Does donating plasma have the same effect as donating blood on HCT? Be nice to get paid for improving HCT.
How much blood needs to be donated for a noticeable effect? 0.5 L?
What is the consensus level for HCT to do a donation? anything over 50? 52? 54?
With plasma donations, they return the red blood cells so it won’t help with HCT. Opinions vary on when to donate. Most would agree 50 is normal. Some suggest over 52. Others including my doctor, don’t worry about it until 54/55.
All of the ranges for hematocrit are arbitrary, 50, 51, 52 and especially 54%. The latter one was written by a doctor for the Endocrine Society, and when I asked why he chose 54% as the cut off for men on T replacement by Dr. Abraham Morgentaler, his reply was, it seemed like a safe number.
So the next time somebody says 55% is too high, for who?
I was at 55 and 57% and a hematologist put a stop to my monthly phlebotomies. I had no symptoms.
The same thing went down for the endocrine society choosing <300 ng/dL to be eligible for TRT, it’s arbitrary and not based on any medical science.
Maybe someday, we will be able to look at our genetics and find out what each individual’s limits are for everything.
Thanks for the excellent info. Amazing and more than a little scary how little the “medical community” can offer on AAS and so many other topics
Great data! Is the left ventricular hypertrophy commonly attributed to AAS use at least partially caused by Hct, Hb and RBCs out of the sweet spot range?
What would you recommend as a course of action, for example, for Hct at 51% while Hb and RBCs in normal range?
I am going to add low dose aspirin daily, a preventative addition also suggested regularly by my cardiologist. Thanks.
I’d say increase in HCT, HB, and RBCs from AAS are an indirect cause of left ventricular hypertrophy. I’d say it is indirect because it seems the BP and heart rate are what matter (from my understanding). If the increase in HCT for example causes BP to go up too much, you will cause LVH.
I could be wrong on this. My understanding is that LVH without AAS is caused by extreme exercise (which makes the heart work hard), or the heart having to work harder than it should absent extreme exercise (BP and heart rate are directly correlated to how hard the heart is working). AAS can directly cause LVH as the heart is a muscle and AAS will cause growth there as well as the biceps (and other muscles).
So for me, if BP and heart rate are at a good spot, I wouldn’t fret too much over HCT being a bit elevated. Perhaps I am missing something, but to measure the work load of a pump, we have pressure and flow rate. Long life of the pump occurs when it’s not required to pump a high flow rate and when it doesn’t have to create large pressures. I don’t see how the contents of what is being pumped matters much as long as flow rate and pressure are good. Disclaimer, there is an argument of incredulity on my part here. I don’t understand everything. I am looking at it from an engineering perspective. For example, perhaps the texture of blood wears the surfaces of the heart or something in which case high HCT could matter.
As an engineer as well, I appreciate your analytical response! Ya I was thinking along the lines of elevated HCT causing the heart to work harder, which in turn enlarges the heart and causes LVH. Keeping all levels - Hct, Hb, RBCs, BP and heart rate sound like keys to minimization of negative results.
And dose reduction or ceasation above 52…
I’d say the latter two are more important. Easier to measure as well.
Measuring the former would be something I’d do if BP or heart rate were high as they may be the cause. If BP and heart rate are good, I’d pretty much ignore the former unless they were quite high (HCT 55+ or something).
It makes sense that AAS could directly cause hypertrophy to the heart muscle (mostly seen in LVH).
Are you saying having a low diastolic pressure would be good? Would it be good at the cost of increasing the distance between systolic (I think this is called pulse pressure, which I hear is bad to have a big pulse pressure?)?
Based on my last trip to the cardiologist, I’m not F’ed yet!
I’ve heard the ladies like the wide PPs 
. Thanks for the follow up!
I’m loving everyone’s engineering-based thoughts on this, but regarding the above statement my immediate engineering mind thought about an engine, naturally I thought of a hot rod engine! And thinking about the engine like a pump, I also immediately thought of…the OIL in the engine and the corresponding analogy of oil to blood. So, if you have MUCH thicker blood due to high hemocrit values, I thought about it like a very heavy weight oil vs. a much lighter weight oil. Now taking out diesel engines from this (since unfortunately our hearts are NOT as robust and impervious to high pressures/heavy beatings like a diesel can take) and just thinking about gasoline hot rod engines, you usually (ha, let’s not digress this into a true engine discussion where we factor in weather, lubricity agents, detergents, etc lol)want a pretty “light”, very viscous type of engine oil. Because with much thicker, heavier weight oils, the engine[heart] has to work much harder to circulate it throughout the entire engine[body].
So having much less viscous, thicker blood will directly correspond to much greater stress placed upon the heart out of the mere fact that your heart will have to increase in size to get strong enough to adequately circulate blood throughout your entire circulatory system…end result, you have higher blood pressure AND a thicker heart as a result.
Personally I like to play it safe and donate blood 2-3x a year. I do the double-red donations, and I just make sure to take a quality daily multivitamin that has QUALITY chelated minerals and overall the most bioavailable/absorbable forms of vitamins/minerals [and for sure Iron!] and I also have been taking the supplement NATTOKINASE which I read about several months back here on T-nation. If those of you following this thread haven’t read up on this heart healthy supplement it’s a highly suggested reading. This supplement is supposed to be VERY beneficial for your heart and blood and really the whole circulatory system.
I’ll step away and leave this discussion to be carried by the much more medically inclined contributors in this thread, but I just thought that thinking of the blood/heart/etc as an engine in a car might help others visualize the importance of hemocrit levels and having healthy blood markers.
I agree with you generally.
My point was more along the lines of BP and heart rate are what matter. If HCT is too high for someone that is going to show in their BP measurements. I don’t care so much what the HCT value is on a lab report if BP is good, but if HCT on the lab report is high, and so is BP, I am looking into addressing HCT as that is likely the culprit (or at least one of them).
I agree with you on that, and would just add for others reading to be VERY mindful of your diastolic number when reading your blood pressure as that is an important marker for heart/circulatory system health! Yes, both numbers are important but the diastolic, or “resting”, number is very important to cardiologists/doctors. If that number is high, or in the elevated range, you would be wise for quickly trying to remedy that situation
Won’t that show up in BP readings though?
Just me personally, I prefer to keep an eye on my HCT values because even if (it’d be nice to see some analysis on the correlation between high HCT and what percentage of people who have this also have higher BP readings) my BP were to be categorized as “good/acceptable”, I still think that I would worry about having a greater chance of developing blood clots e.g. having a stroke! Also it’s just my over-imaginative mind that would get to me, thinking about what potential damage might be occurring within my body as I picture my blood looking like ragu, ha. I cannot even conjure up ONE good reason why having high HCT values might be beneficial…especially over an extended period of time. Perhaps there might be a good reason but I cannot come up with any logic why one would say “okay, my HCT is a 56…my BP is in the acceptable range, therefore I am probably ok”. Would there ever be a “benefit” or an “acceptable reason” for having high HCT? Or is it very black and white: high/bad…moderate to low/acceptable? Just pontificating aloud here.
Thanks for the video. According to this guy…eh, it’s no problem! While I followed his analogy regarding people living at altitude not needing to have blood drawn, I just can’t get on board that line of thinking when it comes to testosterone’s effects on HCT. Something about taking a hormone that causes an unnatural increase in HCT vs. living at altitude and your entire body adapting just doesn’t seem equal. But again, I simply prefer to err on the side of caution and donate blood usually 2 but sometimes 3 times a year because whenever I get my bloodwork back (my physician, and I, like to do bloodwork a few times a year just to keep an eye on all my various hormone and blood markers) my HCT is almost always elevated if I have not donated in awhile…like about 55 or 56…once it was 57. I just don’t feel comfortable having my blood be that “thick”. And I’ve done bloodwork after donating and it doesn’t “crash” my HCT…it usually only drops it a couple points to get it around 50 or a point or two under.
Interesting, I have actually noticed every time that when I train after donating (I do like to wait 3-4 days to let my system recover by taking multivitamins and getting many nutrient-dense meals in me), I get a much more wicked pump during my workouts! I would think that with the reduced blood volume I would not, but for some reason I do. My only thought on that is perhaps my heart is still working as hard as it was before donating, and that coupled with having less viscous blood allows my circulatory system to be more efficient? ha, I don’t know, but I like it.
Plasma doesn’t reduce red blood cells, and it’s my laymen’s understanding that it regenerates within days.
Regarding whole blood donations, anecdotally I find that when hemoglobin hits 50 I’m out of breath, have lower energy in general and feel “full” for a lack of a better term. After donating I feel great. I seem to replace donation values (pint?) right at 3 months.
I’ve given double red too, and felt even better, but feel I still replaced everything within three months, then had to wait three more per donation center guidelines. It was miserable and I was at more like 52-53. My blood pressure was elevated and my pulse was over 105 by the next time I went in. I couldn’t even donate. I had to get a doctors note for a phlebotomy to get to the point I still needed a donation, which the clinic wouldn’t allow, citing time between withdrawal.
I ultimately found a wellness clinic willing to do a phlebotomy for $50 and no questions. I used them, then donated a single pint or whatever they take asap at the normal donor center. It was a scary journey to territory that felt dangerous and wound up being difficult to manage due to liability red tape everywhere.
Now I donate religiously once every three months and sometimes sneak in to the $50 phlebotomist in between just to stay below the threshold instead of right on it.
Definitely find your rhythm and stick with it.