WARNING: Do not believe Internet "gurus" proclaiming no need to manage hematocrit on TRT

Nelson Vergel

Founder, ExcelMale.com
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
 

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