Does Hematocrit ever level out?

[ZoomyR6]

Hey Fellas,

I just got back from donating blood and for the first time since initiating therapy 3.5 months ago, my HCT was 50 and hemoglobin at 16.6. Naturally I was questioned as why I might think it was that high and I explained. They took my blood since the cutoff is 60.

Before starting, my values were 14.4 and 44.6. When I tried clomiphene first, they shot up to 16.6 and 49.9. I quickly donated blood and started my injections at 100mg 1x/week. I had blood drawn 5 weeks later and my levels were normal again at 14.6 and 46.4. The donation helped but I was expecting a significant increase in HCT and hemoglobin but thankfully, that wasn't the case.

The labs showed my TT was less than stellar at 480 so my Doc decided to go from 100mg/wk to 80mg 2x/wk (total of 160mg)- a 60mg per week increase. About 4 weeks into that, I started getting headaches, my BP went to 150/80, my heart was beating faster and I felt flush. All the typical symptoms of elevated HCT. I wasn't able to donate blood for another 2 weeks after that (which was today) but closely monitored myself. My BP stabilized around 120/60 but still had the other symptoms. As of today at the blood draw, it was 110/80.

My question is that, since my HCT and hemoglobin were well within range and not anywhere near borderline high, will it finally stabilize after giving blood this time? Could it stabilize ever? Could it be expected to jump anytime you increase the dose but once you give blood, it will normalize or can it keep creeping up?

I guess I was just hoping I was one of the few lucky ones that didn't have to rely on giving blood every 8 weeks since I was nowhere near high to begin with. I just find it remarkable it jumped that high in 4 weeks time. As stated, I am hoping the massive jump in 4 weeks time was from the significant jump in dosage and all will be fine after this donation.
I am still waiting for the recent labs since the increase.

Aside from this, I found an interesting video on youtube. Its about a Doc saying that elevated HCT from TRT is NOT polycythemia. Polycythemia is a disease that thickens the blood and elevated HCT from TRT does not cause that. Just a healthy increase in red blood cells just as the people that reside in higher elevations get. Thoughts???
https://www.youtube.com/watch?v=mH-J5kXU-jQ

Regards fellas and thanks for any and all responses.

 

[CoastWatcher]

In regard to Dr. Rouzier, his views have been debated on the Forum in the past. As of a year ago he didn't feel estradiol monitoring was a necessary aspect of TRT management, either. My own doctor said, when I presented Rouzier's ideas on Hct to her, that she hoped his malpractice premiums were paid up because he was skating on some thin ice.

 

[ZoomyR6]

I understand but he does make a valid point regarding people living at altitude not needing it. I actually just finished reading a couple of studies where they say the 2 are different. Leaves me wondering...

 

[CoastWatcher]

I understand but he does make a valid point regarding people living at altitude not needing it. I actually just finished reading a couple of studies where they say the 2 are different. Leaves me wondering...

I wasn't trying to shut things down, and sometimes going against the mainstream is healthy. But his positions make me uneasy...though others may feel differently.

 

[ZoomyR6]

I wasn't trying to shut things down, and sometimes going against the mainstream is healthy. But his positions make me uneasy...though others may feel differently.

I know that Coast. I wasn't thinking otherwise.
On the other hand, since donating, I feel better. That also makes me question him though. It's it's not harmful, why do I feel better donating.
I think I will let it go up high next time and see how I feel again.

 

[CoastWatcher]

I am one of those guys who seems to be insulated for Hct changes. Mine hasn't gone above 48 since I started TRT. Im not complaining, but I am puzzled. Anecdotally, my doctor has said she sees about half of her patients achieve some stability in this regard.

 

[Vince]

During my first 2 years of TRT, I donated blood every 8 weeks. Now I haven't donated since February, my HCT has been steady at 47-46.

 

[ZoomyR6]

During my first 2 years of TRT, I donated blood every 8 weeks. Now I haven't donated since February, my HCT has been steady at 47-46.

Well that's not too comforting.
Do you remember what your levels were before initiating TRT?

 

[Vince]

Well that's not too comforting.
Do you remember what your levels were before initiating TRT?

They usually ran in the low forties. If I donated blood they normally were in the high 30s.

 

[ZoomyR6]

They usually ran in the low forties. If I donated blood they normally were in the high 30s.

So not far off from where I was. Thanks for this info.
Hopefully mine will level off like yours soon.

 

[Nelson Vergel]

Hematocrit may stabilize after long term testosterone replacement

Hematocrit may stabilize after long term testosterone replacement Although this study was done in mice, it may explain why hematocrit may eventually decrease and stabilize in men on TRT. I am one of those men who only went for therapeutic phlebotomy twice. There seems to be an adaptive...

www.excelmale.com

 

[MarcoFL]

I have found that drinking a lot of water seems to keep HCT right about 48 even with a higher T and FT. I had a buddy could not get his under control but he drank about 3 bottles worth a day!

 

[chris@]

I have found that drinking a lot of water seems to keep HCT right about 48 even with a higher T and FT. I had a buddy could not get his under control but he drank about 3 bottles worth a day!

I agree with Mark here. I only have one blood test under my belt doing it but I believe habitual long term hydration helped get my HCT to a very healthy level. I don’t believe it is the only factor but it seems to have a positive impact for me.

 

[UroPA]

In my practice, I have had guys who we just could not get their HCT under control or guys who flat out did not want to do phlebotomy. In the end, I tried "split-dosing" or "mini-dosing" and have seen great responses in my patients as a result. Split dosing, meaning rather than having them inject 200mg / 1cc weekly I would have them inject 100mg or 0.50cc twice a week. Some actually preferred mini-dosing meaning even smaller doses more often rather than a large dose once a week. Given that Testosterone Cypionate has a 7 (8) day half-life, it makes it relatively easy to figure the math and after 7 days your body is getting the same target dose without the crescendo-decrescendo effect. Some of my guys are doing 0.15cc daily which works out to 1.05cc a week or roughly 210mg. I found that split-dose or mini-dose patients suffered side effects such as HCT elevations or E2 changes far less often because the dose is at target and the body seems to more readily adapt to the consistent dose rather than the roller coaster.
Just a thought

 

[ZoomyR6]

Hematocrit may stabilize after long term testosterone replacement

Hematocrit may stabilize after long term testosterone replacement Although this study was done in mice, it may explain why hematocrit may eventually decrease and stabilize in men on TRT. I am one of those men who only went for therapeutic phlebotomy twice. There seems to be an adaptive...

www.excelmale.com

Thank you Nelson.
So its been about 2.5 years since I started this thread. Thank you and everyone that responded and helped me.
I try to donate usually every 8-12 weeks or so and I can still tell I need it because of the BP and headaches. It has never seems to get higher than 48-50 via labs but whenever I donate blood, they say everytime that my Iron is 17.6-17.9 (x3 fot HCT put that around 54). Its clear now that their machines overestimate. Because this is the longest i've gone without donating, I don't really know how high it would actually go. i donate now whenever I feel my BP spiking and I wish it didn't have to get to that point. I believe I am one of those that will have to donate for the rest of my life, not because it gets "dangerously" high but because its just plain uncomfortable.

 

[TorontoTRT]

If you read medical papers specific to this effect testosterone has on blood thickness you’ll see that testosterone compensates for this by increasing nitric oxide production and dilating blood vessels.
Also hct is nothing more then a percentage.of Rbc x MCV
Donating blood is a catch 22. After donating your body will ramp up and produce red blood cells at a way faster rate. And you’re back to square one. Also you’re tanking your ferritin.

 

[ta406]

If you read medical papers specific to this effect testosterone has on blood thickness you’ll see that testosterone compensates for this by increasing nitric oxide production and dilating blood vessels.
Also hct is nothing more then a percentage.of Rbc x MCV
Donating blood is a catch 22. After donating your body will ramp up and produce red blood cells at a way faster rate. And you’re back to square one. Also you’re tanking your ferritin.

Any suggestions on what to do for those of us that feel like crap when our hct is elevated?

 

[TorontoTRT]

Any suggestions on what to do for those of us that feel like crap when our hct is elevated?

It might be something else though. Hard to say that slightly elevated blood thickness causes any symptoms. Most men should have similar side effects. I can’t tell the difference between 46 or 58 hematocrit.

 

[Nelson Vergel]

As long as you measure your ferritin once in a while and don’t donate more frequently than every 10 weeks, you will be OK. But if you smoke, have sleep apnea, are using over 150 mg per week, and don’t hydrate well, your battle with high hematocrit will be a longer one. Most guys hematocrit stabilizes after the first year.
Don’t assume that headaches, being short of breath, etc is high hematocrit. Androgens make the body hold more sodium, so it holds more water to bring its concentration down. Watch your salt intake, try to exercise and sweat, eat bananas and other potassium rich foods to counter the sodium retention, and minimize sugar since higher insulin spikes also make the body hold more water and increase blood pressure. The use of NSAIDS can also increase BP in some.