Testosterone & Hematocrit

[EricRF]

Greetings, all...

I'm currently on TRT, and my hematocrit (HCT) is on the high end of normal. It's hovering around 50-52 and the max "normal" is 54%. It's known that extra testosterone can raise HCT. My test levels are still not that great, but the doc won't give me any more because my HCT is too high.

Now, it's "known" that high HCT is a Bad Thing. The theory is that if the RBC concentration is too high, then blood cells may start sticking to the artery walls, giving rise to a stroke.

My question to the assembled masses is: Does anyone know of a study that confirms this is true? I've looked, but it's hard to sift through all the search results to find something comprehensible to the layman.

I'm wondering if this is a "just-in-case-we-don't-want-to-take-any-chances-but-don't-really-know" situation, or if there's hard evidence against a high hematocrit. Oh, and I'm not interested in what your doctor, friend, trainer, whatever, "says", unless it points to a specific study. I even remember my doctor kind of muttering under his breath that they've never actually seen any problems with high hematocrit, but I may have misheard and he wouldn't follow up on that statement.

And the reason for my question? Depending on what I find out, I may have to find some extra test on my own, to at least get my levels to a high normal.

Thanks for any/or constructive answers/suggestions/pointers!

-Eric

[LuvsMusl]

Hi, Eric. It is pretty widely accepted by doctors that high red cell count is a risk factor for arterial disease. I had an elevated count when I was juicing, and my doctor addressed it by having a couple units of blood drained out of me. Apparently the body quickly replaces your plasma level, so that your blood volume will be correct. But there end up being fewer red blood cells (lower hematocrit) in the same amount of blood. And it takes a long, long time (i.e., months) for the count to get too high again.

[EricRF]

Hi LM...

I did have a "bloodletting" (my term for the "therapeutic phlebotomy"), but it only dropped my HCT to 49, which was still considered too high. Just had a another blood draw this week, and see the TRT doc next week, to see where it lands.

What I'm trying to find out though, is though it's "widely accepted by doctors...", it may not actually be a risk. That's why I'm looking for a study (or ten) that confirm it. I've discovered, over the years, a few things "widely accepted by doctors" that turned out to be outright wrong.

Thanks for your reply!

-Eric

[nnnrg]

It's considered a bad thing in general... but according to MedicineNet.com men are considered normal between 39 and 53.9 percent. So at 49 you're a bit higher than the mid-range (and I don't see anything about distribution in the range) but not all that badly off. If you were in Colorado it would be a benefit for the improved oxygenation. As a lifter it may also be a good thing for that reason.

The dangers of high hematocrit: 1) clots. It becomes much easier to bruise, clot, and generally blood gets a little stickier. 2) It makes surgery more dangerous for older people (65 and older generally) and harder to survive due to increased risk of cardiovascular 'events' like heart attack, clots, and death. 3) it's a 'warning' sign for other problems. Using extra T throws off that warning, but for example, certain kinds of cancer cause a high hematocrit.

It will also get you disqualified from cycling for 'doping' if the testosterone didn't already.


I had this particular problem when I was using supplementary T and stopped having it when I stopped - the big honking needles were just too much - but if I can find a source for water-soluble testosterone (not cypionate nor any other oil-soluble form) I'll be able to use insulin needles and subcutaneous injection, and we'll see if the problem returns.

[EricRF]

Thanks for the replies... I was aware of most of the things that everyone mentioned, but I'm still trying to find a study that gives some idea of what the risk would actually be.

Having said that, I'm not going to mess with getting my HCT too high. I saw my T doc a few weeks after the bloodletting, and my HCT was up to 51, too high to add more T So my levels are in the normal range, but kind of on the low side (and I can feel it). I'm supposed to get regular bloodletting every 3 months, and keep an eye on the HCT and see what happens. The doc isn't willing to experiment to see how high my HCT actually goes if I use more T. That'd be an interesting experiment.

Oh, and nnnrg, the big honkin' needles (and they are) are a bit much, and for me it was a major accomplishment to be able to inject myself. It's not much fun, and I'm still not used to it, but it seems to be the best to make sure it all gets in there! There are some newer gels out, but I never go results with the old ones, so I'm sticking with the needles (no pun) for now.

[Dodger]

According to the double blinded studies there's a correlation with increased venous thrombosis, but comorbidity studies can't prove that it's caused by increase HCT.

[EricRF]

Originally Posted by Dodger

According to the double blinded studies there's a correlation with increased venous thrombosis, but comorbidity studies can't prove that it's caused by increase HCT.

Ah, thanks Dodger! And... as we all know... correlation does not equal causation!

[FuzzyKB]

Originally Posted by EricRF

Greetings, all...

I'm currently on TRT, and my hematocrit (HCT) is on the high end of normal. It's hovering around 50-52 and the max "normal" is 54%. It's known that extra testosterone can raise HCT. My test levels are still not that great, but the doc won't give me any more because my HCT is too high.

Now, it's "known" that high HCT is a Bad Thing. The theory is that if the RBC concentration is too high, then blood cells may start sticking to the artery walls, giving rise to a stroke.

My question to the assembled masses is: Does anyone know of a study that confirms this is true? I've looked, but it's hard to sift through all the search results to find something comprehensible to the layman.

I'm wondering if this is a "just-in-case-we-don't-want-to-take-any-chances-but-don't-really-know" situation, or if there's hard evidence against a high hematocrit. Oh, and I'm not interested in what your doctor, friend, trainer, whatever, "says", unless it points to a specific study. I even remember my doctor kind of muttering under his breath that they've never actually seen any problems with high hematocrit, but I may have misheard and he wouldn't follow up on that statement.

And the reason for my question? Depending on what I find out, I may have to find some extra test on my own, to at least get my levels to a high normal.

Thanks for any/or constructive answers/suggestions/pointers!

-Eric

Are you on injectable Depo Testosterone?

If you are on Depo this is made up of the testosterone ester most often at fault for causing this. Have your Doctor use a different testosterone ester because there are numerous others.

The reason that this is most often prescribed is that it is a longer lasting testosterone ester. The problem with the other testosterone esters is that the method of administration will need to change.

Your MD will need to let the Hematocrit level drop for about a month with you off the HRT treatment. Then he will need to make up a group of syringes for you of a different testosterone ester. At that time you go home and inject probably every other day for about a week. They then do a blood draw and check the hematocrit again after a week of you feeling like a pin cushion. If the hematocrit has not risen again, you should then be able to have a pellet type implant of the different testosterone ester.


There are implants available of other esters. Probably the next one to try is Testosterone Undecanoate The old stand by has been Depo Testosterone and it has been so bloody "established" it has become a habit and most MD's fail to realize that there are other routes and esters. If you can take an alternate in injectable form without raising Hematocrit levels then you can overcome the frequency issues with an implant and these ARE available. Your MD just needs to do a little digging.


Most MD's are sadly not qualified to do male HRT because they are not aware that there are alternatives that can be tried and most of the time when one fails an alternative will work.

[EricRF]

Originally Posted by FuzzyKB

Are you on injectable Depo Testosterone?

If you are on Depo this is made up of the testosterone ester most often at fault for causing this. Have your Doctor use a different testosterone ester because there are numerous others.

The reason that this is most often prescribed is that it is a longer lasting testosterone ester. The problem with the other testosterone esters is that the method of administration will need to change.

Your MD will need to let the Hematocrit level drop for about a month with you off the HRT treatment. Then he will need to make up a group of syringes for you of a different testosterone ester. At that time you go home and inject probably every other day for about a week. They then do a blood draw and check the hematocrit again after a week of you feeling like a pin cushion. If the hematocrit has not risen again, you should then be able to have a pellet type implant of the different testosterone ester.


There are implants available of other esters. Probably the next one to try is Testosterone Undecanoate The old stand by has been Depo Testosterone and it has been so bloody "established" it has become a habit and most MD's fail to realize that there are other routes and esters. If you can take an alternate in injectable form without raising Hematocrit levels then you can overcome the frequency issues with an implant and these ARE available. Your MD just needs to do a little digging.


Most MD's are sadly not qualified to do male HRT because they are not aware that there are alternatives that can be tried and most of the time when one fails an alternative will work.

Hi Fuzzy! Thanks for your reply....

No, I'm on injectable Testosterone Cypionate 120 mg/week (managed to get them to let me up it from 100mg)

The doctor I'm working with is not a "Primary Care" physician, but a Men's Health specialist, whose practice specializes in TRT among other men's issues. That being said, no other ester of test was ever offered. The implants, however, were, but seemed WAY more trouble (and expense) than they were worth, though he said they may not affect HCT levels as much as the injectables. If they're a different ester, that would be why.

At last check, my HCT had dropped, which is why the increase in test dosage was OK'd, though it'd unlikely I'll feel a difference (and I haven't). What I don't understand, is when I started the injections, I felt the difference in a big way, but it faded after a few weeks. That's one reason (plus the actual test blood levels weren't that great) why I've been after a higher dose, so I'd actually notice a difference in how I feel. But the HCT created a ceiling, so unless it drops (which it may, since I started on a CPAP) I'll have to stay where I am.

Thanks again!

-Eric

[FuzzyKB]

Originally Posted by EricRF

Hi Fuzzy! Thanks for your reply....

No, I'm on injectable Testosterone Cypionate 120 mg/week (managed to get them to let me up it from 100mg)

The doctor I'm working with is not a "Primary Care" physician, but a Men's Health specialist, whose practice specializes in TRT among other men's issues. That being said, no other ester of test was ever offered. The implants, however, were, but seemed WAY more trouble (and expense) than they were worth, though he said they may not affect HCT levels as much as the injectables. If they're a different ester, that would be why.

At last check, my HCT had dropped, which is why the increase in test dosage was OK'd, though it'd unlikely I'll feel a difference (and I haven't). What I don't understand, is when I started the injections, I felt the difference in a big way, but it faded after a few weeks. That's one reason (plus the actual test blood levels weren't that great) why I've been after a higher dose, so I'd actually notice a difference in how I feel. But the HCT created a ceiling, so unless it drops (which it may, since I started on a CPAP) I'll have to stay where I am.

Thanks again!

-Eric

Hi Eric,
I want to apologize for taking so long to answer on this.
In 2001 I was placed on both HGH and T by my MD from extreme stress. The numbers based on this at the time were in the basement. I was for about six months given T, HGH and HGC and then as things began to get better these treatments were slowly withdrawn. I did recover from the stress damage but I only had about a week of really heavily noticeable T related things I would have expected. This was a long time ago and age has slammed be back into the basement.

My personal opinion is that about 90% of all MD's are not qualified to do this one because it is a great deal more than just Testosterone. If it is not done as combination therapy one makes a bigger mess than they fix.

Feel free to PM me at this point and I will explain what my personal experience was in detail. I will then explain the details on how it needs to be done and where the problems tend to be. I had to learn this one myself from an MD now deceased who was an expert at male HRT. I also did a great deal of research and what he told me proved out. I am looking for an MD who will do it correctly. None seem to want to do anything other than Depo Testosterone which is Testosterone Cypionate and they even tend to screw that one up. Send me a PM and I will go over this personally with you.

[midtownnavyguy]

Fuzzy et al;

Thanks so much for sharing your wisdom and experience on this subject; it's actually a current situation I'm experiencing too. Have been on Test for years--and started the injections at the VA within the past year. My white blood count is usually high due to a congenital condition since I also have no spleen,and my blood work generally appears to point to leukemia, which I don't have. But it complicates the MD's following of my case. Have been body-building conscientiously but measuredly for some years. I have also been on moderate doses of HGH for ten years. All of the above is background for my VA MD recently wanting to limit my Test injections to every three weeks. That level had been 900 but the white cell count had him concerned. Got a second opinion and was prescribed the regular dose of Test (Cyp).... My question is this: am I being short-sighted to disregard the very conservative VA doc? I take mild blood pressure med as a precaution and with the test it seems to also kick in and help. Also, I have toyed with doing a cycle of Decca. Any comment/recommendations? As always, your comments are most appreciated. Midtownnavyguy

[DragonKnight]

Testosterone/androgens shouldn't have any effect on your WBC count. Androgens trigger hematopoiesis, basically ramping up red cell creation, causing an increase in hemoglobin and hematocrit. Your white cells are made by a completely different process, not triggered by test.

[raven79]

DragonKnight is 100% correct because my hematocrit is really high right now because i am taking test and androgel. My levels were drastically low so my doctor put me on both.

[Mdlftr]

Originally Posted by raven79

DragonKnight is 100% correct because my hematocrit is really high right now because i am taking test and androgel. My levels were drastically low so my doctor put me on both.

Are you lifting with that in your system? Do you notice any changes?

Mdlftr