Thanks for the help, brother!
The fear is real, i get it bro, but you should have symptoms if it was too high.
Yes morning dehydration can cause it to be high or hydration can lower it.
Itās been a long while since Iāve dived into this topic. Iāll find some notes and post them in a bit to explain why worrying about HCT alone on trt is not needed.
1 Like
Thank you, bro! Iād really appreciate it!
1 Like
Here is what my provider wrote and I modified it a bit for easier reading
Hematocrit
Testosterone therapy causes erythrocytosis. This is an increase in red blood cells due to increased production of erythropoietin by the kidneys.
the same occurs when a cyclist takes EPO or procrit to raise RBCs, which produces increased O2 carrying capacity.
Patients with chronic lung diseases such as COPD also experience erythrocytosis as a compensatory mechanism for inadequate oxygenation.
Individuals that live at high altitudes also experience erythrocytosis in response to being in an environment with low O2 concentrations. Doctors usually donāt have these patients donate blood for the natural physiologic response, erythrocytosis, caused by high altitude and etcā¦
So why do we TRT users have to and are told we might get a stroke if HCT was the deciding factor behind when to give blood?
Furthermore , It is understood that only RBCs are increased & clotting factors are not increased in these patients and therefore not at risk. Meaning rbc isnāt the only measure. Thereās more to it than a hematocrit.
The confusion occurs when practitioners that do not specialize in HRT confuse erythrocytosis ( secondary polycythemia ) with Polycythemia Vera. PCV is a dangerous genetic blood clotting disorder in which RBCs, WBCs, and Platelets are ALL elevated. PCV increases blood viscosity & puts patients at risk for blood clots/stokes.
That is the difference and why you need a trt specialist and not some one who is not taking the time to wrap their head around this: we have never seen a patient die forms. Stroke in the last decade + with a hematocrit in the mid 50s. Also the phlebotomists who cannot use logic, google and his education to dig into this topic for his patient population.
Instead they are just lazy and take the word of others before them.
I realize itās a scary Thought. I would also be worried if it werenāt for my doctor and colleagues explaining this to me. I am Especially not worried because doctor Rouzier backs this up and made a video on YouTube about this exact topic.
The mans a leader in HRT and his work had brought this therapy to more folks than before. I also havenāt seen anyone have any issues that sit around 56-57. I know several who have levels around this for years now.
Biggest thing to realize is symptoms. Regardless of what labs say or donāt say; you should be fine ( no need to have a knee jerk reaction. Or be too worried right this moment) if you are not experiencing symptoms due to thickening of the blood. I believe these symptoms are hard to breathe, pressure on the chest, head, heart and etc I also think tingling in the extremitied is another thing that happens .
I would google a bit more on what exactly happens and what factors increase in lab tests when blood is thick. Donāt focus on HCT alone brother.
1 Like
That is a PHENOMENAL explanation, brother! Thank you so much for taking the time to share. I actually had my CBC re-tested this morning (when I got TT/FT tested), and I focused more on hydration ahead of the test, so I will have another measurement soonā¦but either way, I wonāt panic about HCT. You are the man!
Think thereās any reason to be concerned about my reducing HDL? It was at 51 pre-TRT and is now 35.
1 Like
Thatās a valuable perspective too, brother ā I really appreciate the time you put into compiling all your responses. Lots of data and nuance to sort through!
For someone like me ā young, plans to be on TRT forever, no autoimmune issues or other symptoms ā what do you think is a good (or fine, at least) HCT range?
Edit: I should add I recently had an EKG and my doctor said it was flawless and he has no concerns about my heart at this point. Granted that can only tell you so much (limited data), but figured it might be relevant.
IMO, look at HCT and BP. If BP is high, and so is HCT, I would look at lowering HCT as a means to lower BP. BP is a good indicator of how hard the heart is working. If HCT is somewhat high, but BP is good, I think your body handles the HCT well (it isnāt causing a lot more stress on the heart).
1 Like
Thank you, my man ā interesting point. My BP is good right now! So thatās good news.
I donāt have the scientific rigor of @anon18050987 (too lazy for that), but I am able to understand mechanical things in a practical way. Readalot and I had a discussion on this a while back, and concluded a great tool to assess heart work load is BP and heart rate (BPM). Higher pressure = more stress on a lot of tissues in the body (including some things most wouldnāt think of like kidneys, but also artery walls). I wouldnāt advocate a super high HCT if BP is normal, but I wouldnāt be worried about borderline HCT if BP is normal.
3 Likes
Thatās what Iām thinking for right now. I will have another HCT value on file soon, as I just had it retested, but my BP has always been very normal ā so Iām not overly concerned, though Iāll certainly keep an eye on it!
1 Like
I dont know much about cholesterol because i never had any issues, and did not have to look into it. I bet someone here knows way more about that than i ever will.
You are very welcome.
Whatever your genetics say. I mean when we get low t, obviously our HCT will drop some, maybe a ton. When we take TRT it increases. Thatās my educated guess. Some folks on huge doses of TRT are in the high 40s. Others take little and sky rocket into the 50s. I dont think there is a one size fits all standard.
I see the other guys posts and it is a bit perplexing.
There is a rare fucking chance this or that could be the problem. They are very quick to jump on anyone who does not account for the 1 out of 1 million chances. Reference a group of people who will inherently have morbidity issues because old people are morbid. They are close to death. haha. comparisons of the ages. literally.
I know my information comes from two doctors who practice hormone therapy. The info the guy above is posting, is from an armchair expert. He refers to anabolic abusers / body builders and says ask them about their HCT and blood. Last i recall we are both on TRT.
The amount of folks who used to give blood on TRT was massive just 3 years ago. Today i rarely see anyone giving blood.
Im saying this to just as a response, but im also saying it because it is reality. I mean the guys around here arenāt popping up like flies and telling us "be careful guys. "My friend, husband, dad, brother just had a stroke/heart attack on TRT. He had a 54 HCT and now hes dead ". We would hear about it and i am sure of it.
Shit we would see this all over the place, but we donāt.
Doctor Rouzier and Nichols and others have been practicing for a very loooong time now and they are not having patients who have had these issues. I say this in response to "These guys should stop making these suggestions because they are going to hurt someone "ā¦
Mind boggling how experience and education can be thrown out the window by a nobody.
Good luck man. I bet your HCT levels are lower this time around.
Hey thats a good point. Check bp ā¦ DURRRRR. Simplicity
I agree that the line has been blurred, as folks like me take TRT to high doses, but I still think there is an important difference. BBers often take astronomical doses these days.
2 Likes
Many start on TRT and decide to throw in a blast. Then it is an annual blast. Maybe the blasts are moderate. Do we call this a TRT guy or Blast and Cruise? Does it matter if he has a script? Some of the guys with a script are abusing more than the UGL guys.
I think a majority here are on because of wanting to feel and look younger and perhaps be more muscular / more powerful. I think one can do things safely (or moderately safely), or not. I think one can even Blast and Cruise moderately safely if the blast isnāt extreme and neither is the cruise. One can perma blast (not safe in my book, but probably wonāt kill you for at least a decade).
One thing we have in common is most of us are using T for itās benefits. We fall on different points on the risk scale though.
Additionally, I would not call @anon18050987 an armchair expert. HIs info could be a bit more practical in some cases, but he knows his stuff. There arenāt a lot of people who I would trust to read medical literature and take their word on conclusions, but I would with him.
1 Like
I trust everyone who regularly weighs in here, just trying to help me (and others) 
That definitely includes @anon18050987 ā the dude knows his stuff!
2 Likes
Hmm, great point. I hadnāt thought of that. I think if someone doesnāt ever blast, though, but just takes TRT to high doses for legitimate medical purposes, we can fairly call him a TRT guy. Maybe performance TRT.
Edit: I donāt care if someone says Iām a steroid user. I am. But I do think, when weāre talking about long-term health outcomes, there is some difference between TRT (at high doses) and even higher-dose AAS usage.
2 Likes
I can get down with this! Or maybe King Kong Mode. I saw the new movie last week ā King Kong is a great physique/performance goal, lol.
My PCP gave it extremely slim odds of success, but insurance approved our request for an echocardiogram! So Iāll have more data soon. I donāt expect to see anything too troubling at this point (on TRT for a little over 2 years), but at least it will give me a good reference point for down the road.
1 Like