High Hematocrit: Effect on Blood Pressure & Effect of Altitude on Hematocrit

[GreenMachineX]

I don't think comparing the same dose per week of 1 IM shot versus 2 subq shots leads to more testosterone. What it does is smoothing peaks and valleys, so testosterone tests may catch what seems more testosterone blood levels. Having lower peaks may lower the chances to stimulate more red blood cell production.

I also think lower dose subcutaneous (or shallow IM) doses can decrease chances of water retention and blood pressure. At least that is my experience.

Gotcha. I've noticed that going from 50mg twice per week deep IM to 22mg eod shallow IM/subQ brought my free T from top 3rd to very top of range on trough. But, my hct and hgb also began to rise to 51.9 and 18.1. I've since dropped to 16mg eod for a couple weeks but felt awful, so bumped to 18mg eod so far and hoping to keep hgb and hct controlled. Sleeping better and less achy but not quite right yet. But, i still felt better and slept so much better at 22mg eod. Haven't slept that good in 5 years.

 

[Nelson Vergel]

Reading this book soon. Will summarize what I learn.

 

[tareload]

View attachment 21674Reading this book soon. Will summarize what I learn.

I will check this out and comment as applicable.

I wonder if Rouzier will become the John Romano of TRT world?

"Where are the dead bodies?"

I thought Hct was harmless and just O2 in the blood?

 

[Nelson Vergel]

"Where are the dead bodies?"

Only a specific registry can detect that. Mortality is also not equal to morbidity. Some people can live long but with a bunch of comorbidities related to high blood viscosity (example: kidney dysfunction caused by high blood pressure, etc).

The reason people like Rouzier's views is because he oversimplifies everything. I have been to two of his lectures and all he does is to show the front page of papers. No analysis whatsoever.

 

[Nelson Vergel]

I will check this out and comment as applicable.

I wonder if Rouzier will become the John Romano of TRT world?

"Where are the dead bodies?"

I thought Hct was harmless and just O2 in the blood?

Great lecture! Thanks @readalot !

 

[Nelson Vergel]

 

[BigTex]

My RBC etc tested high in April, so we say lowering your dose may help. Using that train of thought my doctor had prescribed me 200mg of test cyp every 10 days on 1-18-22, and on 3-26-22 I tested and my serum T levels were at 2103. I immediately dropped the dose to 100mgs every 10 day and on 4-18-22 (3 wks later) my serum levels were 830 but my RBC count etc were all high. Could this very high dose cause my RBC etc to rise and stay elevated 3 weeks after I lowered the dose and tested again?

There has been no change in my blood pressure and the average has actually significantly dropped since I switched from Losartan to Telmisartan in April.

Another thought, when you go it to do blood work they always insist that you are fasted, meaning noting to east after 10PM the night before. So naturally I also don't drink anything. How much effect would that have on blood levels so if you test at 8am?

Granted I am very educated and very well read but stuff admittedly is way out of my field of exercise physiology and sports nutrition.

 

[GreenMachineX]

My RBC etc tested high in April, so we say lowering your dose may help. Using that train of thought my doctor had prescribed me 200mg of test cyp every 10 days on 1-18-22, and on 3-26-22 I tested and my serum T levels were at 2103. I immediately dropped the dose to 100mgs every 10 day and on 4-18-22 (3 wks later) my serum levels were 830 but my RBC count etc were all high. Could this very high dose cause my RBC etc to rise and stay elevated 3 weeks after I lowered the dose and tested again?

There has been no change in my blood pressure and the average has actually significantly dropped since I switched from Losartan to Telmisartan in April.

Another thought, when you go it to do blood work they always insist that you are fasted, meaning noting to east after 10PM the night before. So naturally I also don't drink anything. How much effect would that have on blood levels so if you test at 8am?

Granted I am very educated and very well read but stuff admittedly is way out of my field of exercise physiology and sports nutrition.

It takes about 8 weeks for rbc, hct and hgb to drop after dose reduction. Donating will drop it faster.

 

[tareload]

My RBC etc tested high in April, so we say lowering your dose may help. Using that train of thought my doctor had prescribed me 200mg of test cyp every 10 days on 1-18-22, and on 3-26-22 I tested and my serum T levels were at 2103. I immediately dropped the dose to 100mgs every 10 day and on 4-18-22 (3 wks later) my serum levels were 830 but my RBC count etc were all high. Could this very high dose cause my RBC etc to rise and stay elevated 3 weeks after I lowered the dose and tested again?

There has been no change in my blood pressure and the average has actually significantly dropped since I switched from Losartan to Telmisartan in April.

Another thought, when you go it to do blood work they always insist that you are fasted, meaning noting to east after 10PM the night before. So naturally I also don't drink anything. How much effect would that have on blood levels so if you test at 8am?

Granted I am very educated and very well read but stuff admittedly is way out of my field of exercise physiology and sports nutrition.

Good question and these aren't the guys to be getting your info from. Run from thus channel. Watching this channel is akin to somone trying to cheat off the kids that barely have a C-/D+ in the class.

Here you go:

High HGB/HCT

The normal ranges depend upon the population that's being tested. The normal ranges for the people living in the Himalayas is going to be different. Gotcha. I still don't understand that analogy for people in the Himalayas. I hear it a lot that with H of 55 up there, no big deal. But what...

www.excelmale.com

RBC lifetime about 115 days so you will need to wait see a reduction (absent a donation). Also your RBC production can be a nonlinear function of T dose. So if you don't see a significant reduction in 12 weeks then your dose may still be above the threshold where RBC production is significantly increased. You could also check with your hematologist if you are hemochromatosis carrier.

On your point re hydration. Yes you should drink water and hydrate before bloodwork. Dehydration going into lab work may cause Hct to appear high. But don't rationalize if you have properly hydrated going into the test and still too high in your provider's judgment.

Good primers on terminology. The terms get bastardized alot:

Normal Dose Test or Low Dose Test+ Anadrol

Ref: Erythrocytosis is defined as an increase in red blood cell (RBC) mass, usually absolute , and is also associated with an increased hematocrit (HCT) and hemoglobin concentration. Although some use the term polycythemia interchangeably with erythrocytosis, the two are not...

forums.t-nation.com

 

[tareload]

Still amazing how some one can give out such dangerous blanket advice.

Compare with lecture above.

Still very few emphasize that two men with same Hct can have very different whole blood viscosity. Kudos to Sloop.

COVID was a timely reminder.

 

[BigTex]

RBC lifetime about 115 days so you will need to wait see a reduction (absent a donation). Also your RBC production can be a nonlinear function of T dose. So if you don't see a significant reduction in 12 weeks then your dose may still be above the threshold where RBC production is significantly increased. You could also check with your hematologist if you are hemochromatosis carrier.

On your point re hydration. Yes you should drink water and hydrate before bloodwork. Dehydration going into lab work may cause Hct to appear high. But don't rationalize if you have properly hydrated going into the test and still too high in your provider's judgment.

So my theory is most like correct, the 2103 serum T level I got probably cause RBC production to be high since I tested 21 days after discovering it was high. Most likely if I just wait until July and test again it might have corrected itself. However, a week ago I started having tachycardia, with an irregular sinus rhythm, non- A-Fib. After my cardiologist reviewed my EKG and blood testing , he said it was very probable that the high RBC's caused this. Now I am taking metoprolol to keep the heart rate under control. In a week I have gone from a 100+ RHR to 61. So I am definitely donating blood tomorrow. Hopefully by July when I do blood testing again it will be back to normal. I am also going to have my doctor to check for iron status.

So I will drink about 40oz of water before testing and I am also going to add some low intensity aerobic exercise back into my training. I saw anther doctor on video called the anabolic doctor. I did agree with his statement that "we need to do a lot more research in this area." Its too bad that the past 30+ years have been wasted as a result of this witch hunt against anabolic steroid users. Science could have used this time. There is so much more we need to know.

 

[tareload]

Most likely if I just wait until July and test again it might have corrected itself. However, a week ago I started having tachycardia, with an irregular sinus rhythm, non- A-Fib. After my cardiologist reviewed my EKG and blood testing , he said it was very probable that the high RBC's caused this.

I'm sorry to hear this. I hope you make a full recovery. I went into AFIB a little over two years ago and I've haven't fully recovered since then mentally or physically. I recovered back to sinus rhythm quickly but have struggled to get back to even 80% of where I was in terms of power output. Something broke, maybe my head.

I wonder if this was covid, my hobby, or a combination of things (including thyroid). Given your tolerance it is interesting you have now run into an issue after many years. Had you had any prior complications from AAS use besides bloodwork hit? Age also plays into this I gather.

Its too bad that the past 30+ years have been wasted as a result of this witch hunt against anabolic steroid users. Science could have used this time. There is so much more we need to know.

Amen.

 

[BigTex]

I'm sorry to hear this. I hope you make a full recovery. I went into AFIB a little over two years ago and I've haven't fully recovered since then mentally or physically. I recovered back to sinus rhythm quickly but have struggled to get back to even 80% of where I was in terms of power output. Something broke, maybe my head.

I wonder if this was covid, my hobby, or a combination of things (including thyroid). Given your tolerance it is interesting you have now run into an issue after many years. Had you had any prior complications from AAS use besides bloodwork hit? Age also plays into this I gather.




Amen.

If you had covid it is possible this was the cause. My wife caught it in July of 2020 and for almost a year she was dealing with the after effects. It started out with tachycardia. Anyway, sorry to hear about your issues. Hope you get that fixed.

Readalot, it has not been possible to get blood work done in the past because you would have to divulge information to a doctor. I got luck and found a good doctor in 2016, plus a few inexpensive services started popping up where you could get a online doctor to sign off on blood work orders. Once all of this happened I started testing frequently. Before that I never went to a doctor for anything other than knee surgery in 2010. So I never had any issues with AAS that I knew of. No doubt age plays a part, as we age the rate at which process drugs in the body also slows down.

I did legs today at the gym and actually forced my heart rate up to 161. 155 is my age related max. This happened even with a beta blocker. All I had to do this week is increase the rest periods to 3 minutes between sets. I previously only rested 45 seconds. I never got dizzy, ight headed or super winded.

I am very disappointed with my cardiologist. I chose this guy based on his qualifications. Yet I have only seen him one time in two years. I only see a NP. She claims all decisions are made by the doctor. Yet someone is making questionable decisions. For instance he had me checking my blood pressure morning and evening and taking an average. He prescribed my Losartan. My evening reading was 15-20 points higher than the morning reading. By accident I looked at the half life of Losartan and it is 4.6 hours. I took the medication in the morning so it is little wonder there was such a difference in morning and evening readings. I asked to be put on Telmisartan and now find out it has a 24 hour half-life. My morning and evening reading are now very close to the same. No doubt the longer half-life is the reason. I wasn't unresponsive at all. I think a cardiologist should know this stuff.

Anyway, I gave blood yesterday. I have an open order for 2 years. By the way my hematocrit level was at 58.5 3 weeks ago, yesterday it was 55 before giving blood.

 

[GreenMachineX]

If you had covid it is possible this was the cause. My wife caught it in July of 2020 and for almost a year she was dealing with the after effects. It started out with tachycardia. Anyway, sorry to hear about your issues. Hope you get that fixed.

Readalot, it has not been possible to get blood work done in the past because you would have to divulge information to a doctor. I got luck and found a good doctor in 2016, plus a few inexpensive services started popping up where you could get a online doctor to sign off on blood work orders. Once all of this happened I started testing frequently. Before that I never went to a doctor for anything other than knee surgery in 2010. So I never had any issues with AAS that I knew of. No doubt age plays a part, as we age the rate at which process drugs in the body also slows down.

I did legs today at the gym and actually forced my heart rate up to 161. 155 is my age related max. This happened even with a beta blocker. All I had to do this week is increase the rest periods to 3 minutes between sets. I previously only rested 45 seconds. I never got dizzy, ight headed or super winded.

I am very disappointed with my cardiologist. I chose this guy based on his qualifications. Yet I have only seen him one time in two years. I only see a NP. She claims all decisions are made by the doctor. Yet someone is making questionable decisions. For instance he had me checking my blood pressure morning and evening and taking an average. He prescribed my Losartan. My evening reading was 15-20 points higher than the morning reading. By accident I looked at the half life of Losartan and it is 4.6 hours. I took the medication in the morning so it is little wonder there was such a difference in morning and evening readings. I asked to be put on Telmisartan and now find out it has a 24 hour half-life. My morning and evening reading are now very close to the same. No doubt the longer half-life is the reason. I wasn't unresponsive at all. I think a cardiologist should know this stuff.

Anyway, I gave blood yesterday. I have an open order for 2 years. By the way my hematocrit level was at 58.5 3 weeks ago, yesterday it was 55 before giving blood.

How long were you on telmisartan? Is there a correlation between starting telmisartan and the reduction in hematocrit?

 

[Biobro]

How long were you on telmisartan? Is there a correlation between starting telmisartan and the reduction in hematocrit?

Just in general, and hgb, not htc.

Effect of angiotensin converting enzyme inhibitors and angiotensin receptor blockers on hemoglobin levels - BMC Research Notes

Background Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely used in the management of congestive heart failure (CHF), diabetes mellitus (DM) and hypertension (HTN). Use of these agents is reported to cause anemia. Methods We examined the...

bmcresnotes.biomedcentral.com

We found that the use ACEIs was associated with a lower Hgb at follow up, while the use of ARBs was not. The difference was small but statistically significant. Clinicians should consider possible effects of ACEI and ARB therapy on Hgb, especially in ambulatory patients with unexplained anemia. An improved understanding of the association between the use of ACEI and ARB therapy and the development of anemia could contribute significantly to the management of patients with DM, CHF and HTN.

 

[GreenMachineX]

Effect of angiotensin converting enzyme inhibitors and angiotensin receptor blockers on hemoglobin levels - BMC Research Notes

Background Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely used in the management of congestive heart failure (CHF), diabetes mellitus (DM) and hypertension (HTN). Use of these agents is reported to cause anemia. Methods We examined the...

bmcresnotes.biomedcentral.com

We found that the use ACEIs was associated with a lower Hgb at follow up, while the use of ARBs was not. The difference was small but statistically significant. Clinicians should consider possible effects of ACEI and ARB therapy on Hgb, especially in ambulatory patients with unexplained anemia. An improved understanding of the association between the use of ACEI and ARB therapy and the development of anemia could contribute significantly to the management of patients with DM, CHF and HTN.

I'm pretty sure telmisartan reduces my rbc and hgb a little. I just started it up again about 2 weeks ago because my BP was acting up again. Brought it back down quick. My hgb and rbc are climbing back up at 17.7 and 5.88, while hct is only 49.1. I'll be retesting soon.

 

[Biobro]

I'm pretty sure telmisartan reduces my rbc and hgb a little.

I have heard that too.

 

[BigTex]

How long were you on telmisartan? Is there a correlation between starting telmisartan and the reduction in hematocrit?

I have only been on Telmisartan for maybe 5 weeks. Yes there is research that show reductions.

 

[Biobro]

Comparative effect of angiotensin II type I receptor blockers and calcium channel blockers on laboratory parameters in hypertensive patients with type 2 diabetes

Both angiotensin II type I receptor blockers (ARBs) and calcium channel blockers (CCBs) are widely used antihypertensive drugs. Many clinical studies have demonstrated and compared the organ-protection effects and adverse events of these drugs. However, ...

www.ncbi.nlm.nih.gov

We found a significant reduction of serum TC, HbA1c, hemoglobin and hematocrit and RBCcount and a significant increase of serum potassium in ARB users, and a reduction of serum TC and hemoglobin in CCB users, from the baseline period to the exposure period. The reductions of RBC count, hemoglobin and hematocrit in ARB users were significantly greater than those in CCB users.

 

[GreenMachineX]

Comparative effect of angiotensin II type I receptor blockers and calcium channel blockers on laboratory parameters in hypertensive patients with type 2 diabetes

Both angiotensin II type I receptor blockers (ARBs) and calcium channel blockers (CCBs) are widely used antihypertensive drugs. Many clinical studies have demonstrated and compared the organ-protection effects and adverse events of these drugs. However, ...

www.ncbi.nlm.nih.gov

We found a significant reduction of serum TC, HbA1c, hemoglobin and hematocrit and RBCcount and a significant increase of serum potassium in ARB users, and a reduction of serum TC and hemoglobin in CCB users, from the baseline period to the exposure period. The reductions of RBC count, hemoglobin and hematocrit in ARB users were significantly greater than those in CCB users.

Any idea how long it took for the reductions to take place?