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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Controlling the polycythemia effect associated with TRT
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<blockquote data-quote="madman" data-source="post: 276926" data-attributes="member: 13851"><p>[URL unfurl="true"]https://www.excelmale.com/threads/management-of-erythrocytosis-during-trt.28358/[/URL]</p><p></p><p></p><p><strong>Key Takeaways:</strong></p><p><strong></strong></p><p><strong><em>*In the <u>absence of clear evidence, there are no unambiguous guidelines and cutoff values</u> for the management of testosterone-induced erythrocytosis.</em></strong></p><p><strong></strong></p><p><strong>*</strong><em><strong>The <u>largest increase in hematocrit levels is seen in the first year after initiation of testosterone therapy</u>. After this first year, levels still rise slightly but remain quite stable over time [4].</strong></em></p><p><em><strong></strong></em></p><p><em><strong>*<em> <strong>When levels are >0.52 in hypogonadal men or >0.48 in transgender people before initiation of testosterone therapy further investigation for <u>other causes of erythrocytosis should be executed</u>. Other causes can be pulmonary (smoking, COPD, asthma, OSAS), hematological (Polycythemia vera (PV), other bone marrow disease), or erythropoietin-related [8].</strong> <strong>In the <u>assessment of testosterone-induced erythrocytosis, other causes should also be considered</u>.</strong></em></strong></em></p><p></p><p><strong>*</strong><em><strong> <u>If levels are >0.55 phlebotomy is indicated</u>. <u>If levels are 0.52–0.54 measures could be taken to prevent a further rise</u>. These can be testosterone-related: switch from injections to gel, <u>avoiding supraphysiological levels or even aim for lower target levels</u>.</strong> <strong>Or related to other determinants: cessation of smoking, lose of weight if BMI >25 kg/m2, and optimizing therapy for pulmonary disease in the medical history.</strong> <strong><u>If hematocrit levels do not decrease due to these measures, we recommend PV diagnostics</u>.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>*As <u>erythrocytosis is known to increase cardiovascular risk it is important to take other cardiovascular risk factors into account and to treat these risk factors when applicable</u> [3]. For patients with hypercholesterolemia, hypertension, a medical history of a cardiovascular event, obesity, or diabetes <u>a lower cutoff value to prevent further increases might be reasonable</u>.</strong></em></p></blockquote><p></p>
[QUOTE="madman, post: 276926, member: 13851"] [URL unfurl="true"]https://www.excelmale.com/threads/management-of-erythrocytosis-during-trt.28358/[/URL] [B]Key Takeaways: [I]*In the [U]absence of clear evidence, there are no unambiguous guidelines and cutoff values[/U] for the management of testosterone-induced erythrocytosis.[/I] *[/B][I][B]The [U]largest increase in hematocrit levels is seen in the first year after initiation of testosterone therapy[/U]. After this first year, levels still rise slightly but remain quite stable over time [4]. *[I] [B]When levels are >0.52 in hypogonadal men or >0.48 in transgender people before initiation of testosterone therapy further investigation for [U]other causes of erythrocytosis should be executed[/U]. Other causes can be pulmonary (smoking, COPD, asthma, OSAS), hematological (Polycythemia vera (PV), other bone marrow disease), or erythropoietin-related [8].[/B] [B]In the [U]assessment of testosterone-induced erythrocytosis, other causes should also be considered[/U].[/B][/I][/B][/I] [B]*[/B][I][B] [U]If levels are >0.55 phlebotomy is indicated[/U]. [U]If levels are 0.52–0.54 measures could be taken to prevent a further rise[/U]. These can be testosterone-related: switch from injections to gel, [U]avoiding supraphysiological levels or even aim for lower target levels[/U].[/B] [B]Or related to other determinants: cessation of smoking, lose of weight if BMI >25 kg/m2, and optimizing therapy for pulmonary disease in the medical history.[/B] [B][U]If hematocrit levels do not decrease due to these measures, we recommend PV diagnostics[/U]. *As [U]erythrocytosis is known to increase cardiovascular risk it is important to take other cardiovascular risk factors into account and to treat these risk factors when applicable[/U] [3]. For patients with hypercholesterolemia, hypertension, a medical history of a cardiovascular event, obesity, or diabetes [U]a lower cutoff value to prevent further increases might be reasonable[/U].[/B][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Controlling the polycythemia effect associated with TRT
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