Advice About Hematocrit and TRT Dose

[Nelson Vergel]

My endo so busy he cant see me for a few weeks so I paid privately to have another 1 unit drawn, and headaches etc stopped.

What is your blood pressure? High BP can cause headaches.
In my opinion, the best indicator of the need for blood donation is high blood pressure+ hematocrit above 52. Having normal blood pressure is an indicator that your blood vessels are still handling higher hematocrit OK.

 

[Nelson Vergel]

Thread 'Does a high hematocrit change your blood's clotting profile? High altitude vs TRT.'

Aug 13, 2024

Does having a high hematocrit mean your blood is more likely to clot? This study looks at a city where people with the highest hematocrit in the world live and work.

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• Systemlord
• high hematocrit
• Replies: 33
• Forum: Testosterone Side Effect Management

Thread 'Stroke-Related Mortality at Different Altitudes: A 17-Year Nationwide Population-Based Analysis From Ecuador.'

Jan 6, 2023

Living at higher elevation with higher hematocrit may decrease cardiovascular risk!

Stroke-Related Mortality at Different Altitudes: A 17-Year Nationwide Population-Based Analysis From Ecuador - PMC

Introduction: Worldwide, more than 5.7% of the population reside above 1,500 m of elevation. It has been hypothesized that acute short-term hypoxia exposure could increase the risk of developing a stroke. Studies assessing the effect of altitude on ...

www.ncbi.nlm.nih.gov

PubMed Central Image Viewer.

• Systemlord
• erythrocytosis; trt
• Replies: 5
• Forum: Testosterone Side Effect Management

• 

@Systemlord

I know all of you want to feel OK about not having to manage hematocrit.

Ok, time for me to AGAIN repeat the same info I have repeated in the past to debunk this wrong information. The Internet "gurus" and even some "expert doctors" want to oversimplify things without any deep review of the data.

People living at high altitudes who have high hematocrit are NOT the same as men on TRT with high hematocrit who live at "normal" altitudes. Why?

TRT increases red blood cells/hematocrit AND blood volume (due to sodium retention and other factors) AND blood pressure (depending on the patient). People at high altitudes (and not on TRT) are exposed to lower atmospheric partial pressures, which increases dilation of blood vessels. These people also do not experience increased blood volume even with higher red blood cells/hematocrit.
"In order to compensate for the low partial pressure of oxygen at altitude, the human body undergoes a number of physiological changes. A vital component in this process is the increase in the concentration of circulating hemoglobin. The role of HIF-1alpha, erythropoietin and red blood cells in this acclimatization process is described, together with the fall in plasma volume that increases the concentration of hemoglobin in the early stages of hypoxic exposure."

Difference between these people and men on TRT: We have increased blood volume and hemoglobin/hematocrit.

Full paper: Heights and haematology: the story of haemoglobin at altitude


We already are gathering data on higher mortality in men on TRT who have high hematocrit:

Rises in Hematocrit Are Associated With an Increased Risk of Major Adverse Cardiovascular Events in Men Starting Testosterone Therapy: A Retrospective Cohort Claims Database Analysis


Rises in Hematocrit Are Associated With an Increased Risk of Major Adverse Cardiovascular Events in Men Starting Testosterone Therapy: A Retrospective Cohort Claims Database Analysis

Thread 'Rises in Hematocrit is Associated with An Increased Risk of Cardiac Events in Men Starting Testosterone Therapy'

Mar 31, 2024

ABSTRACT

Objective

Elevated hematocrit (Hct) can result in increased risk of major adverse cardiac events(MACE) in men receiving testosterone therapy (TTh). However, the impact of the magnitude of the change in Hct from baseline after starting TTh has never been assessed.


Methods

To assess whether an increase in Hct after initiating TTh is associated with an increased risk of MACE within 3 and 24 months of initiating TTh, we queried the TriNetX Research network database for men over the age of 18 with Hct values obtained within six months before starting TTh, and...

• madman
• erythrocytosis; testosterone; hematocrit; trt
• Replies: 9
• Forum: Testosterone Side Effect Management

• 

 

[Systemlord]

Rises in Hematocrit Are Associated With an Increased Risk of Major Adverse Cardiovascular Events in Men Starting Testosterone Therapy: A Retrospective Cohort Claims Database Analysis

The standard of care for TRT being, 200 mg every 2-4 weeks. A lot of these men are poorly managed on therapy as it is. These protocols are known to increase chances of erythrocytosis (supraphysiological to hypogandal every 10-14 days) for these metabolically compromised men.

These men are unhealthy which is why they need TRT in the first place. That crucial adjustment phase to therapy, which can last for several months, is where I believe what this study is focusing on.

I also strongly believe men not having issues with high hematocrit and hemoglobin have lower end (<100) ferritin, because too much iron in the body can create dehydration.

I look forward to studies showing long term supraphysiological levels in men.

What about the risks of long term therapy?

 

[Willyt]

Hi Guys,

So got bloods done, haemocrat .52
Testosterone 605.

But, suffering pressure headaches, and facial pain

I know it's the haemocrat being at .52

Last October it was at .52 and had pressure headaches, my endo took 1 unit blood and all headaches etc stopped, all good

Been taking 50mg twice a week since then, and now in the past week my haemocrat is back again at .52

My endo so busy he cant see me for a few weeks so I paid privately to have another 1 unit drawn, and headaches etc stopped.

Problem is my endo and my doctor both said I've to reduce my testosterone to keep my haemocrat from rising, my endo wants to lower my testosterone so my results come in around 350 ngdl

I'm trying to fight against this, as at 605 I'm feeling great except for the pressure headaches.

My doc said try the gel patches and use every day and get a steadier numbers, and that may keep haemocrat from rising, based on that

I'm thinking maybe inject 14mg every day see does that help with lowering haemocrat.

Thing is I can see my doc and endo eventually saying no more to drawing 1 unit of blood every 3 months to lower haemocrat, my doc says at .52 I'm looking for trouble of a heart attack or blood clots and stroke

What would you guys do in my position

Thanks guys

Mike

Try 10mg daily subq injections (31 gauge 5/16" insulin needles). Quite a forum members have had success lowering hematocrit moving to low dose daily. Many guys will easily hit TT of 700 on 10mg daily.