Both are mediated by Erythropoietin. I’m not even aware that we know why the body increases erythropoietin in the presence of higher serum testosterone. I could be wrong but you don’t seem clear on this either. It seems a jump to assume what you’re assuming in the highlighted sentence. It may turn out that the body requires more oxygen in the presence of higher serum test and all of the implications for that.
So, if someone who’s ancestors lived in Bangladesh were to move to a remote community in the Swiss Alps, and - like everyone else in that community - developed high levels of red blood cells, they should start donating blood regularly?
As for the bolded sentence, I am not saying (nor was Dr. Crisler, nor is Rouzier) that we should just let all the numbers go wild and not pay attention to them at all. What IS to be avoided, rather, is the knee-jerk reaction that just because your RBC is a bit above the normal values, that we should start giving blood every 6 weeks or so.
I can say with personal experience that this was totally counterproductive in many ways; when my RBCs at one point came in at slightly higher-values than normal, I began (at the behest of Dr. Crisler) to donate blood. And my numbers climbed higher; and so I donated blood monthly. But the more blood I gave, the more my numbers climbed.
And then I met Dr. Rouzier, who convinced me that I shouldn’t be doing this. And when I stopped doing it, guess what? My RBCs subsided quickly to very normal levels. In other words, the elevated RBC was likely transitory; and by donating blood every month I was sending my body into some sort of hyper-erythropoietin state.
Ok, I see how I misread the line I quoted, but I’m still not sure why I was tagged. If you have relevant info to share that abides by forum policy, of course go ahead.
One thing I’d appreciate, and I believe others in here in the TRT forum would too, is a super-quick intro before dishing out a ton of advice. I’ve previously suggested someone start a “Credentials”-type thread for everyone to post in.
A bad habit I’ve been noticing is people speaking very definitively about complex topics when they’re still learning themselves - beginners teaching beginners, essentially. With TRT, that’s a dangerous and confusing game.
Why is this even a debate? If a trained professional recommends you to donate blood, do so. The downside risk is completely immaterial, and the upside benefits are potentially life saving.
Not just life saving for you, but for the person who is going to benefit from your donation. You can literally save a life by giving 10 minutes of your time. Folks can get caught up in semantics and academics…there are thousands of chemo kids sitting in hospitals all over the country that need a transfusion NOW. There is a blood shortage. Folks are literally going to die because they don’t have access to a blood transfusion.
We sit here and squabble about should we/shouldn’t we…guys put this entire topic in perspective and you’ll quickly realize how ridiculous this conversation is. At the end of the day take care of yourself, and take care of those in need.
Yes, donating is a good thing; and everyone healthy enough to do it, should. Platelets too, etc…
But when TRT patients donate regularly because they are told to by their doctors (sometimes but not always legitimately), problems can arise:
Did the doctor tell him to make sure to take iron? I’ve known many TRT patients that become anemic - which is no joking matter.
What if the person takes or took propecia?
Or, what if the person is at (exceedingly remote) risk for any number of diseases - such as having traveled to a country during a specific time period and ate meat (Creutzfeldt-Jakob disease (vCJD))
Now that person has to get a prescription to get this done AND has to pay for it.
And so on.
The point is: do it because you want to; and do it if you have to - but ONLY if you have to. And that is what is at issue in the “debate”.
Thanks for sharing your story. My intention above was to provide information on the effects of elevated Hct. Nowhere in my posts in this thread have I mentioned or suggested phlebotomy. At what Hct level or with what means one decides to take corrective action is up to them and their provider. I hope the attached information is helpful to folks on this forum. Best wishes on your journey.
Results: For men undergoing TTh, the risk of developing erythrocytosis compared with controls is well established, with short-acting injectable formulations having the highest associated incidence. Potential mech-anisms explaining the relation between TTh and erythrocytosis include the role of hepcidin, iron sequestration and turnover, erythropoietin production, bone marrow stimulation, and genetic factors. High blood viscosity increases the risk for potential vascular complications involving the coronary, cerebrovascular, and peripheralvascular circulations, although there is limited evidence supporting a relation between TTh and vascular complications.
Op… I tried to donate late last year, but got turned away as my hgb was 18.4, mid 17 was their upper acceptance limit for men ,… I’ve since finished cycle. I’m assuming all is back to normal, red blood cells will die off after three months, and hgb return to normal assuming no medical condition so relax not much in the way of blood testing in Ireland. I’ll try donate next time they are in town and see
Good news! Blood donation dropped everything by 10% exactly! Hematocrit went from 56 to 50 and Hemoglobin from 19.1 to 17.2. I only dropped 10 points on my ferritin also.
I’ve thought off and on about this feedback. Thank you for suggesting it and sharing your perspective. I know others have participated in the TRT credentials thread. Since this is an anonymous forum (at least one is given the option to be that and given the material some would not engage in discussion unless it was anonymous), providing any sort of credentials when discussing such a complex topic would seem potentially deceptive to me (appeal to authority). I know of no experts on this topic (elevated Hct with TRT and risks after 1, 5, 10, 20 years). The folks who I gravitate towards freely admit we don’t understand all aspects of it as it is very much an active area of research.
I’ve spoken with many very well-respected board certified medical providers. Some have worked at institutions that start with the letter M if one likes to drop names. Heck I have a couple of men’s health doctors who freely text me since they think I am much more knowledgeable/up to date on the research than they are. It’s that combination of theoretical knowledge and clinical experience that is so valuable which I seek out.
Note to the interested reader, I’ve created a separate thread for discussion/debate/examination of the literature around hematocrit elevated via TRT, and the merit of the idea that high altitude erythrocytosis gives a blanket justification for running Hct above range with TRT:
I hope the theory/mechanistic information can be debated freely without names being dropped as justification for the stance/position. I know this idea of “double blind” anonymous (both author and reviewer) peer review is being hotly debated currently in the academic community since currently most journals still identify the author(s) during the peer review process.
From article: When humans are exposed continuously to hypoxia, they develop adaptative mechanisms that are far more efficient than those observed in newcomers.50–53 These long-lasting mechanisms include anatomical (wider chests, shorter and lighter bodies, etc), embryological (smaller fetus and placentas), circulatory (improved maximum flow output and higher pulmonary arterial pressure) and respiratory adaptations (improved hypoxic ventilatory response and oxygen diffusion capacities).52 54–56 Chronic exposure to hypobaric hypoxia leads to the development of more subtle compensatory mechanisms. These factors include long-term erythrocytosis, angiogenesis, capillary remodelling and an improved ventilatory response57–60 (figure 2).
It’s odd as to how testosterone mediated side effects are somehow considered distinct from that of side effects mediated from the pharmacological effects of synthetic anabolic steroids.
High HCT on EQ? That’s dangerous! Stop using steroids
High HCT on T? It’s JuSt TeStOsTeRoNe BrO! Do you really think ‘TOT’ (say 200-250mg test/wk) is that much safer than 200mg of methenolone per week? Probably not… I’d wager for some the methenolone might even be ‘safer’, not that AAS use is ‘safe’ to begin with.
Yes, however this argument is a moot point. Synthetic doesn’t necessarily mean inferior either.
It reminds me of the old age “its just a plant” argument as to why cannabis is purportedly so great for you (it isn’t aside from medicinal applications that in todays society/culture have been heinously overblown).
You know what else comes from a plant? Morphine… “iT’s JuSt A pLaNt BrO”… oh wait…
Scopolamine also comes from a plant… What about the gazillion other deadly plants like Atropa Belladona?
Agreed. I don’t have any issues with my metoprolol tartrate/succinate or propanolol being synthetic. Very grateful. Same for those nasty synthetic thyroid meds (joking).
I don’t think I gave them a fair shake and I got pretty desperate. So doing a more comprehensive study on myself. I think my hashimotos got really bad and was causing micro bursts of thyroid hormone from dying tissue perhaps? Very hard to chase down.
not much in the way of blood testing in Ireland. I’ll try donate next time they are in town and see