Power Red or whole blood donation for high hematocrit ?

[JohnPierson]

I made a Power Red donation one day before my Doctor's appointment to receive my testosterone supply.
My doctor tests my hemoglobin every 10 weeks when I go in. I always worry I won't be given my testosterone if I test high. My doctor won't administer if I score is near 18g/dl.

My hemoglobin level tested 18.2 at the red cross site before the power red donation.
The very next day at my doctor's office it tested 18 on first finger prick and 17.8 on repeated test.

I am a 75 year old man and I have been on TRT for four or five years.
My hemoglobin levels have increased from the beginning at 16 to usually low 17's recently.

My question, what happened that the power red donation did not reduce my Hgb?
Should I be donating whole blood instead?

 

[Systemlord]

My doctor tests my hemoglobin every 10 weeks when I go in. I always worry I won't be given my testosterone if I test high. My doctor won't administer if I score is near 18g/dl.

This doctor of yours is wound up too tight and seems to have the potential for overreacting. High hematocrit by itself in the short term is benign (unless you have heart issues) which allows you time to make course corrections.

I would make sure you drink plenty of water within 24 hours of your blood tests.

My doctor won't administer if I score is near 18g/dl.

Why aren’t you self-administering your injections at home?

 

[Systemlord]

My question, what happened that the power red donation did not reduce my Hgb?

I get phlebotomies every month and on two separate occasions my hemoglobin was virtually unchanged. I don”t have an explanation. I also supplement 140 mg iron daily.

No, I don’t think you should get a double red power donation unless you absolutely need one because you risk crashing your ferritin levels with repeated phlebotomies.

 

[tareload]

My question, what happened that the power red donation did not reduce my Hgb?
Should I be donating whole blood instead?

"Double red" RBC apheresis will remove twice the number of RBCs as a typical 1 unit donation. But it does come with the tradeoff that your plasma, platelets, WBCs is being pumped back in along with "healthy" dose of plasticizer from the tubing/bags made from PVC.

My hemoglobin level tested 18.2 at the red cross site before the power red donation.
The very next day at my doctor's office it tested 18 on first finger prick and 17.8 on repeated test.

Perform a more accurate CBC panel using venous blood draw before and after the double red. Finger prick has poorer precision (capillary sample).

See fig 2 in this paper and a good read:

The difference between fingerstick and venous hemoglobin and hematocrit varies by sex and iron stores

Fingerstick blood samples are used to estimate donor venous hemoglobin (Hb).Fingerstick Hb or hematocrit (Hct) was determined routinely for 2425 selected donors at six blood centers, along with venous Hb. Using sex and measures of iron status including ...

www.ncbi.nlm.nih.gov

 

[JohnPierson]

This doctor of yours is wound up too tight and seems to have the potential for overreacting. High hematocrit by itself in the short term is benign (unless you have heart issues) which allows you time to make course corrections.

I would make sure you drink plenty of water within 24 hours of your blood tests.


Why aren’t you self-administering your injections at home?

I am administering at home. I receive a vial and supplies at the doctor's office.

 

[JohnPierson]

"Double red" RBC apheresis will remove twice the number of RBCs as a typical 1 unit donation. But it does come with the tradeoff that your plasma, platelets, WBCs is being pumped back in along with "healthy" dose of plasticizer from the tubing/bags made from PVC.



Perform a more accurate CBC panel using venous blood draw before and after the double red. Finger prick has much poor precision (capillary sample).

See fig 2 in this paper and a good read:

The difference between fingerstick and venous hemoglobin and hematocrit varies by sex and iron stores

Fingerstick blood samples are used to estimate donor venous hemoglobin (Hb).Fingerstick Hb or hematocrit (Hct) was determined routinely for 2425 selected donors at six blood centers, along with venous Hb. Using sex and measures of iron status including ...

www.ncbi.nlm.nih.gov

View attachment 26596

"Double red" RBC apheresis will remove twice the number of RBCs as a typical 1 unit donation. But it does come with the tradeoff that your plasma, platelets, WBCs is being pumped back in along with "healthy" dose of plasticizer from the tubing/bags made from PVC.



Perform a more accurate CBC panel using venous blood draw before and after the double red. Finger prick has poorer precision (capillary sample).

See fig 2 in this paper and a good read:

The difference between fingerstick and venous hemoglobin and hematocrit varies by sex and iron stores

Fingerstick blood samples are used to estimate donor venous hemoglobin (Hb).Fingerstick Hb or hematocrit (Hct) was determined routinely for 2425 selected donors at six blood centers, along with venous Hb. Using sex and measures of iron status including ...

www.ncbi.nlm.nih.gov

View attachment 26596

The variability of fingerstick measurements was demonstrated in my doctors office when back to back fingersticks resulted in different results. However, I have to deal with their results as my doctor insists on them. I get a CBC panel three or four times a year as well. My results are mid 17 to 18g/dl.
Still want to know if I would be better off with the standard blood donation.
My iron levels are fine.

 

[NeverSayNeverAgain]

I can't find the study now but absent iron stores a capillary stick will show much higher HG than a venous test. I find this shocking you had the same level the next day as Power Red is definitely thins the blood since it's a whopping 400mg iron loss, this might be because you do not weigh enough for the machine to extract that many RBCs. Maybe whole blood would be better. It pulled me one time from 18.6 to 14.4 and I felt that.

 

[Gman86]

I can't find the study now but absent iron stores a capillary stick will show much higher HG than a venous test. I find this shocking you had the same level the next day as Power Red is definitely thins the blood since it's a whopping 400mg iron loss, this might be because you do not weigh enough for the machine to extract that many RBCs. Maybe whole blood would be better. It pulled me one time from 18.6 to 14.4 and I felt that.

Wow a whole blood donation dropped ur HGB from 18.6 to 14.4?

 

[ajax31]

Wow a whole blood donation dropped ur HGB from 18.6 to 14.4?

Yes, but those drops are only temporary. After two weeks you’re back to 50% or more of your pre-donation hemoglobin level. Of course if you aggressively continue to donate for years the average hemoglobin declines long term.

That was my experience donating while not on TRT.

Guys on exogenous testosterone have a different set of problems- high hemoglobin / hematocrit and low ferritin, the latter of which will be exacerbated by donating blood.

 

[NeverSayNeverAgain]

@Gman86

I'm sorry I should have clarified that was Power Red, and no you don't bounce back from that big of an iron loss is a short period of time but you have to really try to limit iron supplementation or you will bounce back if your erythrocytosis is pretty bad. To avoid what @ajax31 is stating you have to avoid almost 95% iron and take chelating agents a lot of guys do this and are not symptomatic walking around or even working out with little iron lol. Tumeric gummies are a big chelating agent for me and I take them at night but still have to have an iron rich breakfast (beef bacon, beet juice) in the morning to get the day going.

 

[Nelson Vergel]

Double Red Cell Donation

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Double red blood vs whole blood donations effect on hematocrit, which is more effective?

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[FDV70]

No, I don’t think you should get a double red power donation unless you absolutely need one because you risk crashing your ferritin levels with repeated phlebotomies.

? Crashing ferritin is a thing of the past.

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[Hank Moody]

I did my first Power Red donation on 12/7 after a 12/1 blood draw at LabCorp reported my hematocrit at 56.1 and 53.4 (see chart below). BTW - I had two different doctors orders for the labs and the blood was drawn at the exact same time. I am still very confused / concerned as to how results between the tests can vary so much and it calls into question the overall accuracy of the Lab Corp processes and tests. Regardless, I knew it was time to donate and I opted for a Red Cross power red donation. The double red process was relatively painless, took about 45 minutes and I did not feel nearly as tired / drained as I normally do after a whole blood donation. I retested at LabCorp on 12/15 and hematocrit was 48.1 vs 56.1 (53.4) on 12/1.

 

[Systemlord]

I am still very confused / concerned as to how results between the tests can vary so much and it calls into question the overall accuracy

The accuracy is one factor, the other is your CBC will vary throughout the day just as with anything else. I saw a large difference bwteen my last two tests, hemoglobin 17.8 and 18.4.