Hematocrit Rising

Pharma / TRT Testosterone Replacement
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I had my blood drawn at Quest and the results were a little concerning to me only because I am just looking at the lab ranges. Am I being silly ?

RBC: 5.82
Hemoglobin: 17.6
Hematocrit: 51.5%

I haven’t seen my doctor yet and don’t have appointment until 3 weeks. Is this at all concerning ? At the time of this lab I was taking 100mg once a week with an SHBG of 11. I think it was spiking levels but who knows as I am no expert by any stretch. I am not currently on daily injections of 10mg. ( 70mg cypionate a week ).

Thanks all !

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PS Hematocrit Rising sounds like a badass movie title now that Im reviewing it lol

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Maybe a song title from some metal band

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I wouldn’t be concerned, assuming you are otherwise healthy, have no heart conditions, normal lipids, etc.

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lol right?!

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Donate Blood… no joke

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Prefer not to donate if I don’t have to. I just asked the doc I work with ( pulmonary ) and he wasn’t concerned at all. Said he wouldn’t bat an eye until over 54% or symptomatic. He did say it would be good to take a baby aspirin with TRT though from his experience . I guess that seems like sound advice. Didn’t think he would be in the office today.

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My endocrinologist is less concerned about hematocrit and focuses more on the hemoglobin values. Recently my hematocrit was 58.5%, hemoglobin 19.1. He only showed concern for the hemoglobin value.

With a secondary erythrocytosis there is an increase in blood volume which enlarges the vascular bed, decreases peripheral resistance and increases cardiac output. Therefore, in a secondary erythrocytosis optimal oxygen transport with increased blood volume occurs at a higher hematocrit value than with a normal blood volume. A moderate increase in hematocrit may be beneficial despite the increased viscosity.

There are over 80 million people that live higher than 2,500 meters and they develop a secondary erythrocytosis. Men in parts of Bolivia for instance have a normal range of HCT from 45-61%. These men are not at an increased risk of thrombotic events nor do they have to undergo phlebotomies to manage their hematocrit.

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I would follow your docs advice first and foremost.

I do believe self-advocation can be important, however.

In my opinion and experience blood donation on TRT is very important. It’s a scenario where you can’t hurt yourself doing it but might if you don’t.

I personally feel like shit when hematocrit and/or hemoglobin climb outside of normal ranges. It’s hard to say which is the culprit as they occur simultaneously for me.

While I understand the discussion around increased oxygen, my take is the oxygen still has to be able to circulate or it’s a moot point. There is a limiting return, though I’m sure this point can vary from one person to the next.

My blood will get thick enough it affects blood pressure and heart rate if I don’t donate. I typically measure BP right at 120/80 with slight variations in either direction, and a resting heart rate of around 70.

I start noticing headaches, sort of a low grade pressure, general tiredness/lethargy and lack of energy at the gym as values climb. When this begins to happen, measuring blood pressure generally shows an increase to about 140/90 and sometimes as high as 160-170 / 100-110.

This recently occurred and I donated blood immediately on Monday of this week (2 days ago). My heart rate was also at 106.

By the time I got home and measured my BP it was 122/79 and has stayed there. In my experience this will be the case for about two months and everything will start to climb again, sometimes gradually sometimes abruptly and significantly. Donating always regulates successfully.

Interestingly when donating, my blood is very thick, slow moving and a super dark red initially. Through the donation process it begins to flow better and the color even changes to a bright red. You can literally watch the thick blood leave my body, and I swear I can feel it too. The pressure subsides and I just feel better in general. Happens every time.

I couldn’t even finish my lifts on Monday, pre donation. I did heavy squats and felt like my head would explode/had no energy. I was back in the gym today and felt fantastic. Went hard and still left with gas in the tank.

So objectively I see health markers improve with donations, and anecdotally I feel immense benefit.

You will not hurt yourself by donating blood but you may if you don’t. I don’t care what Brazilian jungle tribes are doing, over pressurized pipes are simply bad news. It’s a matter of physics. Plus you may save a life.

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Thank you , my hemoglobin was not too bad at all. I’ve also lowered my TRT dose pretty significantly as well over the last year. Most recently down to daily injections. Maybe this will help it as well ?

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Makes sense. I will take my blood pressure today, but resting heart rate is still pretty low at around 61 and im not in great shape. Working on it though lol

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Getting ahead of the curve can be smart. If you see it starting to rise go ahead and donate, and get on a schedule. If you wait until it’s a problem you’ll always be managing the top end of normal at best.

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I will monitor blood pressure. If it starts going up then I will definitely donate blood. My doc said there is a strong chance of mild dehydration as well . Thank you for responding, i will definitely keep donating blood in mind.

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I’m assuming you meant “I am now…”. For me daily injections made a huge difference in terms of alleviating the negative side effects of Testosterone (Estrogen, really), including lowering water retention, blood pressure and hematocrit.

If those numbers were on 100mg/week in a single weekly injection and you’re now doing 10mg/day and haven’t yet done labs, I would wait and give it some time for things to settle down. Not only are you taking significantly (30%) less Test, but you also moved to daily injections; I’d be shocked if your Hct doesn’t go down a lot, but it could take a while for it to normalize, so keep an eye on it and be patient.

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I think this has been shown not to be true, actually. I don’t have time or care to look for the evidence right now to be frank, but I would caution anyone against making that assumption. Make sure you do some research

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Yes after feeling like dog shit for 6 weeks on 100mg once a week I switched about a week ago to daily. I have found so far I feel slightly better already and sleeping better which was a huge problem before. I will wait another 6 weeks and repeat labs.

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So went to PCP today regarding my lab work and “ slightly “ elevated HCT. He said he is very concerned and considering stopping the TRT. I am hoping these daily injections will reduce HCT and start trending the other way. I assume going from 100mg once a week injection to 10mg daily injections should do the trick. If not , would perhaps creams work better ? I strongly prefer not to donate blood and my physician said thats a last resort as well.

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So you make a claim but don’t care to take the time to provide evidence! This only weakens your argument.

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Your doctor is of the typical bread of doctors that freaks out due to lack of understanding of the therapy he is providing. There are people living at high altitude with higher HCT and no one is forcing them into donation centers to manage their HCT!

Your risk crashing your ferritin levels. You’re headed down a path that leads to suffering. Your HCT will recover within weeks of the donation, and you’ll be right back where you started, another donation and crashed ferritin.

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My thoughts exactly. If he wants to stop the therapy I will be happy finding a new provider. I feel like he has no idea what he is doing. I told him i have low SHBG therefore more prone to spikes from less frequent injections. He has a deer in headlights look on his face.