Managing Polycythemia by reducing DHT

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Hi All,

First post, hopefully a good one.

I've read the main thread on managing Polycythemia (elevated HGB/HCT) caused by TRT.

One post in there by Nelson references a correlation between elevated DHT and Polycythemia. (link removed as I don't have 4 posts yet)

I am on 100mg T-Cypionate twice per week + a tiny bit of anastrazole.

For years, I have had a unit of blood removed every 4-8 weeks to manage the HGB/HCT. It would be nice to do that less often.

My DHT when measured at trough is slightly over the top of range. At peak, it will be further over range.

I'm aware of the sexual side effects in Finasteride users. The people experiencing damage, seem to be those who were not on TRT at the time they took Finasteride. I'd suspect that they drove their DHT down too far for too long, but perhaps there is another cause.

My questions are:

1. Has anyone here successfully reduced the HGB/HCT growth rate by lowering their DHT? Any details?

2. If I was to carefully reduce my DHT from over-range to 50-75% of range (measured at trough), am I going to see side effects?

I appreciate any advice.
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Nelson Vergel

I would rather give blood than trying to reduce DHT to reduce hematocrit. DHT is a precious variable not to be messed with if you don't need to. But I am not answering your question, so hopefully someone tried to do this.


Welcome to Excelmale! It would seem that you may be complicating your life by adjusting a variable, in this case your DHT values, to deal with two other values, HGB/HCT. Balancing a TRT protocol, subjective response and lab results, is such a tricky business that I would be hesitant to manipulate something that doesn't need manipulation. I respect the fact that you would love to no longer have to donate blood, but be very careful with adjustments. I, too, hope you hear from someone who has first-hand experience.


You may well be someone that produces a lot of HGB/HCT, just like some guys produce a ton of E2 conversion. In other words, it may be genetic and have nothing to do with your DHT levels. DHT is generally a good thing to have so I would not try to lower it.

You are on the highest possible TRT dose of 200mg/week. Have you considered dropping that in half and injecting 50mg twice a week instead? What are your Total T & Free T levels?


Thanks guys. I appreciate the input.

Last time I was tested my Total T was ~1200 at trough. Free T was ">50" - or double top of range, but I think this may have been an error as it has previously been closer to top of range. Of course, peak would again be higher.

I should think about dropping the dose. I haven't yet as I've wanted to retain muscle and get an anti-aging benefit. At 45, I'm not trying to get bigger just maintain. (I'm lean, 175 lbs). At one time, I was on 160mg/week and still needed phlebotomies, so if I am to see a reduction in polycythemia, I suspect I would have to drop down lower as suggested to 100mg/week or so.

Tom Larabee

Some guys are just prone to create more red blood cells, its not a bad thing as long as you control it with phlebotomizes, along the way. I am one of those, it used to be I had to have one every 8 weeks, now I am about 3-4 a year, it does seem to get better but doesn't go away. I think all of the advise you are getting is deal with this, don't change in order to try and manage something you state you had to deal with even at lower amounts, it really is best to just handle it with a phlebotomy.
I haven't seen anyone manage this with any other way than donating/phlebotomy. Those that don't need to do that seem genetically(?) predisposed to lower HCT/HGB values, where as others, like me, it's the norm but still a problem. I'm one that I have to donate a min of every 90 days as my RBC production seems very high.
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