High blood pressure from Hematocrit and Hemoglobin

[Melody68]

I have searched the forum but haven't found a lot of information, or concern, for the high blood pressure that can result from the thicker blood that higher hct and hemoglobin can give to you.

I've been on Trt for about 6 months now (currently 84 mg/week) and my hct and hemo are climbing; I suspect my next blood test will show hct of .53-.54 and hemo of 179-181 (ref 135-175). Before Trt my hct was around .48 and hemo of 170; my blood pressure was always excellent, about 120/80 and even 110/70.

But the last few times I've tested my blood pressure it has been higher, almost always 144/80, which from what I read is considered high blood pressure. Surely others deal with the same issue . . . or not? What BP limits do you guys feel comfortable with?

 

[Vince]

Maximum limit for me 130/80

 

[Nelson Vergel]

Can High Hematocrit Cause Hypertension?

Hi guys, I know that I have high hematocrit, and I'm booked in for donation next Tuesday. My question is, can high hematocrit cause hypertension, as my doc says I've now high blood pressure, he says my high hematocrit does not cause high blood pressure, but my research says different...

www.excelmale.com

High Hematocrit: Effect on Blood Pressure & Effect of Altitude on Hematocrit

So Jay and Dr Nichols are doing a full court press on evidence based symptoms, saying most initial sides are basically psychosomatic and to quit being pussies and get through it, Dr Nichols wents so far a couple days ago and said pretty much the entire membership of Excel Male needs to apply...

www.excelmale.com

Hematocrit Increasing Blood Pressure

Pre TRT my blood pressure was 130/80 with HCT of like 47 (top range 51.0) and hemoglobin of 16.8 (top range 17.7). My last labs have my HCT now at 51.8 (top range 51.0) and hemoglobin at 17.6 (top range 17.7) and I've been having some BP issues with spike readings of 160/90. I have anxiety as...

www.excelmale.com

 

[Seagal]

I have searched the forum but haven't found a lot of information, or concern, for the high blood pressure that can result from the thicker blood that higher hct and hemoglobin can give to you.

I've been on Trt for about 6 months now (currently 84 mg/week) and my hct and hemo are climbing; I suspect my next blood test will show hct of .53-.54 and hemo of 179-181 (ref 135-175). Before Trt my hct was around .48 and hemo of 170; my blood pressure was always excellent, about 120/80 and even 110/70.

But the last few times I've tested my blood pressure it has been higher, almost always 144/80, which from what I read is considered high blood pressure. Surely others deal with the same issue . . . or not? What BP limits do you guys feel comfortable with?

No, not the same here.
It appears like a correlation with HCT, and high BP is indeed a potential risk of elevated/high HCT. I would consistently monitor my BP over longer period of time in order to have more data than 'the last few times'.
Without any other changes since starting TRT, I would see this BP as big red flag. I would try to donate blood, check HCT and keep monitoring BP. You can figure out if/how your BP relates to HCT.

 

[Systemlord]

I have searched the forum but haven't found a lot of information, or concern, for the high blood pressure that can result from the thicker blood that higher hct and hemoglobin can give to you.

I've been on Trt for about 6 months now (currently 84 mg/week) and my hct and hemo are climbing; I suspect my next blood test will show hct of .53-.54 and hemo of 179-181 (ref 135-175). Before Trt my hct was around .48 and hemo of 170; my blood pressure was always excellent, about 120/80 and even 110/70.

But the last few times I've tested my blood pressure it has been higher, almost always 144/80, which from what I read is considered high blood pressure. Surely others deal with the same issue . . . or not? What BP limits do you guys feel comfortable with?

If you give a blood donation and blood pressure drops, you have your answer.

 

[Melody68]

No, not the same here.
It appears like a correlation with HCT, and high BP is indeed a potential risk of elevated/high HCT. I would consistently monitor my BP over longer period of time in order to have more data than 'the last few times'.
Without any other changes since starting TRT, I would see this BP as big red flag. I would try to donate blood, check HCT and keep monitoring BP. You can figure out if/how your BP relates to HCT.

Well, it's a bummer topic, but I have to deal with it.

Monitoring it on a daily basis and then averaging is a good idea. Do you use a home kit of some sort to take your blood pressure? If so, when would be the best times of the day to do so?

 

[Seagal]

Well, it's a bummer topic, but I have to deal with it.

Monitoring it on a daily basis and then averaging is a good idea. Do you use a home kit of some sort to take your blood pressure? If so, when would be the best times of the day to do so?

I use a wrist blood pressure monitor. I usually measure it in the evening. Just try to keep it consistent: sitting for 5 minutes, relaxed, I repeat the measuring three times (having at least two measurements close to identical). You could keep a log/table: day time, BP, notes (e.g. stress, physical exercise etc). Could be also something else besides HCT that cause your high BP.

 

[Melody68]

I looked at the wrist monitors, $30-40, not a lot of money. Do they work OK? Do you find yours as accurate as conventional medical equipment?

I'm looking at the whole situation closer now. I DO drink a lot of coffee, and I DON'T drink a lot of water. I've also been reading that circumin reduces blood iron and hematocrit. I'll have to come up with a plan . . .

I'm still in my first year of TRT, and it was supposed to be an experimental year to test whether I go on T permanently. My T wasn't way low, but lower at around 11.0. It certainly hasn't solved a number of initial concerns that I had, but it really has helped with one issue, my body composition. At the age of 68 I had lost a lot of upper body muscle, and the waist was getting out of line. I'm 6'3" and in earlier years I was consistently 240 lbs, people would say well built. Despite not exercising much, the shoulders and arms are coming back quickly and the waist is leaning out. Really, I like the effect, so does my wife, so I guess I'll stay on T and thus have to figure out all these other pesky sides . . .

 

[Seagal]

I looked at the wrist monitors, $30-40, not a lot of money. Do they work OK? Do you find yours as accurate as conventional medical equipment?

I'm looking at the whole situation closer now. I DO drink a lot of coffee, and I DON'T drink a lot of water. I've also been reading that circumin reduces blood iron and hematocrit. I'll have to come up with a plan . . .

I'm still in my first year of TRT, and it was supposed to be an experimental year to test whether I go on T permanently. My T wasn't way low, but lower at around 11.0. It certainly hasn't solved a number of initial concerns that I had, but it really has helped with one issue, my body composition. At the age of 68 I had lost a lot of upper body muscle, and the waist was getting out of line. In earlier years I was consistently 6'3 and 240 lbs, people would say well built. Despite not exercising much, the shoulders and arms are coming back quickly and the waist is leaning out. Really, I like the effect, so does my wife, so I guess I'll stay on T and thus have to figure out all these other pesky sides . . .

I compared mine (Sanitas) to an expensive/professional one. You need to have the wrist monitor on level with your heart.
How did you get the BP measurements you mentioned?

 

[Melody68]

I've had to go to the doctor a few times, for different issues, the last while - they always test your blood. I've been surprised by the higher figure. I also tested myself at the pharmacy yesterday, same kind of reading. But I'm curious as to what the result might be when I test myself in the relaxed setting of my home. I'm checking Amazon right now and will get one of these monitors. Are you saying your Sanitas was accurate compared to professional equipment?

 

[Seagal]

I've had to go to the doctor a few times, for different issues, the last while - they always test your blood. I've been surprised by the higher figure. I also tested myself at the pharmacy yesterday, same kind of reading. But I'm curious as to what the result might be when I test myself in the relaxed setting of my home. I'm checking Amazon right now and will get one of these monitors. Are you saying your Sanitas was accurate compared to professional equipment?

Yes. You could check yours against the pharmacy's

 

[madman]

I have searched the forum but haven't found a lot of information, or concern, for the high blood pressure that can result from the thicker blood that higher hct and hemoglobin can give to you.

I've been on Trt for about 6 months now (currently 84 mg/week) and my hct and hemo are climbing; I suspect my next blood test will show hct of .53-.54 and hemo of 179-181 (ref 135-175). Before Trt my hct was around .48 and hemo of 170; my blood pressure was always excellent, about 120/80 and even 110/70.

But the last few times I've tested my blood pressure it has been higher, almost always 144/80, which from what I read is considered high blood pressure. Surely others deal with the same issue . . . or not? What BP limits do you guys feel comfortable with?

48 h ambulatory BP monitoring would be needed to see the true impact on BP.

Would not get too caught up on just elevated hematocrit when it comes to use of exogenous T and BP.

Although many tend to blame estradiol when it comes to bloat/water retention keep in mind that androgens increase sodium/water.

Androgens increase the retention of electrolytes.

The use of exogenous androgens will result in the retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates.

Bloating/edema can be common in some and to what degree depends on many factors.

This can easily drive up ones blood pressure.

Inhibition of corticosteroid 11β-hydroxysteroid dehydrogenase enzymes plays a role.

Most of the initial increases in weight gain on trt are water-related whether extracellular/intracellular.

Many men on trt can gain 5-15 lbs of water weight within the first month.

The majority of gains when first starting trt are due to extracellular water (between the muscle and skin) which shows up as bloat/puffiness and intracellular water (inside the muscle cell) which will make the muscle look fuller and harder due to increased glycogen stores.

Even then once the body adjusts or measures have been taken to minimize the bloat/puffiness you are always going to hold more water when using androgens as the muscle cells will retain more water (intracellular).

When coming off androgens, especially high doses you are always going to be pissing out the water weight (extra/intracellular).

Part of the reason why men who abuse androgens mainly the so-called wet compounds deflate when they come off is because they are holding a shit load of excess water weight which is always going to be pissed away.

Does Patient-Applied TRT Pose Risk for Blood Pressure Elevation?

Does Patient-Applied Testosterone Replacement Therapy Pose Risk for Blood Pressure Elevation? Circadian Medicine Perspectives (2022) Michael H. Smolensky, Ramon C. Hermida, Linda Sackett-Lundeen, *Ramon G. Hermida-Ayala, and Yong-Jian Geng ABSTRACT We reviewed medication package inserts, US...

www.excelmale.com

Some take home points here!

• Complications of TRTs are elevated blood pressure (BP) and hypertension. Further investigation is required to determine if these and other adverse effects, like altered lipids and hematocrit and risk of major acute cardiovascular events (MACE), result from the produced T nonphysiologic 24 h patterning

• Determination of the true risk of elevated BP per unique TRT requires 48 h ambulatory BP monitoring and the correct choice of outcome measures, that is, asleep systolic BP mean and amount of asleep systolic BP dipping, most indicative of risk for MACE




Testosterone Replacement Therapy and Blood Pressure

Elevation of BP and new-onset and worsened HTN are adverse effects of TRTs; they are of major concern because they are predisposing to MACE, especially when accompanied by a treatment-induced increase of low-density lipoprotein cholesterol, a decrease of high-density lipoprotein cholesterol, and polycythemia. The package insert of each PA-TRT reports by type and frequency of the likely medication-caused adverse effects recorded in company-sponsored safety trials. There is a great disparity between the 10 unique PA-TRTs in the reported effects upon BP. BP safety trials conducted prior to 2018 entailed only daytime OBPM; nonetheless, in most package inserts the actual mean numerical change in diastolic (D) and systolic (S) BP (DBP, SBP) from baseline and scheduled clinical patient visits during treatment is not specified. Furthermore, the exact incidence of new-onset and progressed HTN is not always conveyed; instead, their incidence is categorized along with other adverse effects as proportions, for example, less than 1% or less than 3%, of trialed participants so affected. With these limitations in mind, the incidence based on OBPM of new-onset HTN of five of the six gel and solution PA-TRTs, that is, of Axiron® (https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/ 022504s013lbl.pdf),Fortesta®(https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021463s020lbl.pdf), Natesto® (https://www.accessdata.fda.gov/drugsatfda_docs/label/ 2014/205488s000lbl.pdf), Testim® (https://www.accessdata .fda.gov/drug/satfda_docs/label/2009/021454s008lbl.pdf) [and its biosimilar Vogelxo® (https://www.accessdata.fda .gov/drugsatfda_docs/label/2019/204399s010lbl.pdf)], and Striant® (https://www.accessdata.fda.gov/drugsatfda_docs/ label/2004/21543s002lbl.pdf), is reported to be less than 1%. Even though the package insert of the other PA-TRTs warns of BP elevation and HTN as adverse effects, as later discussed few list specific incidences.

Accurate determination of the actual effect of the individual PA-TRTs on BP and induced incidence of HTN in hypogonadal men is difficult because of the inherent limitations of OBPM to ascertain representative DBP and SBP values, even though it is the recommended method of assessing BP and diagnosing HTN.




Discussion

Reports of animal model and human studies concerning the mechanisms mediating T-induced effects on BP are inconsistent (30, 37, 58, 72, 80, 82, 83, 90, 121, 157, 158, 178). According to Dubey et al. (37), T acts as a pro-hypertension hormone by stimulating catecholamine synthesis, modulating the renin-angiotensin-aldosterone system, altering endothelin-1 level, inducing endothelial damage to further atherosclerosis, and injuring glomerular endothelial cells to negatively affect renal function. Although some of the cited reports assert T constricts blood vessels and raises BP, some others assert T dilates blood vessels and lessens arterial stiffness and thus reduces BP.

The major focus of this article has been to compare the PK and achieved 24 h patterning of T concentration in relation to the adverse effects of BP elevation and HTN, known risk factors for MACE, of the different FDA-approved nonbiosimilar PA-TRTs. Serum TT, FT, and DHT concentrations in young adult men exhibit pronounced predictable-in-time 24 h variation. However, in men with an androgen hormone deficiency, these T concentrations are not only abnormally low but lack prominent circadian patterning. Accordingly, we characterized each PA-TRT according to its ability to simulate the normal TT circadian rhythm (Figure 1A). We developed five criteria for this purpose: (i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Because at this time it is unknown whether any one of these criteria, for example, circadian time of highest or lowest TT level, is of greater biological importance than the others, we weighted each one of them equally.

Water Retention With Fine E2 Labs

My most recent labs on 8mg daily test cyp. Total Testosterone 675 ng/dL 250-1100 Free Testosterone 162 pg/mL 35-155 Ultrasensitive Estradiol 32 pg/mL

www.excelmale.com

 

[Melody68]

48 h ambulatory BP monitoring would be needed to see the true impact on BP.

Would not get too caught up on just elevated hematocrit when it comes to use of exogenous T and BP.

Although many tend to blame estradiol when it comes to bloat/water retention keep in mind that androgens increase sodium/water.

Androgens increase the retention of electrolytes.

The use of exogenous androgens will result in the retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates.

Bloating/edema can be common in some and to what degree depends on many factors.

This can easily drive up ones blood pressure.

Inhibition of corticosteroid 11β-hydroxysteroid dehydrogenase enzymes plays a role.

Most of the initial increases in weight gain on trt are water-related whether extracellular/intracellular.

Many men on trt can gain 5-15 lbs of water weight within the first month.

The majority of gains when first starting trt are due to extracellular water (between the muscle and skin) which shows up as bloat/puffiness and intracellular water (inside the muscle cell) which will make the muscle look fuller and harder due to increased glycogen stores.

Even then once the body adjusts or measures have been taken to minimize the bloat/puffiness you are always going to hold more water when using androgens as the muscle cells will retain more water (intracellular).

When coming off androgens, especially high doses you are always going to be pissing out the water weight (extra/intracellular).

Part of the reason why men who abuse androgens mainly the so-called wet compounds deflate when they come off is because they are holding a shit load of excess water weight which is always going to be pissed away.

Does Patient-Applied TRT Pose Risk for Blood Pressure Elevation?

Does Patient-Applied Testosterone Replacement Therapy Pose Risk for Blood Pressure Elevation? Circadian Medicine Perspectives (2022) Michael H. Smolensky, Ramon C. Hermida, Linda Sackett-Lundeen, *Ramon G. Hermida-Ayala, and Yong-Jian Geng ABSTRACT We reviewed medication package inserts, US...

www.excelmale.com

Some take home points here!

• Complications of TRTs are elevated blood pressure (BP) and hypertension. Further investigation is required to determine if these and other adverse effects, like altered lipids and hematocrit and risk of major acute cardiovascular events (MACE), result from the produced T nonphysiologic 24 h patterning

• Determination of the true risk of elevated BP per unique TRT requires 48 h ambulatory BP monitoring and the correct choice of outcome measures, that is, asleep systolic BP mean and amount of asleep systolic BP dipping, most indicative of risk for MACE




Testosterone Replacement Therapy and Blood Pressure

Elevation of BP and new-onset and worsened HTN are adverse effects of TRTs; they are of major concern because they are predisposing to MACE, especially when accompanied by a treatment-induced increase of low-density lipoprotein cholesterol, a decrease of high-density lipoprotein cholesterol, and polycythemia. The package insert of each PA-TRT reports by type and frequency of the likely medication-caused adverse effects recorded in company-sponsored safety trials. There is a great disparity between the 10 unique PA-TRTs in the reported effects upon BP. BP safety trials conducted prior to 2018 entailed only daytime OBPM; nonetheless, in most package inserts the actual mean numerical change in diastolic (D) and systolic (S) BP (DBP, SBP) from baseline and scheduled clinical patient visits during treatment is not specified. Furthermore, the exact incidence of new-onset and progressed HTN is not always conveyed; instead, their incidence is categorized along with other adverse effects as proportions, for example, less than 1% or less than 3%, of trialed participants so affected. With these limitations in mind, the incidence based on OBPM of new-onset HTN of five of the six gel and solution PA-TRTs, that is, of Axiron® (https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/ 022504s013lbl.pdf),Fortesta®(https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021463s020lbl.pdf), Natesto® (https://www.accessdata.fda.gov/drugsatfda_docs/label/ 2014/205488s000lbl.pdf), Testim® (https://www.accessdata .fda.gov/drug/satfda_docs/label/2009/021454s008lbl.pdf) [and its biosimilar Vogelxo® (https://www.accessdata.fda .gov/drugsatfda_docs/label/2019/204399s010lbl.pdf)], and Striant® (https://www.accessdata.fda.gov/drugsatfda_docs/ label/2004/21543s002lbl.pdf), is reported to be less than 1%. Even though the package insert of the other PA-TRTs warns of BP elevation and HTN as adverse effects, as later discussed few list specific incidences.

Accurate determination of the actual effect of the individual PA-TRTs on BP and induced incidence of HTN in hypogonadal men is difficult because of the inherent limitations of OBPM to ascertain representative DBP and SBP values, even though it is the recommended method of assessing BP and diagnosing HTN.




Discussion

Reports of animal model and human studies concerning the mechanisms mediating T-induced effects on BP are inconsistent (30, 37, 58, 72, 80, 82, 83, 90, 121, 157, 158, 178). According to Dubey et al. (37), T acts as a pro-hypertension hormone by stimulating catecholamine synthesis, modulating the renin-angiotensin-aldosterone system, altering endothelin-1 level, inducing endothelial damage to further atherosclerosis, and injuring glomerular endothelial cells to negatively affect renal function. Although some of the cited reports assert T constricts blood vessels and raises BP, some others assert T dilates blood vessels and lessens arterial stiffness and thus reduces BP.

The major focus of this article has been to compare the PK and achieved 24 h patterning of T concentration in relation to the adverse effects of BP elevation and HTN, known risk factors for MACE, of the different FDA-approved nonbiosimilar PA-TRTs. Serum TT, FT, and DHT concentrations in young adult men exhibit pronounced predictable-in-time 24 h variation. However, in men with an androgen hormone deficiency, these T concentrations are not only abnormally low but lack prominent circadian patterning. Accordingly, we characterized each PA-TRT according to its ability to simulate the normal TT circadian rhythm (Figure 1A). We developed five criteria for this purpose: (i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Because at this time it is unknown whether any one of these criteria, for example, circadian time of highest or lowest TT level, is of greater biological importance than the others, we weighted each one of them equally.

Water Retention With Fine E2 Labs

My most recent labs on 8mg daily test cyp. Total Testosterone 675 ng/dL 250-1100 Free Testosterone 162 pg/mL 35-155 Ultrasensitive Estradiol 32 pg/mL

www.excelmale.com

Madman, an excellent write-up as always, thanks.

Yes, it's easier for the layperson to comprehend the simple notion that blood is "thicker" and therefore harder to pump through the body, thus causing an elevation in BP. It seems there is always more to it than meets the eye.

Today is exactly two months since I was taking 60 mg/week and then had a blood test and started the higher dose of 84 mg week. I'd like to test my blood in another month - I know I shouldn't change the protocol too much, otherwise I won't be able to discern anything from my then three month experience. I'd like, however, to do a few things . . . 1. buy a BP monitor and log the results 2. cut down dramatically on my coffee consumption and 3. increase my water intake. No need to reduce salt, we don't add salt to any of our foods. I'll keep the injection periods the same until the test at least.

I presume that a blood phlebotomy would also be premature before the three month test . . .

 

[madman]

Madman, an excellent write-up as always, thanks.

Yes, it's easier for the layperson to comprehend the simple notion that blood is "thicker" and therefore harder to pump through the body, thus causing an elevation in BP. It seems there is always more to it than meets the eye.

Today is exactly two months since I was taking 60 mg/week and then had a blood test and started the higher dose of 84 mg week. I'd like to test my blood in another month - I know I shouldn't change the protocol too much, otherwise I won't be able to discern anything from my then three month experience. I'd like, however, to do a few things . . . 1. buy a BP monitor and log the results 2. cut down dramatically on my coffee consumption and 3. increase my water intake. No need to reduce salt, we don't add salt to any of our foods. I'll keep the injection periods the same until the test at least.

I presume that a blood phlebotomy would also be premature before the three month test . . .

Yes do not deviate from your protocol (dose of T/injection frequency) as you need to see where your trough TT and more importantly FT let alone estradiol, SHBG, RBCs, hemoglobin and hematocrit sit before deciding if any tweaking is needed!

At least you put in the 3 months on said protocol as such will be needed in order to truly gauge how you feel regarding relief/improvement of low-t symptoms and overall well-being.

As I have stated numerous times on the forum how one feels 6 weeks in means nothing when looking at the bigger picture.

As I have stated in previous threads where your hematocrit sits 6 weeks in whether one is starting TTH or tweaking a protocol (increasing dose of T) is not where it will end up as it will take anywhere from 6-9 months and in some cases up to a year to reach peak levels.

Seeing as you will not have access to the most accurate assay (Equilibrium Dialysis) for FT then you will need to use/rely upon the linear law-of-mass action cFTV.

Again you will need your TT, SHBG and albumin in order to calculate your FT.

 

[madman]

Madman, an excellent write-up as always, thanks.

Yes, it's easier for the layperson to comprehend the simple notion that blood is "thicker" and therefore harder to pump through the body, thus causing an elevation in BP. It seems there is always more to it than meets the eye.

Today is exactly two months since I was taking 60 mg/week and then had a blood test and started the higher dose of 84 mg week. I'd like to test my blood in another month - I know I shouldn't change the protocol too much, otherwise I won't be able to discern anything from my then three month experience. I'd like, however, to do a few things . . . 1. buy a BP monitor and log the results 2. cut down dramatically on my coffee consumption and 3. increase my water intake. No need to reduce salt, we don't add salt to any of our foods. I'll keep the injection periods the same until the test at least.

I presume that a blood phlebotomy would also be premature before the three month test . . .

Before Trt my hct was around .48

If this is the norm for you then seeing as it is on the higher end it would be a given that you will be struggling with elevated hematocrit on exogenous T if you push your trough let alone steady state FT too high!

 

[madman]

Madman, an excellent write-up as always, thanks.

Yes, it's easier for the layperson to comprehend the simple notion that blood is "thicker" and therefore harder to pump through the body, thus causing an elevation in BP. It seems there is always more to it than meets the eye.

Today is exactly two months since I was taking 60 mg/week and then had a blood test and started the higher dose of 84 mg week. I'd like to test my blood in another month - I know I shouldn't change the protocol too much, otherwise I won't be able to discern anything from my then three month experience. I'd like, however, to do a few things . . . 1. buy a BP monitor and log the results 2. cut down dramatically on my coffee consumption and 3. increase my water intake. No need to reduce salt, we don't add salt to any of our foods. I'll keep the injection periods the same until the test at least.

I presume that a blood phlebotomy would also be premature before the three month test . . .

Key here being make sure you are well hydrated (fluids/electrolytes) days before not the day of when testing hematocrit!

Hi, new guy (40) on TRT from the Netherlands

Welcome to Nelson's domain! Was your blood work done in the early AM in a fasted state? We always want to test at peak (highest point). Although a TT 13.9 nmol/L (400.9 ng/dL) is far from stellar it is not a given that your FT is low. Need to know where your SHBG sits. You are missing the...

www.excelmale.com

Creatine and rbc H&h ?

So my question is basically does one on trt who has an elevated H&H hematocrit and hemoglobin around 54 and 18 and habitually works out with weights 4/5 days a week want to use creatine without causing any side effects . I know creatine does a lot of wonderful things like increase atp and...

www.excelmale.com

Workout with mask: hematocrit

Did anyone experienced slightly higher hematocrit levels after starting to workout with masks?

www.excelmale.com

 

[Belekas]

Sorry you going through this. I had a similar issue with TRT a year or so ago but my HC and HGB were perfect and barely went higher while on. Mind you I was very lean when starting, no drinking, no coffees, great, smart nutrition, perfect hydration, etc, etc. And still my great BP started spiking and I started getting all kinds of different issues which I covered in my thread, if its still here somewhere. My cardio was always great in the last 20 years or so, even upped it, added proper supps, tried manipulations with salt, electrolites, etc, etc tried different T doses, frequencies and still no bueno. Got off TRT and now probably like a year later my BP is 105/65, 110/70 or so on a good day. I don't mind anything up to 120/80 and feel the best. I worked fucking hard to get that BP down, keep it down and the most important find what works FOR ME. And I found it with lots of trial and error but thats absolutely not what Docs recommend. Now I'm cool, calm and collected with a beautiful BP and HR, not always hot, no red face, no headaches at all, no spiking BP, heart feels more mildly beating, then while on TRT it was beating a lot harder and making me feel it which absolutely didn't sit well with me. Lost some weight as well and got even leaner as been doing some detoxes and other protocols fwiw. Brain feels a lot better, cognitive functions better. Can actually read and remember what I've read as it was bad enough while on TRT. Less flight or fight respons, more calm, less moody and overall feeling better. Ofc I miss TRT for other reasons like erection quality, more libido (at least for me), better gym performace, fuller muscles, better recovery, etc, buuuuuuut there is no point having all that if it comes with the price of high BP. That shit is a silent killer and will do truck loads of damage with time if untreated and yet many people walk with 180/100 and have no idea that its that high on their way to get Starbucks 150g sugar induced Latte for breakfast Given all that I know now and how I manage to control my BP I think I will give TRT(or HRT) another go in the future just not sure when as I still have more then 20ml of Sustanon, 20ml of Deca, 10ml of Prop and 10ml of Primobolan left in my cupboard

 

[sammmy]

I've had to go to the doctor a few times, for different issues, the last while - they always test your blood. I've been surprised by the higher figure. I also tested myself at the pharmacy yesterday, same kind of reading. But I'm curious as to what the result might be when I test myself in the relaxed setting of my home. I'm checking Amazon right now and will get one of these monitors. Are you saying your Sanitas was accurate compared to professional equipment?

A few notes on proper measurement of blood pressure.

Home monitors with a cuff seem to give the most correct values. Wrist monitors have the reputation of very imprecise.

BP is often elevated at the doctor's office from the activation of the nervous system - the "white coat effect". Mine is 100/60 at home and 120/80 or higher at the doctor's, with the same home monitor. So, measure sitting at rest at home (left arm relaxed down, cuff at the level of nipples, no leg crossing), and disregard the doctor's values.

BP should be measured in the morning after you get up and before drinking or eating anything. It gets lower after eating and in the evening.

 

[Melody68]

Sorry you going through this. I had a similar issue with TRT a year or so ago but my HC and HGB were perfect and barely went higher while on. Mind you I was very lean when starting, no drinking, no coffees, great, smart nutrition, perfect hydration, etc, etc. And still my great BP started spiking and I started getting all kinds of different issues which I covered in my thread, if its still here somewhere. My cardio was always great in the last 20 years or so, even upped it, added proper supps, tried manipulations with salt, electrolites, etc, etc tried different T doses, frequencies and still no bueno. Got off TRT and now probably like a year later my BP is 105/65, 110/70 or so on a good day. I don't mind anything up to 120/80 and feel the best. I worked fucking hard to get that BP down, keep it down and the most important find what works FOR ME. And I found it with lots of trial and error but thats absolutely not what Docs recommend. Now I'm cool, calm and collected with a beautiful BP and HR, not always hot, no red face, no headaches at all, no spiking BP, heart feels more mildly beating, then while on TRT it was beating a lot harder and making me feel it which absolutely didn't sit well with me. Lost some weight as well and got even leaner as been doing some detoxes and other protocols fwiw. Brain feels a lot better, cognitive functions better. Can actually read and remember what I've read as it was bad enough while on TRT. Less flight or fight respons, more calm, less moody and overall feeling better. Ofc I miss TRT for other reasons like erection quality, more libido (at least for me), better gym performace, fuller muscles, better recovery, etc, buuuuuuut there is no point having all that if it comes with the price of high BP. That shit is a silent killer and will do truck loads of damage with time if untreated and yet many people walk with 180/100 and have no idea that its that high on their way to get Starbucks 150g sugar induced Latte for breakfast Given all that I know now and how I manage to control my BP I think I will give TRT(or HRT) another go in the future just not sure when as I still have more then 20ml of Sustanon, 20ml of Deca, 10ml of Prop and 10ml of Primobolan left in my cupboard

 

[Melody68]

Belekas, thanks for the detailed response. Yes, it would seem that there is more, perhaps much more, to rising BP than just the belief that elevated HC and HGB results in thicker, harder to push blood. What could it be? I, in fact, had traditionally low blood pressure; I recall 95/55 when I was a teen, and feeling faint when standing quickly. I went to the doctors and most of them treated me as if I had some kind of rare disease, and it became a source of anxiety for me. To this day, I get a little tense when they hook me up to the BP monitor - maybe that contributes to the problem? I've ordered a BP monitor from Amazon due for delivery on Thursday; it'll be interesting to take my own BP in the comfort and relaxation of my own home.

I've improved a lot of BP factors recently; I used to be addicted to popcorn with lots of salt, coffee, etc. I wonder how quickly those changes will show up in a measurement. I really wouldn't want to stop TRT or even cut back too much, the benefit to body composition has been significant. Nope, there's a way to go here before I consider any of that, most important - I'm aware of and addressing the problem . . .