Here's How To Lower Hematocrit While On TRT
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- Опубликовано: 3 окт 2024
- Are you on TRT and having increasing levels of hematocrit may you have to donate blood all the time and. Worried about the impact of this high hematocrit on your health? In this video we look at some of the cause of hematocrit while on TRT and what you can do to manage that and how to lower that risk of elevated hematocrit. In this video we're gonna talk about how to lower hematocrit while you're on T R T.
TRT if you don't know, is also known as testosterone replacement therapy, and it's a very effective treatment for treating men with low testosterone. With this treatment, there's oftentimes improvement in symptoms such as fatigue, libido issues, erectile issues, and sometimes issues with mood too, like depression, anxiety. Problem is it can also lead to elevations or rising levels, of red blood cells and corresponding hematocrit. So what is hematocrit?
So hematocrit is the percentage of red blood cells in a given volume of blood, and it's the percentage of red blood cells as compared to the percentage of the clear fluid or the watery part of your blood. So typically the percentage of red blood cells is gonna be less than the percentage of the watery fluid. So less than 50% would be red blood cells, and, that's kind of a rough range to shoot for in terms of the hematocrit is less than 50% or right around 50%.
When you're on TRT High levels of hematocrit or increased amounts of red blood cells can increase the risk for things like blood clot and potentially other problems. The reason that it could potentially increase the risk for blood clot is because. , there's less fluidity there. So things are moving slower. You can think of it like cement, you know, if you keep cement moving it can never actually solidify.
Same thing with blood, as there's more particles or more red blood cells, in other things in the blood, that slows down the movement, then potentially is when you can get an actual clot. So this is why if you're on T R T, it's important to monitor your hematocrit levels and correct elevated levels or make sure you're staying in a somewhat optimal range.
So when we're looking at this question how the lower hematocrit levels, while you're on t r t, we wanna look at. What's actually causing the increased production of red blood cells and hematocrit? There's a couple things to think about with this. So we know that testosterone stimulates the production of EPO, Also known as erythropoietin, and this molecule or hormone stimulates the bone marrow to make more red blood cells. We also know that D H D or dihydro testosterone is like 10 times as strong as actual testosterone.
This is true for much of the functionality of testosterone versus DHT. So I believe that part of what is triggering some people that have higher hematocrit levels when they're on TRT versus others is a increased level of DHT or dihydro-testosterone. And so that may be playing a larger role in what's triggering your high hematocrit levels. Now, DHT is also responsible for much of the benefits of testosterone replacement therapy or TRT as well. So we wouldn't want to take the D H T number down to zero.
but with this in mind, we can look at how we could potentially lower your hematocrit while you're on TRT. the first obvious thing to look at in terms of how to lower your hematocrit while you're on TRT, is to potentially adjust your dose. so this isn't really me saying you should adjust your dose if you have high hematocrit, but you should talk to your doctor to see what the appropriate steps should be for you.
There is a critical point or threshold at which the testosterone and replacement therapy and the corresponding DHT is not gonna stimulate your bone marrow as much. as you make those adjustments, it's, it's important to continue to monitor the hematocrit red blood cells. and other things to really see what the rate of change or the rate of increased hematocrit is doing. So instead of it going up by five points every month, maybe it goes down to going up by four points or three points every month.
you also have to make sure you're checking at the same interval every time in relation to your blood donations If you are doing blood donations, checking, at a certain time interval before the blood donation or after the blood donation is gonna be important. So you're comparing apples to apples as you make these adjustments to your dose of testosterone.
The dose adjustment that you make is gonna be dependent on how high your hematocrit levels are and how high your testosterone DHT levels are. All these things are gonna be helpful in making that decision, it's not a one size fits all kind of thing, so you do have to kind of customize it to your own body and what's going on with your hematocrit levels.
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Things that can be considered to do : 1) giving blood 2) eating one grapefruit a day 3) drinking more water 4) taking finasteride to lower DHT 5) Splitting more often the testosterone injections to have more stable levels 6) taking aspirin cardio to prevent strokes or risks
Good advice except finasteride is poison and a bad copycat of natural progesterone. Most people’s progesterone levels drop faster than their testosterone through life and 5 mg of progesterone is all you need daily- either take oral or topical, and even easier yet is just take 10 mg if pregnenalone every night - pregnenalone is the precursor hormone for progesterone and available on Amazon. (Pregnenalone is made from cholesterol and also a great supplement for brain function and memory- everyone over 50 should be on it)
Did this help
I'm working if this worked
Terrible advice 😅
@@TF-uo5cggive us the right advice
I'm on TRT through a men's clinic and they check my blood every 8-16 weeks. I also donate blood 6 times per year to keep Hematocrit level around 50%. Drinking more water and limit caffeine intake helps me also.
just got a test done mines high, red blood cells are enlarged and I'm drinking a coffee whilst reading your comment. time to drop the coffee ☕️
Hematocrit is simply a measure of hydration. Check it without hydrating then gain after drinking half a gallon or so. Night and day
@brandonyoung4910 So it's all down to hydration?? and if body isn't staying hydrated then what areas would u look into??
6 times a year is a lot. Don't you think you need your blood in your body? I was doing the same frequency and ended up with low iron. Iron isn't the only thing you lose, you lose everything in blood.
@@brandonyoung4910 no. TRT increases hematocrit regardless of hydration.
So drink water, lower trt dose, donate blood.
9mins to say that
Gents, get tested for sleep apnea. Sleep apnea can significantly increase hematocrit. Treating that is absolutely vital.
Yes this is very important
Thank you I didn't have any idea that was the case.
I should have admitted that to my endocrinologist but I thought it wasn't relevant and I was a bit embarrassed to mention it.
@@swintegrativedoes losing weight help?
@@ozzy6162never be embarrassed about asking questions about your heath.
@@sixpackbinkyI don't think so I'm 5'11" 190 lbs w about 10% body fat I've had it for the last 3 years when I was diagnosed I was about 175lbs 180 and even lower BF but I think if someone is obese then yes would definitely take pressure off the that thing in your throat so you can breathe better
So by this conclusion, people living in higher altitudes with hematocrits of 60 points in a media should be donating blood as well for an optimum number in a paper?, that's a great advice without having various points of view and reviewing studies about high hematocrits during TRT🤔🥴. Many studies concluded that's not direct correlation between cloths or problems of them in TRT with high hematocrits.
Yes I am aware there are additional studies and points of view. Thanks for sharing yours. The high HCT from altitude is more complex than simple erythocytosis from trt. I have another deeper look at the topic of clot risk on trt coming soon. I hope it will add further to the discussion
My husband is 66 and was diagnosed with secondary polycythemia about 10 years ago. Before then he was taking testosterone injections but his hematologist won’t let him take it anymore. He gets phlebotomies often because his hematocrits and hemoglobin gets high.
Nice work, Doc.
Thank you kindly
Will the trade-off is if you give too much blood in a year if you've got an overzealous doctor , this will impact your ferritin levels and you could get such wonderful side effects as losing your eyebrow hair and your beard going all patchy . I switched doctors to where the new doctor said oh my God he had you giving way too much blood. So now I'm patiently waiting for my eyebrows and my beard to grow back
Wow! That would have to be a lot of consistent donations to do that. Thanks for sharing I think it is important for people to hear these things but iron deficiency can definitely cause problems.
I have been on eliquis and have prothrombin gene mutation. So you're saying i POSSIBLY still have a chance 😅. Very informative info 👍🏽 great explainer, 5 STARS! THANK YOU
glad it was helpful!
Thank you for this video
Your welcome
More frequent dosing (EOD or ED) is also incredibly helpful for lowering high hematocrit, surprised this wasn't mentioned..
One would think but I have not seen it actually work. It is worth trying though and should have been mentioned
Fair enough. EOD administration stopped my hematocrit from climbing so thought I’d mention it for anyone considering. Appreciate the reply and content.
@@Eskargo11 good thanks for contributing
Hi @@Eskargo11 EOD meaning ?
Every other day
I’ve just discovered your channel. Excellent information. Thank you. 🙏🏾
You are so welcome
Blood pressure? What can you do to lower blood pressure beside the diet and exercise?
Metoprolol Tartrate. Talk to your doc about it
Yes please.. more videos to help..
Blood donations crashed my iron and ferritin levels.
yes it can. you have to monitor your levels.
@@swintegrative I had no clue. My urologist who prescribes my trt never told me nothing about iron levels and blood donation. I was donating every 8 weeks. Eventually I was so fatigued even though all my blood levels were good. Then by chance my primary doctor told me we should check my ferritin levels and they can back at 14. They told me I had iron deficiency without anemia. So be careful with donating blood and keep an eye on your ferritin levels.
@@Mav646 yes agreed
@@Mav646I did the same, I donated every two months.
Excellent video
Thank you very much!
Helpful. Thank you
Glad it helped
Should you supplement with folate and B12 or avoid?
Folate will thicking blood fyi. Great for body building not so much for hemaocrit
Eat half a grapefruit per day. I saw a study. But, there's always a study somewhere by someone so who knows.
I have heard this before but never looked for study. Please post if u have it.
@@swintegrative Naringin supplement will drop Crit levels by 2 to 4 points. Take 1 capsule every evening.
Can we take a supplement somehow instead? Can't stand the taste if them lol
@Eyyy702Logan Naringin by Swanson. Take 1 capsule at Dinner
Ok I hope this help people. I am on trt my hematocrit were 55 reason for this is because trt increases blood cell production your body needs more water than normal to make extra blood if it does not have this it make abnormal blood cells causing a thick blood concentration, I drank 1 gallon of water day before blood test and day of 2 liters before blood test, test came back hematocrit 46; try this before stopping trt.
I think this is a good idea and worth while to explore. Still you want to be carful with this type of thing. Being well hydrated is important and a dehydrated body will have higher hematocrit regardless of tRT. The purpose of a blood test is to find out what is going on, not game the test to be in the normal. There is also possibility or being over-hydrated. So definitely hydrate but do it every day not just for the test to be normal.
It didn't work for me I drink a gallon every day and red cells going up still 😢
Start my new bipap machine tonight, giving blood tomorrow. It's 19.5
A 3 day food fast brought my hematocrit down from 55.6% to 51%.
And how did the ma home work for you bro ?
Does cardio have an affect on this? Meaning , if you do cardio everyday can it help?
I believe it would but no hard data on that
Thanks for the video. In theory would finasteride lower hemacrit based on what you said about DHT driving levels up?
In theory yes but finasteride can have a lot of side effects for some people so be aware.
Thanks for the reply! Great content!
What are the side effects
@@mrlegs1544peepee no want to come out a play play
There's an easier way, just go to the blood bank and make a donation they will give you your hematocrit number, I do this every 14 to 16 weeks and end up with him retacrit number of 29 which is the lowest that they will treat you...
Thanks Doc.
Very welcome
In the UK if you've had a blood transfusion you can't donate blood because of the control of CJD (mad cows disease) what would you recommend, do you think the doctor would do a "blood dump" this is something I watched on you tube but you will know better than me how it's done, I'm just worried that my blood will get high red blood cells I'm on 200mg of testosterone e, thanks, great vid great knowledge.
Yes it’s called therapeutic blood donation. They should be able to do that but u need dr order.
@@swintegrative Thanks that helps because I didn't think you could do it unless you went to donate blood , I'll have a word with my Doctor thanks again 👍💪
You can get a private blood donation that’s what I do because the hospital won’t do it as I’m not allowed to donate on trt. I get mine done by a company called E-Val they have clinics dotted about but are based mainly in West Yorkshire.
2 weeks out to the stage, HCT is 53 now, did phlebotomy 4 weeks ago with 52.3, dropped to 46.7 and is 53 now. I understand that bloodletting is not the solution and the body obviously needs to rest off the cycle (been for a year now), but how do I better manage te case? The competition is ahead.
I've just completed a 3 day food fast. My hematocrit was way up at 55.6% and after the 3 days without calories is now down to 51%. You can buy a small hematocrit measuring machine online so you can monitor and try out different methods for controlling hematocrit levels.
A few years ago I think I donated whole blood 3 times that year and ended up needing iron infusion so now I’m very nervous about donating to lower my hemocrit levels
Once should track their iron and ferritin if they are donating regularly.
Vitamin C and iron supplements right after donation can help. Its easy to get iron levels up, much harder to reduce them.
Yes, please keep tabs on iron and ferritin levels, donating often tanked my numbers...
thank you, great video
your welcome
@swintegrative I would love to know what your opinion is on IP6 and Naringin for lowering HCT. Apparently they do work.
Doc, what about nattokinase? It worked for me...i think... But hemoglobin is still in 18....
Yeah, thats the thing, hard to know if it is working. It's known to reduce clots but not hematocrit.
I'm taking .01 cc of Testosterone Cyp. every other day subQ in my tummy. My HCT and Hemoglobin were normal, then became high so I donated blood. Now, my iron level and Ferritin levels have bottomed out. So the doctor told me to take iron. I started taking iron and within 3 months my HCT jumped from 44% too 53% and RBC from 13k to 19k. If I stop taking the iron, my iron and ferritin levels crash, if I take the iron my RBC and HCT are out of control. So, I'm thinking of taking .01 CC sub Q just once a week. Otherwise, maybe finasteride or maybe switch to a gel. This whole thing has turned into a nightmare. There seems no way I can have a normal iron/ferritin level and take TRT. I guess a GP can't handle this situation and maybe I should see an edocrinologist. If I had to do it over, I wouldn't do it.
Yeah it can be tricky to manage for some people be sure to rule sleep apnea
Jatenzo, a new oral TRT option, doesn’t typically see cases of erythrocytosis. My HCT is 51% on Jatenzo, even with a 988 peak testosterone. I have to take iron supplements on TRT because it crushes my ferritin. The recommended starting dosages for Jatenzo is 237 mg twice daily. TRT induced erythrocytosis has never been shown to cause harm. I’ve had my hematocrit as high as 57% and no symptoms, I felt amazing. Doctors see a high hematocrit and freak out because a lot of diseases raise it. Some doctors think in the absence of a disease, and symptoms, high hematocrit is of no concern. There was a study on genetically altered mice, had a hematocrit level of 85% and these mice live longer than normal mice. No circulatory problems. I wouldn’t expect endocrinologist to be any better at TRT, all mine are clueless.
I fixed my ferritin with a supplement called LACTORERRIN it went from 7 to 53
Tummy? Really? Does mommy help you? 🤦♂️
Did you figure out what to do? More or less in the same situation although I got two infusions that brought my iron up and hematocrit is sitting at 50 two months later.
I wish somebody would have told me that donating blood regularly would make me anemic. So don't donate to often
It happens a lot and I made a video about that.
My hemoglobin is at 17.8 and my ferritin is 35
They won’t do another phlebotomy until my ferritin is at 50. I’m taking .8 of testosterone once a week. What should I do? I’m dizzy cause of the high hemoglobin as well. Do you have any suggestions of what I can do?! I really don’t want to stop taking TRT cause it’s helped my
Mental health so much!
Switch to eod Injections using insulin pin, Hydrate with electrolytes, grapefruit, turmeric
Take lactoferrin to get your ferritin levels up.
My ferritin level was 4, yes 4. And my iron was 40.
This was after a year of being on TRT, that we did my first ferritin and iron check. I'm on a lactoferrin, iron and copper regimine every other day. Next blood test will be in September to see if it improves. But this trio is golden to raise iron and ferritin levels. If you don't need iron, just take lactoferrin daily.
I'm on TRT therapy. My HCT is 51, right now I'm retaining water to the point I feel full attention the time and having a hard time breathing while laying down. I keep waking up gasping for air. Today they will draw blood. I've only been on TRT for 10 weeks. I always been a water drinker. I do take a iron pill daily. What can I do for all this water retention?
If you haven’t checked your estrogen, it might be wise to do that. I do have videos discussing that as well if you want to check those out.
I heard from a trt specialist that the extra red blood cells are a physiologically response same as some one that lives at high altitude. They dont need blood work done why do I?
This is a good question and I think you’re asking since hematocrit and hemoglobin go up when someone is living at elevation, why is it a problem that my hematocrit and hemoglobin go up when I’m taking TRT? The answer is that is keeps going up when you’re on TRT and it does not continue to go up simply from living at elevation. The main concern with this is increased risk of clotting
@@swintegrativeheard it doesn't continue to go up on trt, just goes up to a new set higher point but that levels off and is your "new" set point.
@@jesusjones3014this makes sense. As long as you don’t keep increasing your test dose it should not keep going up. Can anyone verify?
I find if my cholesterol is high my hermaticrit will also be as cholesterol increases the rbc size adding to its volume
that doesn't sound quite right. cholesterol does not make the size of your cells larger but increased size will increase hematocrit.
When I give blood a couple of times to get my Hematocrit down my Ferritin tanks and I feel like Crap for at least 60 Days!
Happens to some of my patients too. So you just have to be careful with it and sometimes take iron.
I understand Doc but doesn't the Iron just raise the Hematocrit again?
I was on 100MG of Xyosted weekly for about 5-6 months. However, I did drink on a daily basis (usually after work) and my hematocrit level was like 53? ish? BUT, I was drinking the night before, no hydrating at least 24-48 hours before I drew blood, so I'm sure that didn't help. Fast forward to about a year ago and he put my on pellets. NOT doing a ton, but also more importantly, the surgery site, all 3 times got irritated, the first time 2 pellets came out. The 2nd time, one came out, and then just this last time I had 3 pop out. So I'm either looking into going on the Gel OR asking if he'd put me on a lower dose of Xyosted, maybe even start at 50 (weekly), give blood and I've pretty much given up drinking. Hoping that helps.
Thanks ❤
You bet
Can taking fish oil help?
not w hematocrit
Was told IP6 for a few weeks could help bring it down. Any experience or advice regarding this supplement? Has decent reviews.
Thanks
Not for hematocrit
Just to see if I understand. So you're saying reduce vitamin b and zink, so like no energy drinks. And increase water intake? No alcohol.
Really informative and great video by the way
I don’t think I said anything about reducing b vitamins and zinc. Some people need more b vitamins though
Glad it was helpful
I have a prescription to donate blood, the pressure on my head is too much, I know when it’s high. HGUERRA
how can i lower it without donating and without lowering the dose? Aspirin?
Not sure u can but checking for sleep apnea is a good idea
@@swintegrative i did. no sleep apnea. shouldnt aspirin thin out the blood in red blood cells?
Have the high hematocrit level but blood bank won't take blood due to religious reasons. 😢 where do we turn to?
Probably have to find a private doctor that can do it and discard it but not sure how common that is.
Let's narrow this down check to see if you have sleep apnea and be put on a CPAP machine. Once you do that and get that squared away then if you still have to then go donate blood
I'm confused, so I'm factor v leiden, had blood clot 2016 because i was smoking lots of cigs and not working out.
So my T has been 150 for like a year, started trt three months ago and they made me stay on xaralto 10mg
so my T is 450 now, but Hematocrit is like 5.5 now so they won't let me go up until maybe later but only if i double blood thinner.
My question, why wasn't I getting clots before when my testosterone was normal befor 2016, is it only trt that does it?
..
Well not everyone on trt gets clots and the same is true for those with naturally good testosterone. I posted a new video on TRT and blood clot risk that u may want to look at. The answer is some people are more susceptible and likely related to hematocrit.
How do you lower cholesterol on TRT without stains? Any help would be great
sure try this ruclips.net/video/lGsJqyS8n4Q/видео.html
@@swintegrative thanks, I appreciate it 👍
got rejected for blood donation today since my HB was 17.9 would you recommend doing a blood letting or trying to lower it?
I can’t speak to your specific situation, but you don’t want to have ongoin high HCT. You can get a doctors order to donate blood if the donation center take you
I donate at the Red Cross and have been asked about my high Hb. I told them I’m on TRT and this is why it’s a win win to donate. They have been really cool about it.
It's from the TRT I take it's for sure the culprit
@@ExpatTraderFXthat's weird. My center takes blood if it's below 20. Anything below 20 and they are good with it. I was dehydrated one day with lots of coffee in my system, with a level of 20.4 so they couldn't take it. Came back two days later after I drank 40 ounces of water before donation, it was 16.4.
Need to lower hermetic and I'm not on trt
Higher hematocrit isn’t always a bad thing 😎
no it's not especially if you are cycling, haha. I know there are differing opinions on high HCT on TRT. Thanks for sharing
I'm on trt, want to go higher, i'm 450, doctor says once i start working out and get healthier it will help it more, but i thought i stop producing it while on trt?
true but exercise helps produce more androgen (testosterone) receptors
My platelets keep going up slowly n I wonder how to bring them back naturally n if that’s impossible, any comments ?
Thanks!
Often platelets are high bc of inflammation but there are other reasons
@@swintegrative thanks for the reply, I got diagnosed with PV n I’m wondering if there is anything natural to bring the platelets down , don’t want to go on hydro bills .
is it ok to just put the needle in your vein and dump a pint down the sink?
Yes
Just measure out a pint properly
What do you do when you have a VA Endocrinologist who insists that you do one test-cyp injection a week with a 22 gauge 1.5" syringe, then says that your testosterone level is "too high" when tested the day after your 60mg injection, and cuts off your supply of medication? Previously I used a men's health clinic, and they let me do bi-daily injections at the same dosage level/week using 30 gauge 1/2" insulin pins, and my T levels stayed very constant instead of spiking on injection day and troughing a week later. She seems clueless about the aromatization of the testosterone into estradiol and DHT with large single doses. I am a post-treatment PC survivor trying to get the protective benefits of TRT against recurrence. So far, after 5 months of micro-dosing T at a rate of 60mg/week my PSA has remained steady at 0.04ng/ml or less, so I want to stick to this micro-dose protocol, but now she has refused to renew my test-cyp prescription. What should I do?
That's why I didn't use the VA. Why did you get away from the clinic?
@@4motofanatic I had to stop TRT because of a prostate cancer diagnosis. Now it is 2.5 years later, post-surgery, post radiation, and after 20 months of undetectable testosterone due to ADT. So now I am trying to restore a high-normal level of testosterone, because that has been shown to delay or prevent PC recurrence, compared to natural recovery to Low-T levels, which is where I would be without TRT. My T level dropped to 30ng/dl after I stopped TRT.
May you have a long, prosperous, healthy life ahead... @@eddiegardner8232
Tough situation I’m sure your not alone. Many people on similar situation
VA announced that they don't want to help vets to give them testosterone
Great Video. What do you think about. Therapeutic phlebotomies?
I think they are helpful to keep hematocrit levels in check
They work, but they're also great at crashing iron/ferretin. Get your iron checked. A single donation will cut your ferritin in half
I have read that even have high hematocrit and hemoglobin still can have anemia. is it true? I have top of range hematocrit but I have facial pallot especially after workout or more intense exercise, even fast walking. I need to check my iron b12 and folic acid
This is me bro. I never pass out when I did last time since I donated three weeks apart since my body can only donate 250 at a time. Idk how to lower hematocrit naturally. I also use a CPAP.
Have you seen patients where hct will be elevated, but serum ferritin is low?
Yes, I have usually in males taking testosterone replacement therapy and donating blood, and I did make a video on this topic. there are other circumstances or this might arise too
How about a double red blood cell donation? Anyone doing this?
Some of my patients do yes just depends how high your levels of hematocrit are and how low your iron/ferritin is
allo my friends !i want to ask something !I am on trt (150 mg tesr e per week split 3 times M/W/F.I am very hypochondriac about my blood tests and i am afraid the blood thickness etc.the last hemoglobin level was 17,3 and hematocrit 54% (i made the test morning ).I repeat the blood test 2 days later afternoon post workout and the levels was 16,5 and 48,5 .the question is ..what numbers are the real ?Which of theme i must keep?
Sorry for my bad English (I am from Greece!iron is 153 and ferritin 45 !
Can’t say but hydration can affect that test
What does this feel like to the person with this issue? Signs or symptoms?
not sure there are actual symptoms that are directly and only related to high hematocrit... lots of people report palpations high blood pressure, anxiety. It's not clear what part of that is from high testosterone level though.
@@swintegrative thank you, that’s great information.
Good video, your opinion on taking more frequent injections of Testosterone to stop spike in testosterone in the system, andipose injections also?
Theoretically smaller doses more often should reduce or not raise hematocrit. I have not seen a strong effect that way though. You also have to be willing to do many more testosterone shots which I think is not common.
@@swintegrative thanks for your reply, I have an NHS endocrinologist, he can only go by UK Clinical Guidelines, which are daily gel or Enanthate every 3 weeks, at my Doctor's surgery, which isnt always practical, so there has been long periods where I just injected myself andipose with cypionate and I felt that was manageable, on every level I felt better on that regimen, and my HC levels were lower, but can guarantee the Quality from the NHS, blood donation is not normally done here, to control levels. Private Clinics here often go for more frequent injections too, NHS tends to be very backwards especially in mens health.
There is a school of thought that high haematocrit is no problem when TRT is the cause, as long as platelets are normal.
I was surprised when my NHS haematologist very recently confirmed exactly that. But that's what happened.
Thanks for sharing. That’s interesting but not how I read the literature. Seems like there is increase risk of blood clots from high HCT independent of platlet count
@swintegrative correct, but when you pare off those who take testosterone, you might find no link. I'm not saying that that has happened - but that's the point. The school of thought is that high haematocrit is indicative of other problems that may cause clots. So it's association rather than causation that you may be seeing? There are clear obvious things as an aside. An obsese man not on TRT may have Hct 53 and it goes to 50 when he transforms to a 15 kilo lighter fit man.
Extra info : my first haematologist was adamant that I had a point but the (lack of) sophistication in the literature meant he swayed the other way and wanted me down from 56 to 52 (by bargaining with him as I'm naturally 51). I went for foot surgery a month later and the Orthopaedic surgeon's contact was of the other opinion (which hopefully I've described correctly).
By the way, I had four venesections in four weeks and got down from 56 to 53 anyway, for the surgery 😊 so it's not as if I'm inflexible about the issue. Many thanks
ruclips.net/video/OspeshlnPGI/видео.htmlsi=3k8IkEwxq8CyPB_e
In fact contrary to what I implied, and contrary to the causation and correlation argument, the studies have occcured to address this directly. Google ' Galveston Texas study testosterone clotting' and you'll get access to a 30,000 man study that was apparently well designed and found no link, despite the obvious significant nett average HcT count increase.
Finally, for for disclosure, a Frankfurt study confirmed no link long term. However, it found a very small increased risk within the first 12 months. Please let me know if there are any other direct testosterone study groups vis a vis clots.
Is it possible to have high hemoglobin but normal rbc? Why would that happen?
How can i clean or flush out steriods from my system
5 times the half life is generally the amount of time for anabolics to clear your body.
Which blood draw is best for this situation? Whole blood or red blood cells only?
Depends how high your level is. Your doctor should tell you. Whole blood dries hematocrit about 2-4 points
I believe that once hemoglobin exceeds 18, they will collect whole blood only. The reason is that blood exceeding 18 hemoglobin is too thick and risks clogging the machines that separate rbc from plasma/platelets.
Whole blood
@@swintegrative My specialist ordered HCT test for me every 2 weeks then after a good number of 46.8 and 48.6 changed to 3 months with blood draw if HCT greater than 54.. Last week I was 55.5 so blood was drawn. I go to hospital infusion center for that. Thanks for your video.
On TRT @ 80mg twice a week and had 52 HCT. I adjusted my dose to 180mg (taken 60mg three times a week) and my hemocrit jumped up to 59! But I have no side effects and my blood pressure is great (110/80). What gives? I was a little dehydrated when i got tested and I do live at 6,000ft…. But why did it jump up so high?
Prob elevation and dehydration friend. Drink lots of water and gatorade before testing
You increased your weekly dose by 12.5% and your hematocrit increased by 13.5%. Seems like a reasonable response by your blood, regardless of the number of injections per week.
If you have comorbidities, the thicker blood could become a problem. That would be like sticking a V12 Ferrari engine Into an old clunker, the thing is going to fall apart. That’s really where the harm comes from, the disease process, not the high hematocrit. The high hematocrit is in response to the disease process. I have had my hematocrit at 57% and I had no symptoms you would associate with high hematocrit, I was just dehydrated.
@Systemlord30 yeh this is true. Mine was 52% zero symptoms. Just dehydration
This is all super helpful. Yeah turned out to not be a big deal but I appreciate you guys for your help. The big cause was i live at 6000ft elevation + dehydrated (I take vyvanse for adhd which im thinking about getting rid of), it threw it off by a metric ton
So sorry for multiple posts, but could being super dehydrated and, well, a bit hungover durring blood work show higher hematocrit?
yes 100%
Hello,can i take nebido if my platelets are low? Thank you🙏
My hematocrit is 47.5 and I'm considering starting trt. Is the 47.5 a little to close to that 50 mark? Should I donate blood?
How about Aspirin? Does that help?
Doesn’t lower hematocrit but will reduce clotting risk some
@@swintegrative My doc is hell bent on one baby aspirin a day! Is 81mg enough to really make a difference and is taking two a day too much? I used to take two a day just to relieve gym pains, so taking a baby tab seems like nothing.
its not recommended. the risks (stomachbleed) outweigh any benefit.
Does a low dose aspirin do anything to lower hematocrit while on TRT?
No but it can reduce the risk of a clot
Dude, I want my H/H to as high as possible for athletic performance......... BUT, What is the optimum time to donate blood before the test?
Depends what you are optimizing for but if u want to have a lower hemoglobin or hematocrit reading about one week before
@@swintegrative donate 1 time or every day
Living at higher altitudes like Denver Co (example) also raises Hematocrit levels (low to mid 50s on average) - Not to mention other elements the impact like hydration levels like you mentioned. Why is this not a problem in those circumstances, but it is when TRT is in play?
Actually it is. You are at higher risk of blood clots if you live at elevation because of increased hematocrit
Doctors are brainwashed in medical school, they have to follow what they were taught. The organizations that control a doctor’s licensing, control, how they treat the patient and what they treat the patient with. If doctors go outside of the curriculum, what they were taught, they can risk losing their license to practice medicine. It’s OK for people at high altitude to experience erythrocytosis and take no action but for people on TRT induced erythrocytosis, all of a sudden it’s a problem. That should tell you something right there. If it doesn’t make sense, then it’s not true. Chalk it up to confirmation bias. Doctors can’t unlearn what they’ve learned. TRT is the most misunderstood area of medicine for doctors, bodybuilders for decades, have known more about steroids, then western medicine.
@@swintegrative This is false, you are not at higher risk of blood clots if you live at high elevation, or are on TRT. Nitric oxide dilates the veins and blood vessels to counteract the thicker blood. All cause mortality goes down on TRT and or living at high altitude. I have the 17 year-long nationwide study to prove it. High hematocrit doesn’t cause clotting, hemophilia does, an inherited condition that causes blood clots. You can actually clot with low hematocrit if you have polycythemia vera. It’s the disease process that causes platelets to clot, not because of the high hematocrit numbers.
Study -> www.ncbi.nlm.nih.gov/pmc/articles/PMC8525493/ Results: A total of 38,201 deaths and 75,893 stroke-related hospital admissions were reported. High altitude populations (HAP) had lower stroke mortality in men [OR: 0.91 (0.88-0.95)] and women [OR: 0.83 (0.79-0.86)]. In addition, HAP had a significant lower risk of getting admitted to the hospital when compared with the low altitude group in men [OR: 0.55 (CI 95% 0.54-0.56)] and women [OR: 0.65 (CI 95% 0.64-0.66)].
Conclusion: This is the first epidemiological study that aims to elucidate the association between stroke and altitude using four different elevation ranges. Our findings suggest that living at higher elevations offers a reduction or the risk of dying due to stroke as well as a reduction in the probability of being admitted to the hospital. Nevertheless, this protective factor has a stronger effect between 2,000 and 3,500 m.
That is not true, that has been extensively studied. You are wrong doc. Read the studies about people who live at high elevations and hematacrit levels.
Hello doc, after a year on TRT, I have lowered my dose. From 200 a week to 160 every other week. But even then, my hematocrit climbs. I also donated three weeks ago of 250 donation which isn’t a lot but my body couldn’t handle it. So should I take iron prior donating and after? This whole trt is kinda frustrating but if I stop I know depression will kick in.
Check out trt nasal gel
How does one get vitamin b increased? I’m taking b supplements but I’m still really low. Also I’ve read that vitamin b increases blood platelets which I have way too many of. Suggestions ? I’m trying to increase red meat intake. And b12 injections are like $200. Not in my budget
there are many b vitamins. B12 is the main one that can be challenging to get into the body. there are sublingual tabs that work well for many people. b12 injections are usually about $20 per shot or less if using the cyanocobalamin.
Is this why my face has become red on trt (high hematocrit)?
Yes I think that is part of it. Could be estrogen too
My face goes red if I take creatine or a multivitamin aswell. I had my first injection of trt and my cheeks went red and I stopped trt . Took my face over a week to come back normal. Now I back to low t symptoms and don't know what to do . Is there anything you can recommend I look at ? Please
Why didnt you talk about platelets? High hematocrit with low platelets means that there is almost no risk. This video is very disingenuous. Further, there is no evidence that shows that high red blood cells increases risk of stroke. Those who suffer stroke sometimes have higher hematocrit, but that is a totally different thing.
Thanks for sharing your thoughts (although I don't agree with some of your strong statements). Platelets are an acute phase reactant so they go up when people have inflammation in the body (this is not the case with most people on TRT). I think it is another variable that would be interesting to try to separate out from the question of erythrocytosis and clotting. Certainly those with higher platelets would be at higher risk but the risk (for blood clots) is not zero just because you have normal platelets either. Here is an updated video on this topic where I lay that out in more detail if you want to check that out. ruclips.net/video/LaOAEFhBOMk/видео.html
@@swintegrative Appreciate it! I def came off too harsh sorry about that. Thanks for the additional link.
What are some long lasting side effects of high hematocrit?
long lasting...? not sure I understand the question did you mean symptoms? One thing to be aware of it blood clots. High blood pressure could also be connected with high hematocrit.
Like kidney damage or liver damage?
Can low b12 or folate raise hemoglobin and hematocrit? Should I supplement them if so, or would that raise them even more?
See videos on MCV blood test. B12 and folate deficiency can cause low RBC and hematocrit
@@swintegrative Thanks. Definitely not low on rbc or hematocrit.
Question.
My Hematocrit is 56, hemoglobin 19 but my MCV is 85.
My Hematocrit and hemoglobin were high before i got on trt im also of Mediterranean/African decent so i wasn't surprised.
Ive donated once a week for 6 weeks before and my Hematocrit never goes below 51, hemo 15.
I donate once a month now and it stays at 52/17.
Being that my MCV is low, is this still a big worry for me?
I can't say. I would have to know a lot more about your situation, sorry.
Get your iron level checked
I cannot donate blood. So I'm taking IP6 and drinkling more Grapefruit juice.
Im on TRT and my hematocrit runs around 58 ( im 57 white male)...im not getting phlebotomy.
Do you feel fine?
Just has an unrelated dance with pancreatitis and it was brought up. The entire incident has me looking in the mirror on how serious I need to be. Cheers fellas.
Well explained.
Thank you!
Best wishes
Thanks
If you have tanked your ferritin by giving blood doesn’t make sense to stop taking testosterone, which is elevating your HCT long enough so your ferritin can go back up? I made a mistake of giving blood too much on my own, not consulting with a doctor first about the frequency.
My HCT is 47 and my ferritin is 15
My HCT has the propensity to want to go up is why I’m asking
Well in some cases we have patients stop or take iron supplements. It is tricky to manage and should be guided by your doctor
50 is not a reasonable maximum on TRT. New research indicates that HCT up to 55+ is acceptable on TRT. Great video on Man Medicine channel. Several new studies show no risk for clots, stroke, or cardiac event.
There is plenty of research on the risk of clotting from high HCT, trt or otherwise. I am always learning new things though so if you can kindly share that research article I would appreciate it.
@@swintegrative Here is link to a video of another physician who specializes in the area. Goes over several studies and also discusses the flaws in the studies you are referencing. ruclips.net/video/OspeshlnPGI/видео.html
@@swintegrative sorry to not link the studies directly, but Dr. Winge articulates the point much more effectively than I do.
@@crankerupcomJesus, guy. What is wrong with you? Spouting off medical advice you know nothing about. Then when asked for a source, your reply is basically “I don’t know, but this random doctor on the internet said so.” Please stop.
@@cannoncolossus2449 Not giving any advice. There are several new studies that debunk this video. The issue is very complex. Dr. Winge gives a much better explanation and study sources than I can in the comments. Go do your own research. Watch the video and fact check it. Try not being a keyboard warrior.
So plasma donation tends to be the most effective way ?
No whole blood
What about double red since they are only taking red cells. ?
@@timchristie8269I was gonna ask same thing
I have a question....i want to lower my red blood cell count...it is at 51% right now...but doctor told me blood letting/donating isnt an option cuz of my iron/ferritin levels....they say methylene blue can lower red blood cell count....is this a safe option?
Never heard of using methylene blue that way does not sound like a good idea.
I have been on TRT about 10 years. A month ago I had Pulmonary Embolism (blood clots), probably due to long drives and sitting at desk too long and my blood was thick, my HCT was 56.2. The anticoagulation (Eliquis) seems to be going well. ER doctor instruction was no T. Now that I am doing better, I am feeling the awful effects of low T, five weeks off T. Originally mine was around 300. When is it safe for me to get back on TRT? My Primary Care Doctor is negative on T and my Urology specialist is positive on it. How do I balance their views to know what to do to restart TRT? On giving blood which is best for me giving whole blood or Power Red, just red blood cells. Thank you for you time in making this video.
Doctors taking you completely off TRT is DANGEROUS. No, you didn't revert back to 300, you went to ZERO testosterone after 10 years on TRT. Right now you are at a much higher risk for cardiovascular events, diabetes, and other health problems as a result. Go to a real TRT clinic and get with a doctor who specializes in hormone replacement therapy and knows how to manage it better, I left my family doc for that very reason. And I would also recommend doing some aerobic exercise every single day such as bicycling or walking. Endurance exercise for a half hour to hour everyday will increase your plasma level which will lower your hematocrit number as well as keeping the heart pumping and blood flowing to prevent future blood clots. If you donate blood you want to give "double red" as the most effective way to lower your hermatocrit. Remember, if you're on TRT the exercise is NOT optional, it is a requirement if you want to avoid problems.
I took my testosterone level from 298 ng/dl to 545 ng/dl with no shots, creams, or prescription whatsoever.
You shouldn't be taken off of it completely. Funny when it comes to any other drug they won't but when it comes to TRT they would 😂 it didn't have to be because of the TRT to begin with.
@@indiglo1971 What you did to raise your own natural testosterone level is completely irrelevant to johnmontana18 as he had already been on TRT for 10 years which has shut down his body's capability of producing his own testosterone PERMANENTLY. You don't seem to understand that he will NEVER be able to produce his own testosterone again no matter what he does. If you don't know what you're talking about, and you clearly don't, then don't give out bad advice which will only hurt this man. He absolutely NEEDS to get back on TRT as he has no choice.
Damn. You went cold turkey off test after all those years.
Omg this is why my levels are so high🤦🏻♂️ I thought I was dying.
Anybody know if 1 cup of coffee will affect it dramatically?
No but dehydration will increase hematocrit
@@swintegrative thanks bro. quick question, will donating plasma help at all?
So cut out masteron cause of the dht , and only run test alone is better if you want to lower hematocrit and hemoglobin?
Not familiar with masteron but lowering DHT should help but DHT is also part of the benefit of TRT
@@swintegrativeMasteron aka Drostanolone a is an anabolic-androgenic steroid (AAS) of the dihydrotestosterone (DHT) group
I donate blood while on TRT but my ferritin levels are single digits. Does this matter? I heard if you are on supplemental testosterone your body uses it and it’s less of a concern than if it was low normally.
look up chase irons and why not to donate blood....
It has something to do with testosterone depleting hesperidin levels which effects ferritin.
Yes thats completely normal while on trt, also it is completely normal to have high levels of hemoglobin and hematocrit while on trt its not dangerous as long as ferritin and platelets are within normal range, also donating blood to often could cause problems if not needed
stop donating blood. I did the same thing and it is not a good idea to have low ferritin.
@@justinlee3463 if I don’t donate, my HCT will hit 54 or 55 I bet. Even when I lowered my dose to 75 mg of Test only per week, within 5 months I was at 52.5. I run higher T now plus nandrolone so donating is the only thing to keep it in check.
So is it low or high B12 and folate level that yield high hematocrit?
Low levels can cause high mcv if this the. It can lead to higher hematocrit
I have a question. My friend took 60mg of Enanthate every 4 days, he was anxious, woke up all of a sudden the night after the evening administration. The day after he tolerated caffeine very poorly, anxious, a little dizzy. Blood pressure was still good/unchanged, but the resting heart rate was up by 20 bpm. He could "feel the heart beating" the night after administration, and the next day. The symptoms disappeared the 2nd day. Therefore switched to 30mg administration every other day. Still had the symptoms, just as strong. What can that be? He quit after 4 weeks because he thought he would go insane if he did it for years on end. As the day after was very psychologically demanding. Can't find much on it googling. Thanks in advance!
All I can say for sure is some of my patients are sensitive to it and need much lower doses than expected. They still get benefit but on lower doses.
As a functional medicine practitioner I would suggest your friend check thyroid function. Check TSH and Free T4 as well as Free T3. Sounds to me like he could be hyperthyroid and the testosterone is aggravating the situation. I've seen this many times in people with graves disease who cannot tolerate testosterone in even the smallest amounts until their thyroid function was normalized. Why does this occur? In someone with hyperthyroidism you will see the SHBG increase which in turn decreases free testosterone and sometimes increases total testosterone. Then when you add in testosterone, it decreases SHBG and the body doesn't like it. More to it, but this comment is getting long so I will stop here. Hope this helps.
High estrogen levels= Stress to some people. If he use some Ai like an astrozole like half a pill twice a week MAX (and then take it from there) he will be another man. Just don’t overdo it because he will crash his E2..
@@Total_Body_Fitness_USAmy thyroid’s were good and within range. I tried 100mg IM injections 1x/week for 3 weeks then 50mg 1x/week for 1 week. Each time my anxiety, heart rate and Bp spiked. However, I am often sensitive to various meds and have an anxiety disorder. Discontinued injections, tried Androgel for 8 months months and started to raise levels a tiny bit then stopped absorbing for some reason. So the very minimal effectiveness then none. Now trying the Nasal delivery (day 1).
Takes time for your body to figure out what’s going on. Not a matter of weeks, more like months. Some of it is just a tendency for anxiety that is already there.
I am not a doctor but I have used almost all steroids ever made and in high amounts for decades. I know a lot of people that use steroids and o know it is not uncommon to get anxious at the beginning of exogenous hormone use. Everyone I know has gotten used to it over time.
30 mg is very low but he could try an even smaller dose subcutaneously with insulin syringe. And titrate over time 10 mg e5d for a month and then increase to 20 as he gets used to it.
Looking at this video and your 3y old video of TRT with 40k views,
You look way different, sound almost feeble compared to the one from 3y ago.
How come such a drastic change? Hope you’re okay
I have a lot more hair other than that not sure what you mean …could be just the recording quality
You talked about high hematocrit, but what about hemoglobin and rbc
It is mostly the same
@@swintegrative thank you
hi Doctor my haemoglobin is 174g/l haematocrit 0.584l/l MCV 98.7fl is it’s dangerous? thank you in advance
The lab should tell u if it is high or not. If so then yes.
Let’s be clear, no one has ever died as a result of being on TRT and that includes TRT induced erythrocytosis. So to say hematocrit level of 58% on TRT is dangerous is ludicrous. If the person has narrowing of the arteries or say, left anterior descending, then no, a hematocrit level of 58% is not dangerous if there are no symptoms.
@@Systemlord30 Correct. The body adapts as well as something called the Fåhræus-Lindqvist effect. The hematocrit may be 60% in large vessels while it may be 20% in smaller vessels. The body knows what to do hence the reason why people don't die from high hematocrits living at high altitudes. I have seen where it does cause symptoms in some people. Itchy red skin especially after hot showers, breathing issues at night, tiring easily, etc.. In those people I just put them on nattokinase to increase TPA activity and pycnogenol to prevent symptoms. As long as the platelets are normal and the iron saturation is not high, donation is a waste because the body will rebound and the hematocrit could go even higher. A lot to this for sure because during active infection you can temporarily see an increase in platelets and WBC count will increase as well as ferritin. Because of this inflammatory process and the extra WBCs and platelets, theoretically you could see a risk of clotting with the extra RBCs. However, just having an infection increases the risk of clotting so there you go.
Just a thought but I came here to get some quick answers and watched two of your videos about hematocrit and they cover much of the same material. Not sure why you need to have two videos on the same subject. Your channel might be cool if it was more efficient with my time.
Thanks for your feedback
Yeah the world needs to adjust to cater around you