell production.

3

I would think if you had sleep apnea you’d experience a decrease in natural test levels. I just had a conversation with my doctor about this the other day. I am on TRT but it seems my levels have been lower over the last year on the same dose. He suspects apnea is the cause. Just started treatment for SA so I guess we will see.

4

There are a boat load of reasons this can happen. Many are temporary. Have you had any blood work before this where the count was abnormal?

5

That’s the rub. For the last 5-6 years, my RBC has been consistent at the number that it tested at during this most recent test. In this year’s test, the lab changed the reference range, so it got highlighted as “high”. Had the lab not changed the reference range, it would have come in as normal and in range.

1 Like
6

what is the sleep apnea treatment? I don’t think I am going to wear a huge mask to sleep.

7

I’ve gotten the same questions from doctors because my test levels often come back flagged as high (last test measured my TT @ 1100 ng/dl). The accusations can be annoying, but for what it’s worth, I have not found any underlying causes or medical issues associated with naturally high testosterone levels.

If your RBC is only slightly elevated, you may consider regular blood donations after ruling out any potential causes that you or your doctor are concerned about.

I don’t understand the connection between your levels and sleep apnea, but if you snore or often wake up during the night it may be worth exploring.

8

Absolutely! In my mind, the major potential danger of TRT. If hematocrit and hemoglobin are too high, your blood turns “sludgey.” The heart doesn’t like “sludgey” blood; leads to strokes and other unpleasant things.

2 Likes
9

Ways to lower hematocrit:
Donate blood

This is the standard go-to treatment for high hematocrit. Every pint donated has been shown to decrease hematocrit by about 3 points. Unfortunately, you’d likely have to continue to periodically donate blood if you hadn’t adopted any other hematocrit-lowering strategies.

That being said, there’s some evidence that hematocrit levels stabilize after donating blood five times. Whether that’s universally true is unlikely.

You can donate blood to places like the Red Cross or have your doctor perform what’s known as a “therapeutic blood draw.” Be careful not to donate too often, though. Giving a pint of blood more than every two and a half months or so may lead to long stints of fatigue.

Hydrate

High hematocrit readings sometimes occur because the patient was simply dehydrated, making it appear that the concentration of red blood cells was higher than it really was.

Of course, one simple way to determine whether your high hematocrit was caused by dehydration is to do a little simple math: hematocrit must always be three times the value of hemoglobin. If it’s lower (Hct<3 x Hb), you’re over-hydrated. If it’s higher (Hct>3 x Hb), you’re dehydrated. Either way, you’re getting a false value because of your hydration status.

Avoid or reduce red meat consumption

Red meats are high in heme iron (the type of iron found only in animal tissues), which is more efficiently absorbed than non-heme iron (the type found in whole grains, nuts, seeds, legumes, and leafy greens), and ingesting it can raise hemoglobin and, subsequently, hematocrit.

Address sleep apnea

Sleep apnea is a medical condition where patients suffer from fragmented sleep. They literally stop breathing from 10 to 50 seconds multiple times throughout the night.

As a result of this interrupted breathing/sleep, patients experience poor oxygen saturation, which forces the body to produce more red blood cells and more hemoglobin.

Take curcumin

Evidence suggests that curcumin binds to ferric acid in the digestive system, thus reducing hemoglobin levels. Be sure to use micellar curcumin which is 95 times more bioavailable than regular curcumin with piperine.

5 Likes
10

I’d be concerned with high RBC or HCT really only if blood pressure is high (assuming RBC and HCT aren’t sky high). This is just my approach, and not medical advice, but for me if my numbers were borderline or a bit above, but BP and heart rate were in a good spot, I’d just ignore it. If BP was high, and RBC and HCT were borderline, a bit high, or high, then I would look to address RBC and HCT to bring BP into range.

11

It is the mask. I’m using the one that just covers my nose. It’s really not that bad but i’m only a couple days in. The choice I have is solve the issue or not sleep. I can’t go on as I am only getting 2-3 hours of decent sleep per night. I’m pretty much dead on my feet daily. My sleep study shows 22 episodes per hour of apnea.

12

Thanks. I am somewhat curious how my sleep study may come out. I am generally tired when I wake up, but I am fine once I get out of bed and throughout the day.

13

That’s how I was a year ago. Last few months have been almost unbearable. I prob have to leave work to nap at least 2-3 times per week. Can’t think straight. Always exhausted. Barely getting through my workouts…
Don’t let it go. Sleep is so important.

14

My RBC is slightly elevated and hematocrit is right at the upper level currently. Hemoglobin is usually around 16ng/dl. I donate blood regularly. Just started treatment for SA. Will be interesting to see if these markers change.

15

Quick update:

Went to the blood doctor as noted in the original post. Got the bill-- for a 15 minute discussion it cost me $385, and that’s after the “discount” of $115 because he was in network (otherwise the 15 minutes would have been $500. I have a high deductible health plan (I think the deductible is around $8,000(?)), and I have not yet met the deductible.

I did the blood test and have a follow up Facetime with the doctor at the end of the month. No doubt that will be another $385.

I tried to call the lab and my insurance company to find out how much the blood test was going to cost before I went (again, because I am paying for it due to the high deductible), and, incredibly, not even the insurance company could give me the cost. I actually said to them…“so you have no idea how much this blood test costs (despite giving them the specific name of each test) but somehow miraculously two weeks after the test is done, you will know to the penny how much to charge me?” They didn’t have a good answer and said they could not tell me the cost in advance.

Anyway, every test came out within range, even the RBC and the other tests that were slightly out of range. I am still waiting for the Jak2 blood test result which would show a bone marrow issue, but given that everything else came out perfect, I am hopeful the Jak2 will come out fine, too.

I think this whole ordeal is going to cost me about $2,000 when all is said and done.

16

You posting your challenges is such a help!
I’m nearly all synthetic, not by choice.

Threw a clot. They want to blame on T… My hemocrit is high, always has been. I give blood but yeah. I posit it’s more likely either that I had Covid 1 1/2 - 2 months before, or dropped a round (log cut to split) on that leg. It had the weirdest bone bruise I’d ever seen…

But anyway. No one, not even the various specialists have mentioned sleep issue as causal for high RBC/hemocrit… My sleep sucks. And nothing that I’m not already doing can really change that in my case.

So thank you so much for documenting your experience it has given me an avenue that may help me avoid a rather unfortunate event.