Hey guys. I talked to Defy and I’m definitely in a “gray zone,” as the doctor put it. I’m not numbers wise hypogonadal but do have symptoms and my TT is 458 fasted early in the morning but my free T is only slightly below normal. Also, I live at elevation in Colorado higher than Denver so my hematocrit generally sits at about 49-50 with the range maxing out at 51. On this last blood test it was 51.
The doctor was open to prescribing TRT to help relieve my symptoms. I’ve made posts on my symptoms previously. She just mentioned d it was up to me but that if my hematocrit continues to increase they could take away treatment. What are the chances that if I start treatment my hematocrit goes sky high? What is sky high and what does it feel like? If I push over 51 which I suspect will easily happen since I’m naturally high and live at altitude what can I expect and is it worth the risk?
I do plan on moving to lower elevation in 4 months down by the south coast at sea level. It just worries me that I’ll be hanging out in the above normal range and end up stroking out and end up gaining more symptoms on top of what I’m already experiencing.
Thanks for the help.
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Sorry for not including originally. Here are my new labs. Why the hell is my hematocrit so high? On the previous blood test in February it was at 53 and RBC were also elevated. For that one I can only think that it was because I had taken a Yohimbine product which I’ll never do again. It definitely messed me up mentally. I was anxious as hell. Other than that am I consuming too much iron through food that could be increasing hematocrit consistently to the top of the range? This week I cut out my multivitamin which had iron in it.
I’ve also just heard that with a hemoglobin of 17 which mine has been both times and elevated hematocrit this could just mean I’m not drinking enough water. Just posting my thoughts as I go.
HCT is dependent of hydration mostly, so drink plenty water a couple of hours before testing. RBC increase can be due to sleep apnea, smoking, and high elevation. Also, Ive recently had high RBC which I contribute to smoking weed, wearing a mask for hours while I work(required still) and testosterone dosage. So Ive lowered my dose a bit, and I’ve also quit smoking completely. Along with with drinking a 1.5 gallons of water a day, Ive decided to add fish oil capsules in order to help lower my HCT a bit too. I no will no longer go in for a blood test early in the morning, Ive decided that 11am is a good time to test and head out to lunch right after.
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Thanks! I have mild Obstructive Sleep Apnea which I’m working on getting a dental guard for. I drink about 3.5 liters of water a day. I don’t smoke, but I used to dip so I’m currently dipping nicotine pouches so I can have a measured dose and ween off accordingly, but will be totally free from it soon. I just can’t tell if people’s concerns about hematocrit are legitimate if it’s over the 51% limit or if it’s just a thing that gets repeated until it’s true.
51% at high elevation is not uncommon. The fear that has been parroted is that we’re all going to be stroking out due to high HCT. This is not the case. Way too many doctors are not trained in this and hematologists have a better understanding of how blood works in the body and they tend to disagree with the old bro science talking points. Labs also have different max ranges. Labcorp is 54% I believe. If higher than average HCT due to training and blood doping was a silent killer, cyclists with high HCT and RBC would be dropping dead all over the place. I live a sea level and my last test was 52.5% with an RBC count of 6.1
I am working on lowering those values but not being on T is far worse for my heart. So drink water, fix the apnea, and dont supplement with anything that will increase your ferretin, RBC, and platelets. Ive also decided to limit my training to 3 days a week for the next month. By the way, lots of guys in the old days were taking Test and steroids with no labs. They had no clue as to what was happening to their bodies and theyre fine.Were doing TRT and if you’re bringing your levels back to what you had in your 20s there should be no worries.
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HighPull, thanks for the specific studies. I read them all in full, but I have to admit that although I’m a reader I have trouble understanding the point you were trying to make. I think I now know that for men at HA a new hematocrit set point is created and also when on TRT another new set point is made and that there is a relationship between HCT and RBC and serum T at high elevations, but I’m still missing if you were meaning to tell me, “Yeah, it’s dangerous,” or if you meant, “it’s normal and will adjust to a new baseline.” Is there anything specific you’d like to point out in connection to my original questions?
Thanks
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No point, just throwing those out for anyone interested. There are many differing opinions on this subject.
As for me, I do not worry about it and neither do the cardiologists that refer obese, pre-diabetic, diabetic, and/or hypertensive patients.
If a patient describes symptoms, then we’ll alter dosing and/or donate blood or make sure they are properly hydrated prior to testing.
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My hematocrit is 53.6% as of only a week ago, I feel fine and my endocrinologists wasn’t worried at all. The internationally recognized ranges for hematocrit is topping out at 54% and in fact the TRT guidelines instruct doctors to take action once hematocrit is 54% by either blood donation of dosage reduction.
If you need to donate more often, your doctor can instruct you to do so.
Now whether or not your hematocrit is too high, well that’s between you are your qualified doctor (cardiologist) to discuss. Your platelets count has the biggest impact on blood thickness, so a high hematocrit by itself doesn’t mean your blood is significantly thicker.
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Do you have a reference for these guidelines?
You do have a way of getting into our thoughts and I have a donation planned for monday just to drive down those numbers but I’m not overly concerned. I discovered that my increase in RBC has depleted vitamin reserves in my body, so Im now supplementing with vitamins. Some folks report that they feel tingly when RBC goes up. Well that means that B12 goes down with it and voila! That is what tends to cause the fatigue and sluggishness that comes with anxiety which some attribute to high HCT and RBC. So perhaps you might be able to helps us laymen here with some of those handy studies on TRT and vitamin depletion.
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Interesting. It seems throughout your studies and the ones HighPull posted that there is “association,” but no definitive proof on causation meaning that there is some evidence for TRT raising hCT and for elevated HCT (whatever exactly “elevated” means) being not good, but I haven’t seen any so undies that say, “Above this number you will suffer a, b, or c and TRT possibly directly leads to that in some individuals.” I guess there would need to be a specific long term study but it would require that there be a group that did not take measures to control HCT while on TRT and those that did and the following results. May be in humane since there is some historical association.
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