Hematocrit drives Blood Viscosity- Does that Matter in Men on TRT? Effect of Altitude?

[Deleted member 43589]

Nope. Another 30 min of wasted time scanning and playing this vid at 2x. No mention of plasma viscosity. Did mention whole blood viscosity. More hand waving. How do I say this nicely...the coverage of hematocrit was incomplete and inadequate. Fail. Horrible. My recommendation for them is to read the detailed information I have shared here and at TNation to improve their knowledge.

Thanks for sharing though.

I feel dirty and ashamed for them after watching that.

BTW @BigTex: those PL numbers especially the bench on a large regular dose of AAS. Horrible. Makes no sense and then you coach?

If you tell enough people you are a world renowned strength coach, eventually people start repeating it. As well, if you tell enough people that you are an expert on TRT, eventually people start believing it. Once the dream collapses, you do what Bossa did and hide out for a while and then come back with another scam. Out of the goodness of his heart he probably made several $100 thousand and is now sitting the beach laughing about it.

 

[Gman86]

So I’m listening to the latest doctors roundtable that someone posted, and what I don’t get is Keith Nichols says that the majority of his patients feel their best with a free T level around 30-50, and that even 40-60 is a great place to be, from what he’s seen with his patients. And of course Jay had to put in his weird 2 cents and said that the majority of guys that he knows on TRT that are doing well have a free T level around 43. No idea why he got so specific with it. He’s an odd one. But I digress lol. The thing is that a free T level of 30-50, or 40-60, at labcorp, is a free T of 300-500, or 400-600 if u were to compare it to Quest’s free T test. And the free T range at quest is (46-155) or (46-224) depending on the free T test that u do with them. So what I’m confused about is how these guys are getting their patient‘s free T levels this high, while also being proponents of not jacking men’s total testosterone levels into “Bodybuilding” territory. From what I’ve seen over the years, to get a man’s free T into the 40-60/ 400-600 range, ur gonna have to get their total test levels quite high. Even for a guy with a low SHBG in the teens. Let alone for guys with higher SHBG levels. If a guy has a lowish SHBG, ur not gonna need to get his total test levels into a “bodybuilding“ range, to get these free T levels, but ur gonna have to get them higher than I would assume these doctors would be proponents of. Just seems a little contradictory that they look down upon guys jacking their total T levels up too high, but are proponents of getting their free T levels up around 3x the top of quest‘s free T range

 

[FunkOdyssey]

Keith Nichols says that the majority of his patients feel their best with a free T level around 30-50, and that even 40-60 is a great place to be, from what he’s seen with his patients.

I suspect survivorship bias plays a role here. We know he starts people with two clicks of 200 mg/ml cream twice daily, which is going to put most men over 30 ng/dl. If you don't have good results, he certainly isn't going to tell you to try less. The only direction he's going to go is up from there. So either you respond well to these high levels, or you don't return to him for follow-up, or he fires you as a patient for not being a real man.

There you go, a medical practice full of men thriving at 30-50 ng/dl.

 

[Gman86]

I suspect survivorship bias plays a role here. We know he starts people with two clicks of 200 mg/ml cream twice daily, which is going to put most men over 30 ng/dl. If you don't have good results, he certainly isn't going to tell you to try less. The only direction he's going to go is up from there. So either you respond well to these high levels, or you don't return to him for follow-up, or he fires you as a patient for not being a real man.

There you go, a medical practice full of men thriving at 30-50 ng/dl.

Ur probably spot on with this. Thanks for ur input. Still annoying when guys or doctors can advocate for a high free T, sometimes 2-3x the top of the reference range, but will shun a guy for wanting to keep his total T levels 75-100% higher than the top of the total T reference range

 

[Charliebizz]

I suspect survivorship bias plays a role here. We know he starts people with two clicks of 200 mg/ml cream twice daily, which is going to put most men over 30 ng/dl. If you don't have good results, he certainly isn't going to tell you to try less. The only direction he's going to go is up from there. So either you respond well to these high levels, or you don't return to him for follow-up, or he fires you as a patient for not being a real man.

There you go, a medical practice full of men thriving at 30-50 ng/dl.

I hate to throw shade. but I’ve spoken to a few of his former patients. They say he doesn’t like to be questioned and not very flexible. wants all his guys on is protocol of t,dhea,preg and thyroid. And I heard his pricing is pretty high.

 

[FunkOdyssey]

I hate to throw shade. but I’ve spoken to a few of his former patients. They say he doesn’t like to be questioned and not very flexible. wants all his guys on is protocol of t,dhea,preg and thyroid. And I heard his pricing is pretty high.

You don't say! Lol. Yes, I think that is pretty clear based on his forum interactions.

 

[Charliebizz]

more to your point @FunkOdyssey you have to be careful actually believing that these So called “gurus” actually have as big a patient base as they act like they do. Again no disrespect to dr crisler. But when he passed I had got an email with his whole patient list cc on the email, you would be surprised how little patients were actually on the list. For how “popular“ he was on the forums. And you can just tell based on how his practice was run. At the time I think he had one or two employees max. And was always easy to get an appointment. This isn’t saying that he didn’t help many men over his career. but you get my point.

 

[tareload]

If you indulge with androgens ignore at your own risk. Genes for hemochromatosis?

Like being large and muscular? What is the downside for your heart? Combine with elevated Hct and blood viscosity.

Nota Bene.

 

[tareload]

 

[tareload]

Pay to play.

Outline

More muscle = more blood vessel total length

Androgen use - sympathetic activation / RAAS

More hematocrit = more viscosity

Patient subgroups - autoimmune diseases / inflammation / plasma viscosity

More cardiac output / BP / Kidneys / LVH / premature heart failure


BP (understand what drives it)

More risk of endothelial wear and tear

Origin of atherosclerotic plaque?

Transition to turbulent flow / lumenal shear stress

Make sure you set the boundary you are comfortable with between net positive vs net negative (short vs long term).

Know the tradeoffs. You haven't received this info from TOT Roundtable. There it is MORE is always better. A corrupted imbecilic view of OPTIMIZATION which when analyzed competently almost always considers tradeoffs in the real world.

@Nelson Vergel last three posts are most comprehensive and accessible video reviews of the issues here. Since most folks like videos now days you may want to sticky these as an antidote to the trash put out that erythrocytosis is harmless. Dangerous. Guys who hobby in this should understand the tradeoffs and potential risks.

Study harder @RobRoy. Send to Scott.

 

[tareload]

Whole Blood Viscosity vs. Serum and Plasma Viscosity | Meridian Valley Lab

Meridian Valley Laboratory is the only clinical reference lab that provides a comprehensive blood viscosity profile, which includes both systolic and diastolic blood viscosity measurements. There are many reference laboratories and pathology departments of hospitals that can provide clinical...

www.meridianvalleylab.com

Clinical Laboratory Measurement of Serum, Plasma, and Blood Viscosity**

Abstract. This article discusses the fundamentals for measuring the viscosity of whole blood, serum, and plasma and its application to the diagnosis of hyp

academic.oup.com

The Complete Blood Viscosity Profile | Meridian Valley Lab

This comprehensive profile includes both systolic and diastolic (high shear and low shear) measures of blood viscosity, as well as a Complete Blood Count with platelets and differential, BUN and Creatinine.

www.meridianvalleylab.com

@Nelson Vergel have you looked at offering whole blood viscosity measurement as part of your DiscountedLabs service? Outfit above provides a low and high shear result. I have never used them. Would give more information that just Hct. May be of interest for BB or other risk panels. Example report:

https://www.meridianvalleylab.com/wp-content/uploads/2018/04/7136.pdf

I have no financial interest or conflict of interest.

Another less ideal testing algorithm:

Viscosity | MLabs

mlabs.umich.edu

Typical serum measurement which will differ widely from whole blood:

004861: Viscosity | Labcorp

Labcorp test details for Viscosity

www.labcorp.com

Plasma viscosity example:

Pathology

www.thepathologycentre.org

 

[Deleted member 43589]

I hate to throw shade. but I’ve spoken to a few of his former patients. They say he doesn’t like to be questioned and not very flexible. wants all his guys on is protocol of t,dhea,preg and thyroid. And I heard his pricing is pretty high.

I guess I would fire him as quick as I hired him then. I question every doctor I have and I have the final say on everything.

 

[Charliebizz]

@Gman86 check your p.m or hit me up on fb messenger got a few questions for you

 

[tareload]

Pay to play.

Outline

More muscle = more blood vessel total length

Androgen use - sympathetic activation / RAAS

More hematocrit = more viscosity

Patient subgroups - autoimmune diseases / inflammation / plasma viscosity

More cardiac output / BP / Kidneys / LVH / premature heart failure


BP (understand what drives it)

More risk of endothelial wear and tear

Origin of atherosclerotic plaque?

Transition to turbulent flow / lumenal shear stress

Make sure you set the boundary you are comfortable with between net positive vs net negative (short vs long term).

Know the tradeoffs. You haven't received this info from TOT Roundtable. There it is MORE is always better. A corrupted imbecilic view of OPTIMIZATION which when analyzed competently almost always considers tradeoffs in the real world.

@Nelson Vergel last three posts are most comprehensive and accessible video reviews of the issues here. Since most folks like videos now days you may want to sticky these as an antidote to the trash put out that erythrocytosis is harmless. Dangerous. Guys who hobby in this should understand the tradeoffs and potential risks.

Study harder @RobRoy. Send to Scott.

Only three likes on the three posts above (128 to 130) and no response from @RobRoy. I must be on to something.

Thanks for taking a look @FunkOdyssey

 

[J2048b]

I hate to throw shade. but I’ve spoken to a few of his former patients. They say he doesn’t like to be questioned and not very flexible. wants all his guys on is protocol of t,dhea,preg and thyroid. And I heard his pricing is pretty high.

Sounds a lot like doc crisler as he used most of these together and serves great purpose to backfill feedback loops and keep everything even keel… people have to remember that once a chemical is enhanced others need to be balanced

 

[Nelson Vergel]

@Nelson Vergel last three posts are most comprehensive and accessible video reviews of the issues here. Since most folks like videos now days you may want to sticky these as an antidote to the trash put out that erythrocytosis is harmless. Dangerous. Guys who hobby in this should understand the tradeoffs and potential risks.

Thanks a lot!!! I am tired of doctors who keep saying that a high hematocrit is harmless. They based it on "people who live at high altitudes," which is the most simplistic and wrong reasoning!

 

[Gman86]

Thanks a lot!!! I am tired of doctors who keep saying that a high hematocrit is harmless. They based it on "people who live at high altitudes," which is the most simplistic and wrong reasoning!

What’s the differences between someone living at a high altitude having a high HCT and someone say on HRT having a high HCT?

 

[tareload]

Thanks a lot!!! I am tired of doctors who keep saying that a high hematocrit is harmless. They based it on "people who live at high altitudes," which is the most simplistic and wrong reasoning!

Which brings up the next issue. Erythrocytosis mediated by altitude is not harmless. As with everything your mileage may vary.

https://journals.physiology.org/doi/full/10.1152/physiol.00029.2021

And a whole thread in addition to this one.

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

But does not stop the tired use of erroneous abracadabra hard waving. Keep saying it and people will believe.

Of course none of this is as exciting as talking about growth hormone tonight on youtube, right @RobRoy ?

Sounds close enough.

No one?

Post in thread 'Hematocrit drives Blood Viscosity- Does that Matter in Men on TRT? Effect of Altitude?' Hematocrit drives Blood Viscosity- Does that Matter in Men on TRT? Effect of Altitude?

Surely someone.

 

[Charliebizz]

Sounds a lot like doc crisler as he used most of these together and serves great purpose to backfill feedback loops and keep everything even keel… people have to remember that once a chemical is enhanced others need to be balanced

Sounds good on paper. Unfortunately that craze fell out of favor pretty quick. I remember back on dr crislers forum how pregnenolone was going to be the savior for all. Turns out very few actually felt better on it. (Not saying it isn’t great for some)

 

[tareload]

What’s the differences between someone living at a high altitude having a high HCT and someone say on HRT having a high HCT?

Do you believe erythrocytosis is harmless? Is that a good way to phrase that question? Curious your thoughts with the information available on this site.