Rising Hematocrit and RBC

[pyater]

Need some input and assistance from the forum. Have been on TRT since 2018. Tried most forms (Compounded creams, Androgel, shots) and have most recently been on:

• Testosterone Protocol – Since 2/25/21
• T-cypionate - 200mg/ml - 0.28ml Subcutaneous shots - every 2.5 days

Latest Labs (Labs were on trough day):

• Latest Testosterone results – Total T : 461, Free T 30.2
• Estradiol Sensitive - 30.9 – up from 18.7 (2/3/21)
• Sex Hormone Binding Globulin - 16.4 Low
• DHT – 37 - DHT up since low last reading at 20
• DHEA – 262
• Prolactin – 12.23

The more concerning labs are :

• Hematocrit Up to 50.8% High
• Was 40.8 Low in June of 2018 (Pre-TRT)
• Hemogloblin – 1.72
• RBC – 5.90 on the border line
• Steady climb of RBC since started shots 4.83 (7/22/20) to 5.90 now
• Pre-TRT Baseline 7/23/18 – 4.62

Iron and Ferritin results

• TIBC – 418
• Iron – 71
• Iron Saturation – 17 Low
• Ferritin Serum – 97.3

I am a Defy patient and had an appointment yesterday. Dr. said I could donate but didn’t have to but was not worried that I would crash my iron or ferritin. So, I went to donate for the first time today. Once the needle was in, the tech was having trouble with the blood flow into the first bag but then got it started. They asked if I had hydrated well, which I had. Then a more senior tech came over about said there were issues and I was only able to donate half a donation and she mentioned that the smaller bag that they test flow in or whatever was already clotted.

Long story short I am concerned about this. Any others with high Hemoglobin and RBC have these issues? I know once Hemoglobin gets too high they will not let you donate.

Any suggestions? I am concerned. I do high hypertension which is treated with medicine.

 

[xcpatr922]

My only advice is to check yourself into a good cardiologist and check everything. Also need to find out your CAC score , just to avoid surprise.

 

[AndyPandy66]

My latest labs have come back almost the same as yours. I’ve stopped the injections for now until I can get a donation. I’m so scared about it. The rise has been rapid over three months.

 

[TorontoTRT]

I think you have things backwards. Your bloods are NOT high at all. Hematocrit upper range is 54 and rbc upper range is 6. Regardless of what lab ranges your place uses. What I’d be more concerned about is your injection protocol cause your testosterone levels are too low for 200 mg a week. Your numbers should be over 1200-1500 at that dosage., not in the 400’s. Time to inject IM instead of subq.

 

[Systemlord]

Any others with high Hemoglobin and RBC have these issues?

I recently did a double power red donation (phlebotomy) because my endo didn't like my hemoglobin at 19.2 and wasn't concerned with my 57% hematocrit.

The only issue I had was erections were alittle more difficult to maintain and achieve.

You blood levels aren't high. You did need to up your iron intake though.

 

[Systemlord]

I’ve stopped the injections for now until I can get a donation. I’m so scared about it. The rise has been rapid over three months.

High blood parameters on TRT can be the result of sleep apnea.

 

[xcpatr922]

I recently did a double power red donation (phlebotomy) because my endo didn't like my hemoglobin at 19.2 and wasn't concerned with my 57% hematocrit.

The only issue I had was erections were alittle more difficult to maintain and achieve.

You blood levels aren't high. You did need to up your iron intake though.

Hb 19.2 is actually equal more or less to 57% HT.

High blood parameters on TRT can be the result of sleep apnea.

--if untreated

in my experiences, it's more relevant to dosage and frequency.

Also if you can attach your platelet count that would be the best...since you have clotting issue.

You need to check:
platelet count
PT/INR
in case you have high RBC/HTC that's bit dangerous.

 

[Systemlord]

in my experiences, it's more relevant to dosage and frequency.

The severity of sleep apnea definitely dose-dependent in my experience, this last dosage increase really took my sleep apnea to another level.

I dose twice daily (237mg) with Jatenzo. I'm do for a sleep study Jan 6th.

 

[xcpatr922]

The severity of sleep apnea definitely dose-dependent in my experience, this last dosage increase really took my sleep apnea to another level.

I dose twice daily (237mg) with Jatenzo. I'm do for a sleep study Jan 6th.

better use CPAP.
I guess CPAP is the best invention ever made that's very useful......

 

[DFL]

My Hematocrit runs 53-55 and I donate every 3 months. I don't like it, but I haven't been able to do anything about it. I wouldn't donate if I was under 53.

 

[xcpatr922]

My Hematocrit runs 53-55 and I donate every 3 months. I don't like it, but I haven't been able to do anything about it. I wouldn't donate if I was under 53.

Everyone of us is very different. Before TRT I know the state of my heart in every artery so I would not take a chance if HT goes above 50-51. I also know my CAC,LVEF and how my artery looks like.

For you guys that has high hematocrit, make sure your platelet counts remain low and don't do too much outside exercise activity in the morning in the winter session, that's what kills people becoz the platelet is very sticky in the morning.

 

[pyater]

Platelate count is:

Platelet Count

269 k/mcL

145 - 445 k/mcL

I do have Sleep Apnea but it is well controlled with CPAP. The cardiac calcium score was zero 2 years ago. Had and Echo done last year. No issues.

• Lp(a) - 15.4
• CRP - 2.05 up from 1.35 on 2/3/21 and .66 on 2/23/18
• Homocysteine - 10.2

The thickness of the blood on blood donation is what spooked me. You other guys that donate with high hematocrit. Did you have issues with coagulation when donating?

 

[Systemlord]

Did you have issues with coagulation when donating?

No, my clotting is within normal limits at 27 seconds.

 

[xcpatr922]

Interesting, your number really looks good. My blood is almost like water now. Blood donation only took few minutes. No coag at all.

 

[ed031561]

I think you have things backwards. Your bloods are NOT high at all. Hematocrit upper range is 54 and rbc upper range is 6. Regardless of what lab ranges your place uses. What I’d be more concerned about is your injection protocol cause your testosterone levels are too low for 200 mg a week. Your numbers should be over 1200-1500 at that dosage., not in the 400’s. Time to inject IM instead of subq.

What he said!

 

[jobshopper]

For what its worth. My RBC and Hematocrit started moving slightly out of range when I started IM injections a couple of years ago. My physician had me start taking 1 baby aspirin per day. That brought my RBC and Hematocrit back into the normal range. My recent labs show that they have continued to come down a little lower over the past couple of years and have stayed in the normal range. ... we are all different though and respond differently which goes without saying.

 

[michaely23]

Where are some places you can get therapeutic phlebotomies. I’m *** and also have a tattoo so I can’t donate blood

 

[Vince]

Where are some places you can get therapeutic phlebotomies. I’m *** and also have a tattoo so I can’t donate blood

They will take your blood if your doctor calls in an order to the blood center near you. I believe the order is good for two years.

How to Lower High Hematocrit Caused by Testosterone Replacement Therapy (TRT)

High Hematocrit Caused by Testosterone Replacement Therapy By Nelson Vergel, B.S.Ch.E., M.B.A. High hematocrit occurs when there is an excessive production of red blood cells. High hematocrit can cause the blood to become very viscous or "sticky," making it harder for the heart to pump. High...

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[michaely23]

Thanks Vince! So I can ask my doctor to send in an order to red cross for example?

 

[Vince]

Thanks Vince! So I can ask my doctor to send in an order to red cross for example?

Yes