Too Many Red Blood Cells or Platelets Stall Blood Flow in Cerebral Capillaries

[Nelson Vergel]

The demonstration by Dr. Santisakultarm and colleagues of stalled blood flow in increased percentages of cerebral capillaries in PV and ET provides a mechanism other than thrombosis for focal cerebral hypoxia and subsequent microinfarction. The abrupt, spontaneous resolution of these capillary stalls with re-established rapid blood flow may explain the frequent but transient central nervous system symptoms including headaches, dizziness, vision loss, dysphasia, and focal paresis that are associated with PV, ET, and secondary polycythemia. Stalled blood flow in cerebral capillaries may also help explain how increased hematocrit is associated with reduced reperfusion and enhanced infarct size on serial MRIs following ischemic strokes.7 Therefore, stalled cerebral capillary blood flow may play a role in microinfarcts and in exacerbation of ischemic damage from compromised blood flow in larger cerebral vessels.

Santisakultarm TP, Paduano CQ, Stokol T, et al. Stalled cerebral capillary blood flow in mouse models of essential thrombocythemia and polycythemia vera revealed by in vivo two-photon imaging. J Thromb Haemost. 2014;12:2120-2130.

 

[Scottsyracuse]

I am fifty-eight. Been on TRT (cypionate only, 100mg every 5-6 days) for 14 months. I take 10mg Cialis once a week. My hematocrit was 41 when I started TRT and bodyweight was a lean 160 lbs.
My hematocrit has steadily climbed to 54.1, weight now at 180 lbs, lifting more and liking it. Doing less cardio. Blood pressure not a problem so far. Feeling OK.
My question is, this hematocrit needs to be lowered? Now. Right?
Donating blood. Grapefruit juice. Diet. Cardio...please advise Nelson.

 

[Nelson Vergel]

I am fifty-eight. Been on TRT (cypionate only, 100mg every 5-6 days) for 14 months. I take 10mg Cialis once a week. My hematocrit was 41 when I started TRT and bodyweight was a lean 160 lbs.
My hematocrit has steadily climbed to 54.1, weight now at 180 lbs, lifting more and liking it. Doing less cardio. Blood pressure not a problem so far. Feeling OK.
My question is, this hematocrit needs to be lowered? Now. Right?
Donating blood. Grapefruit juice. Diet. Cardio...please advise Nelson.

Donate one unit of blood (if you are healthy and won't be rejected from donation, otherwise get an order from your doctor for a therapeutic phlebotomy). Your dose is good and really you should not lower it. Make sure you don't smoke or have sleep apnea since these two factors will make it very hard to keep your hematocrit under 53 without having to donate too frequently, which can deplete your iron stores.

I recommend you read these posts: hematocrit control in men on TRT

 

[fifty]

Hct of 50+ makes cardio easier. Performance enhancing

 

[Paul M]

Hct of 50+ makes cardio easier. Performance enhancing

Isn't it EPO that makes cardio easier and the high Hct is just a by-product? Have never heard of cardio being easier with high Hct from T. I could be wrong.

 

[Fernando Almaguer]

The demonstration by Dr. Santisakultarm and colleagues of stalled blood flow in increased percentages of cerebral capillaries in PV and ET provides a mechanism other than thrombosis for focal cerebral hypoxia and subsequent microinfarction. The abrupt, spontaneous resolution of these capillary stalls with re-established rapid blood flow may explain the frequent but transient central nervous system symptoms including headaches, dizziness, vision loss, dysphasia, and focal paresis that are associated with PV, ET, and secondary polycythemia. Stalled blood flow in cerebral capillaries may also help explain how increased hematocrit is associated with reduced reperfusion and enhanced infarct size on serial MRIs following ischemic strokes.7 Therefore, stalled cerebral capillary blood flow may play a role in microinfarcts and in exacerbation of ischemic damage from compromised blood flow in larger cerebral vessels.

Santisakultarm TP, Paduano CQ, Stokol T, et al. Stalled cerebral capillary blood flow in mouse models of essential thrombocythemia and polycythemia vera revealed by in vivo two-photon imaging. J Thromb Haemost. 2014;12:2120-2130.

Nelson can these symptoms go away or improve with blood letting?

 

[fifty]

Isn't it EPO that makes cardio easier and the high Hct is just a by-product? Have never heard of cardio being easier with high Hct from T. I could be wrong.

Hemoglobin rbc hematocrit. They usually follow one another. Every marathon runner would love your levels.

 

[Scottsyracuse]

Donate one unit of blood (if you are healthy and won't be rejected from donation, otherwise get an order from your doctor for a therapeutic phlebotomy). Your dose is good and really you should not lower it. Make sure you don't smoke or have sleep apnea since these two factors will make it very hard to keep your hematocrit under 53 without having to donate too frequently, which can deplete your iron stores.

I recommend you read these posts: hematocrit control in men on TRT

Thank you Nelson. I donated today.
Two more questions, what do we call "donating too frequently", and,
I get up to pee 2-4 times per 8 hour night due to the prostate thing, is that creating something similar to a sleep apnea situation?
I go right back to sleep, deeply, dreaming frequently. Even as a boy I got up a least once per night.

 

[Nelson Vergel]

Donating more frequently than every 2 months can decrease iron and ferritin in some men, causing fatigue and pretty much a lot of the low T symptoms.

Warning about frequent blood donations used to decrease hematocrit.

Low Ferritin Solutions With Frequent Blood Donations

I would definitely get a treatment that makes you get up to pee no more than twice per night.

https://www.webmd.com/drugs/2/drug-92266/vesicare-oral/details

I would also avoid these foods/drinks