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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring
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<blockquote data-quote="madman" data-source="post: 206879" data-attributes="member: 13851"><p><strong><u>Hematocrit</u></strong></p><p></p><p><em><strong>*Some authors recommend that TTh be discontinued if hematocrit is >54%, which may be reasonable while baseline hematocrit level >50% is a relative contraindication for starting testosterone therapy. <u>However, these recommendations are based on assumptions – the clinical significance of a hematocrit >54% is unknown</u></strong></em></p><p><em><strong></strong></em></p><p><em><strong>*<em><strong>The lack of increase in cardiovascular events with elevated hematocrit may be due to the fact that T acts as a <u>vasodilator and has anti-atherosclerotic effects</u> [223]. In addition, testosterone is able to decrease plasma concentrations of <u>procoagulatory substances such as fibrinogen and PAI-1 as well as Factor XII</u> [224] Isolated hematocrit elevations can be the result of insufficient fluid intake on a hot day. Only repeated measures of hematocrit >54% should be followed by concomitant administration of aspirin, bleeding, therapeutic phlebotomy, and/or discontinuation of TTh until hematocrit declines below 54%. After normalization of hematocrit levels, TTh can be continued with a reduced dosage</strong></em></strong></em></p><p><em><strong></strong></em></p><p><em><strong>*Periodic hematological assessment is, however, indicated, i.e. before TTh, then 3–4 months and 12 months in the first year of treatment, and annually thereafter. Although it is not yet clear what upper limit of hematocrit level is clinically desirable, dose adjustments may be necessary to keep hematocrit below 52–54%</strong></em></p><p><em><strong></strong></em></p><p><em><strong><em><strong>*<em><strong>Men with significant erythrocytosis (hematocrit >52%), severe untreated obstructive sleep apnea, or untreated severe congestive heart failure should not be started on treatment with TTh without prior resolution of the co-morbid condition.</strong></em></strong></em></strong></em></p></blockquote><p></p>
[QUOTE="madman, post: 206879, member: 13851"] [B][U]Hematocrit[/U][/B] [I][B]*Some authors recommend that TTh be discontinued if hematocrit is >54%, which may be reasonable while baseline hematocrit level >50% is a relative contraindication for starting testosterone therapy. [U]However, these recommendations are based on assumptions – the clinical significance of a hematocrit >54% is unknown[/U] *[I][B]The lack of increase in cardiovascular events with elevated hematocrit may be due to the fact that T acts as a [U]vasodilator and has anti-atherosclerotic effects[/U] [223]. In addition, testosterone is able to decrease plasma concentrations of [U]procoagulatory substances such as fibrinogen and PAI-1 as well as Factor XII[/U] [224] Isolated hematocrit elevations can be the result of insufficient fluid intake on a hot day. Only repeated measures of hematocrit >54% should be followed by concomitant administration of aspirin, bleeding, therapeutic phlebotomy, and/or discontinuation of TTh until hematocrit declines below 54%. After normalization of hematocrit levels, TTh can be continued with a reduced dosage[/B][/I] *Periodic hematological assessment is, however, indicated, i.e. before TTh, then 3–4 months and 12 months in the first year of treatment, and annually thereafter. Although it is not yet clear what upper limit of hematocrit level is clinically desirable, dose adjustments may be necessary to keep hematocrit below 52–54% [I][B]*[I][B]Men with significant erythrocytosis (hematocrit >52%), severe untreated obstructive sleep apnea, or untreated severe congestive heart failure should not be started on treatment with TTh without prior resolution of the co-morbid condition.[/B][/I][/B][/I][/B][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring
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