Hey guys- Needing advice here regarding my TRT. Age 62, 5’8” 185lbs. Been on TRT about three yrs now. Awesome experience for me in multiple ways. 3-4 days training w/trainer. I inject 1/2 ML weekly. About 1 yr ago I started experiencing the common elevated red blood cell count which my Urologist scheduled red blood draws every 90 days. All good until now. My blood has become thick and increasingly difficult to draw. Last week went for my labs (3 viles). Nurse barely pulled 2 viles and had to enter a 2nd vein for third vile. Prior to that I was in for 3 mo phlebotomy and what was normally a 30 min procedure took well over one hr due to thick blood.
Red flags for my Urologist and he now has asked that I not inject this week until I see a Hematologist. He also wants me to see a ENT specialist. I had been taking a single baby aspirin until last week when my MD encouraged that I move to full aspirin.
I find myself in uncharted waters and will confess that I do have concerns. I am NOT dehydrated as I am a water guzzler LOL. Nor do I use any sort of tobacco.
Please offer advice, experience, suggestions etc etc.
All this talk about high hemoglobin and hematocrit and no labs provided. No testosterone values either, so advice will be difficult.
I get phlebotomized every month and the skill level of the phlebotomists is all over the place, some are able to get the blood flowing out easily while others struggle. I found out that if they stick the needle in to far, blood will not flow out and it can’t be from my left arm either.
The problem might be your veins and not overly thick blood.
This is not a TRT protocol, this is volume of medicine minus the strength, and for all I know you’re injecting 50 mg, 100mg or more weekly.
There’s a disconnect here, you feel great and yet your doctor is concerned about your overly thick blood. It stands to reason if your body is dealing with overly thick blood, there would be symptoms to go along with that thick blood.
I find that all doctors within my provider are completely out of touch with hormonal treatments, even the phlebotomists doesn’t understand why I’m getting phlebotomized, because they normally see people with iron overload, not guys with just high hemoglobin and hematocrit.
People living in Denver, Colorado have high hematocrit and hemoglobin because they are living at high altitude, but aren’t getting phlebotomized on a regular basis.
Go consult with hematology. There is no one on this board who can meaningfully comment on the clinical significance on your elevated hematocrit. You have another observation that your whole blood viscosity may indeed be elevated. The link shared above helps you to understand why. Ask your hematologist about plasma viscosity and blood markers for inflammation / proteins in plasma. All elevated hematocrit (same value, e.g., 53%) is not created equal with respect to whole blood viscosity.
Compilation of relevant research and info if you want more than just hand waving and someone to tell you everything is fine.
Notice that between the two posts I shared above they only got 1 like and that was from @unreal24278. I will that as equivalent or better than 1000 regular likes. Good luck on your journey.
Thank you for your time and insight! Much appreciated. I am taking the week off from TRT while fishing in Alaska. I do plan to visit the Hematologist soon and hopefully figure this out.
Update on yesterdays phlebotomy. The RN used an 18ga needle on left arm. Not sure needle size on previous times but was always right arm. I have good veins. Blood flowed like water and was finished in about 20 min. Only other adjustment was replacing daily baby aspirin with full dose aspirin.
It seems my hemoglobin is coming down and was able to skip my phlebotomy. My doctor was quite surprise to see such a drastic reduction (HCT 55 ->52%/HGB 19.2 ->17.9) and hadn’t seen these values in a long time.
I had recently started vitamin K supplements due to low normal levels.
