What are the reasons for high blood cells on TRT?

Thread starter #1
If Hematocrit and Hb is fine, RBC is slightly over the maximum. Would blood donation still help in lowering high blood pressure?
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"Donating blood only twice is enough to significantly improve blood pressure levels while reducing a number of markers of cardiovascular disease." Be careful in the number of donations and spread them out to two, no more than three, per year or you may reduce your iron and ferritin levels too far.

Benefits of Donating Blood: Reduced Systolic Blood Pressure and Lower Risks for Heart Disease and Diabetes
Thread starter #4
If i have to phrase my question in other words.
Why high estradiol causes high blood pressure? I tried hard over the internet but couldnt find a definite answer.
If i have to phrase my question in other words.
Why high estradiol causes high blood pressure? I tried hard over the internet but couldnt find a definite answer.
Why do you conclude high estradiol is raising your blood pressure? What is your e2 level and how was it measured? Which lab test - standard or sensitive (LC, MS/MS)?
Thread starter #6
Hello Sir,
I have great respect for your work that has helped thousands of newbies like me.

I would like to use your knowledge further. Please explain why elevated Estradiol levels causes high blood pressure? I have searched this topic with no specific answers.
Thread starter #7
I am having a throbbing heart rate since many days. I have tried to search for an answer and the only definite reason is high estradiol. I have low shbg 14.5. And Free T at 55pg/m (8 to 28). Total T is 979. I am on 17.5 mg EOD. So there is no obvious reason except that its high E2. Which is 55 pg/ml. Its on a non sensitive test because the gold standard sensitive test is not available in my under developed country. So i have no option but to take it as an indicator if not accurate its still over the lab range.
The theoretical reasons exogenous testosterone elevates hematocrit are because it elevates erythropoietin and is a hepcidin inhibitor: https://www.ncbi.nlm.nih.gov/pubmed/24158761

Hepcidin helps regulate production of red blood cells so when it is inhibited, RBC production increases.

If you don't have elevated hematocrit, your hormone therapy may have little or nothing to do with your high blood pressure. Elevated estradiol is not a definite reason, it is a possible factor. And with the non sensitive test it is likely that your E2 level is actually quite alot lower than what the non sensitive test indicates. The typical error for men with non sensitive tests are they read too high.

Perhaps it would be worthwhile to see a doctor and review the many different causes of hyper tension. Here are a few: https://www.healthline.com/health/high-blood-pressure-hypertension#causes
Will you explain why high Estradiol is related to high blood pressure? This will solve my confusion !
For many years doctors believed the estrogen women consumed in the form of oral contraceptives and hormone replacement therapy (HRT) pills was good for their patients' hearts. Recent studies however have shown that long-term exposure to estrogen can be a danger to women as it has been associated with high blood pressure, a key link to heart- and brain-attacks (strokes). Although the process by which estrogen induces high blood pressure in females is unclear, Michigan State University (MSU) researchers have found that long-term estrogen exposure generates excessive levels of a compound, superoxide, which causes stress in the body. The build-up of this compound occurs in an area of the brain that is crucial to regulating blood pressure, suggesting that chronic estrogen induces a build up of superoxide that in turn causes blood pressure to increase. The study also found that the anti-oxidant resveratrol reverses the increase in both superoxide and blood pressure.

Will you explain why high Estradiol is related to high blood pressure? This will solve my confusion !
The key is the protection factor coming from Estrogen. The Estrogen receptor stimulates nitric oxide production in the endothelium, decreasing BP; also, the receptor is present in the kidney, increasing the release of sodium and water, thus reducing the BP at long-term. At the menopause, no estrogen is produced at all, so this protection factor ais abolished, thus increasing BP. In additon, during the menopause, the balance between estrogen-testosterone is affect because of the estrogen reduction, so there's more free testosterone than estrogen. This increase in testosterone is highly related to increases in BP.
This article is punctual to demonstrate this differences.
I hope you understand.

Thread starter #13
Thank you so much for the effort you have put in to explain my question.
So what i have gathered from the articles is that both high frer testosterone and estradiol are linked to high BP. Is it also trur for men like me who are on TRT. I have high frer T 55 pg/ml reference range 8-28. My estradiol is also high 55 pg/ml.
I have shbg of 14.5
EOD Test E 17.5 mg.
I am planning to reduce my dosage to 10 mg EOD and see how it goes. I am attributing my high BP to high Free T and high Estradiol.

If you add a little bit of your experience here, that would really help my course of action.
I am reluctant to take Arimidex at this point because just 0.5 mg once a week crashed my Estradiol.
I am unfortunate because LC/MS estradiol test is not available in my country and i have to rely on my symptoms and regular estradiol test and use it as a mild indicator. I know its not perfect but also i have no option.

I am also thinking to go for blood donation as it keeps my Bp stable for 4 months.
As you know better than the rest that its so tough for a low SGBG person to gain pisitives from TRT. After such Struggle i am having these positives. I dont want to alter my dosage too much like adding an AI just for the sake of BP. For time being i want to continue receiving the benefits of TRT without any pause, its really important for my confidence on TRT.

So do you think for the time being blood donation and reducing my Test dose is the best option for me? If anything other than that i will take a bo medicine in future. But i dont want to take the risk of arimidex specially when m not sure its the definite cause.
TRT is so different for everyone, it can be very hard to dialed-in. Many members have to lower their dose of testosterone to feel good (I'm not one of them) so it's definitely worth trying. I do think it's the best option for you.
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Many guys have problems with tanking ferritin by donating blood. I did only one donation prior to checking ferritin and ended up at 27, when at least 50 and preferably more than 100 indicates that it is safe to donate blood.

Check your ferritin.