High Hematocrit after years on TRT

[roadglide]

Labs came back at 54.4 so I went off TRT for two weeks retested and results were 49.4 before donating blood. I reduced my Testosterone and will be doing more labs this monday and donating blood. Looks like my Hematocrit had been creeping up over a few lab cycles, but the Doc was not concerned. Then it shot up four points in six months. Is this unusual?

 

[Vince]

Any chance you have sleep apnea?

 

[roadglide]

Any chance you have sleep apnea?

I do and have for many years. Does that mean anything?

 

[Systemlord]

I do and have for many years. Does that mean anything?

You’re basically suffering from hypoxia, you’re holding your breath. I’m not breathing properly while sleeping. Your body is trying to keep you alive is increasing your red blood cell count.

Untreated sleep apnea will shorten your lifespan. I had a friend recently died in his sleep and for years he had horrible sleep apnea which triggered a heart attack in his sleep.

When they told me he died in his sleep, I knew exactly what happened. He used to make god-awful noises, holding his breath for minutes at a time, and he would wake up in a frantic effort to start breathing again.

Treating the sleep apnea with a CPAP machine should see the hematocrit decline.

 

[Vince]

I do and have for many years. Does that mean anything?

Yes, it raises your Hematocrit.

 

[roadglide]

You’re basically suffering from hypoxia, you’re holding your breath. I’m not breathing properly while sleeping. Your body is trying to keep you alive is increasing your red blood cell count.

Untreated sleep apnea will shorten your lifespan. I had a friend recently died in his sleep and for years he had horrible sleep apnea which triggered a heart attack in his sleep.

When they told me he died in his sleep, I knew exactly what happened. He used to make god-awful noises, holding his breath for minutes at a time, and he would wake up in a frantic effort to start breathing again.

Treating the sleep apnea with a CPAP machine should see the hematocrit decline.

It must be something else because I use a CPAP very successfully. What about alcohol consumption or dehydration? We drink more after retiring.

 

[roadglide]

Yes, it raises your Hematocrit.

I use my CPAP and they monitor my data via a modem. It does the job. What about alcohol consumption or dehydration?

 

[Systemlord]

It must be something else because I use a CPAP very successfully. What about alcohol consumption or dehydration? We drink more after retiring.

Alcohol can easily dehydrate you. Back when I was on TRT one morning I had dehydration from diarrhea, my HCT was 54% and 4 to 5 hours later after rehydration HCT decreased to 51%.

 

[Vince]

I use my CPAP and they monitor my data via a modem. It does the job. What about alcohol consumption or dehydration?

Yep, stay Hydrated. Drink lots of water.

 

[Fernando Almaguer]

You’re basically suffering from hypoxia, you’re holding your breath. I’m not breathing properly while sleeping. Your body is trying to keep you alive is increasing your red blood cell count.

Untreated sleep apnea will shorten your lifespan. I had a friend recently died in his sleep and for years he had horrible sleep apnea which triggered a heart attack in his sleep.

When they told me he died in his sleep, I knew exactly what happened. He used to make god-awful noises, holding his breath for minutes at a time, and he would wake up in a frantic effort to start breathing again.

Treating the sleep apnea with a CPAP machine should see the hematocrit decline.

dID HE not wear a sleep mask ?

 

[Systemlord]

dID HE not wear a sleep mask ?

No, he refused to wear a CPAP mask. Very stubborn guy. He was a smoker.

 

[WhiteMale]

Your HCT did not drop 5 points in two weeks going off Test. Even with a 1 pint whole blood donation you can't drop 5 points.

 

[SH3P]

Your HCT did not drop 5 points in two weeks going off Test. Even with a 1 pint whole blood donation you can't drop 5 points.

Red blood cells hang out for around 120 days, so this would be my thought as well.

Also, I would be interested in seeing how much his RBC count and HGB tracked with that hematocrit. That would give more insight.

 

[roadglide]

Red blood cells hang out for around 120 days, so this would be my thought as well.

Also, I would be interested in seeing how much his RBC count and HGB tracked with that hematocrit. That would give more insight.

Really, what about dehydration or alcohol consumption the day before?

These are my test results on 10/18. I stopped T and did labs again on 10/31.

RBC	5.99 High	10E12/L	4.10-5.70	Details
HEMOGLOBIN	17.5 High	g/dL	13.0-17.0	Details
HEMATOCRIT	54.4 High	%	39.0-49.0

These are from 10/31 before blood donation.

RBC	5.55	10E12/L	4.10-5.70	Details
HEMOGLOBIN	16.8	g/dL	13.0-17.0	Details
HEMATOCRIT	49.4 High	%	39.0-49.0

These are 12/9 before blood donation. For some reason I had two sets of data. The nurse explained there was two orders so they tested twice. The problem is the results don't match.

RBC	5.36	10E12/L	4.10-5.70	Details
HEMOGLOBIN	16.3	g/dL	13.0-17.0	Details
HEMATOCRIT	48.5	%	39.0-49.0

RBC	5.47	10E12/L	4.10-5.70	Details
HEMOGLOBIN	16.5	g/dL	13.0-17.0	Details
HEMATOCRIT	50.1 High	%	39.0-49.0

 

[Systemlord]

The problem is the results don't match.

Lab testing has flaws. It’s not 100% perfect. Your last two labs, I don’t see a problem.

 

[Ribeye]

Really, what about dehydration or alcohol consumption the day before?

These are my test results on 10/18. I stopped T and did labs again on 10/31.

RBC	5.99 High	10E12/L	4.10-5.70	Details
HEMOGLOBIN	17.5 High	g/dL	13.0-17.0	Details
HEMATOCRIT	54.4 High	%	39.0-49.0

These are from 10/31 before blood donation.

RBC	5.55	10E12/L	4.10-5.70	Details
HEMOGLOBIN	16.8	g/dL	13.0-17.0	Details
HEMATOCRIT	49.4 High	%	39.0-49.0

These are 12/9 before blood donation. For some reason I had two sets of data. The nurse explained there was two orders so they tested twice. The problem is the results don't match.

RBC	5.36	10E12/L	4.10-5.70	Details
HEMOGLOBIN	16.3	g/dL	13.0-17.0	Details
HEMATOCRIT	48.5	%	39.0-49.0

RBC	5.47	10E12/L	4.10-5.70	Details
HEMOGLOBIN	16.5	g/dL	13.0-17.0	Details
HEMATOCRIT	50.1 High	%	39.0-49.0

It's likely some lab mistake, or a combination of that and dehydration. It seems like in my case, dehydration can easily make a %point or more difference easily. I have apnea also, and my HCT tends to climb up to about 54% about every 4-5 months, but staying hydrated, donating about every 4 months to 5 months, and using my CPap keeps it down under the magic number of 54% pretty regularly. I don't mind donating a couple times a year of so, either. But recently mine climbed up faster than usual, in about 3 1/2 months. I have been having some new sleep issues and seem to finally have them resolved. I have a hematologist that follows, and she doesn't get worried at all about HCT at 54%, but doesn't like it to ge much higher. she is also ok with me donating every 3 months if needed. She watches my iron and does counsel me on diet so my iron doesn't get depleted. Good news, is I get to eat lots of red meat if I have to donate more often. She doesn't give me iron supplements because she believes it will further aggravate the HCT production. If your iron swings down, bring it back gradually with diet.

 

[roadglide]

It's likely some lab mistake, or a combination of that and dehydration. It seems like in my case, dehydration can easily make a %point or more difference easily. I have apnea also, and my HCT tends to climb up to about 54% about every 4-5 months, but staying hydrated, donating about every 4 months to 5 months, and using my CPap keeps it down under the magic number of 54% pretty regularly. I don't mind donating a couple times a year of so, either. But recently mine climbed up faster than usual, in about 3 1/2 months. I have been having some new sleep issues and seem to finally have them resolved. I have a hematologist that follows, and she doesn't get worried at all about HCT at 54%, but doesn't like it to ge much higher. she is also ok with me donating every 3 months if needed. She watches my iron and does counsel me on diet so my iron doesn't get depleted. Good news, is I get to eat lots of red meat if I have to donate more often. She doesn't give me iron supplements because she believes it will further aggravate the HCT production. If your iron swings down, bring it back gradually with diet.

Interesting, has she mentioned any other vitamins that increase HCT?

 

[Ribeye]

Interesting, has she mentioned any other vitamins that increase HCT?

No the big driver of HCT and HBG would be iron, especially if taken as supplements in high doses over short periods of time, like days or a week. If your supplements have iron, and some have lots of it, stop those immediately. I have a brother who actually got diagnose with hemochromatosis, a genetic disease that gives someone very high iron levels and the treatment is phlebotomy, taking blood as needed to reduce HCT and HBG. Turned out he didn't have hemochromatosis, he was taking a supplement that had a lot of iron in it! Once he stopped that, it returned to normals on its own.