Dr Crisler Now Says No Blood Donation is Needed When Hematocrit is High

Ok,I read Dr Crisler's post on facebook yesterday, that says:

"I wish you had all seen the incredible 90 minute lecture my old pal Dr Neal Rouzier just gave at AMMG. There is absolutely no reason to perform therapeutic phlebotomies in men on TRT whose H/H rises above 18/55, as long as platelets have not risen too high. Based upon irrefutable evidence-based medicine, I am changing my practices."

While I dislike Rouzier, I highly respect Dr Crisler. But it seems he went full potato with this.


Listen to the podcast here:
http://www.trtrevolution.com/new-data-men-dont-need-phlebotomy-with-dr-john-crisler/

The objection Rouzier has to phlebotomies isn't a new one; he's held that position for some time. I wonder what now convices Dr. Crisler of the truth of the position? As an aside, Rouzier does not monior estradiol, either. So, absent more information, I'm not changing my mind. An older thread on point.
https://www.excelmale.com/forum/sho...it-and-Estradiol-Management&highlight=rouzier

CoastWatcher said:

The objection Rouzier has to phlebotomies isn't a new one; he's held that position for some time. I wonder what now convices Dr. Crisler of the truth of the position? As an aside, Rouzier does not monior estradiol, either. So, absent more information, I'm not changing my mind. An older thread on point.
https://www.excelmale.com/forum/sho...it-and-Estradiol-Management&highlight=rouzier

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Yeah, Rouzier stances always seemed like a non-sense to me. And now Crisler supports him.

I think we definitely need more data before accepting such silly conclusions .

Is this referring to on the CBC, "Platelet Count" with a (Quest) range of 140-400 (thousand)/uL

Vince Carter said:

Is this referring to on the CBC, "Platelet Count" with a (Quest) range of 140-400 (thousand)/uL

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Yeah, platelets are included in complete blood count.

so he's saying it's all good as long as your platelet count is...<400K....????

Yeah, if platelets are normal.

I have not seen any references that support what Crisler says on this subject.
The podcast has none. Zero.

Here are several references for high hematocrit and health problems.
Need help to convince my doctor to treat my high hematocrit

I cannot imagine waiting until my hematocrit went above 55 to donate blood. I do not agree with the conclusions of Dr. Rouzier.

I know atleast subjectively that when I've been 55/56 that I can feel that and that I feel better after donating. I can't say its the lowering of HCT or anything else but in reveiwing my platelet counts in the past, I'm under 160/170 in the 400,000 lab range.

Same. I've had high hematocrit (53) but very low platelets (thrombocytes) at around 162.

Vince Carter said:

I know atleast subjectively that when I've been 55/56 that I can feel that and that I feel better after donating. I can't say its the lowering of HCT or anything else but in reveiwing my platelet counts in the past, I'm under 160/170 in the 400,000 lab range.

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Curious as to what you feel before you donate blood? What symptoms do you experience?

Mountain Man said:

Curious as to what you feel before you donate blood? What symptoms do you experience?

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That we don't derail this thread how about starting a thread for your question?

Mountain Man

Here are a few symptoms associated with high hematocrit: http://www.discountedlabs.com/blog/what-you-should-know-about-the-main-side-effect-of-testosterone/

Nelson Vergel said:

Mountain Man

Here are a few symptoms associated with high hematocrit: http://www.discountedlabs.com/blog/what-you-should-know-about-the-main-side-effect-of-testosterone/

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Got it! Thanks Nelson.

I've long disagreed with Rouzier's stance on estradiol and also this stance on increases in hematocrit.

You wouldn't see me walking around for too long with a HCT > 52-53.

And that's why you two (Dr Saya and Nelson) are best in the game!

Here are studies that are contrary to Dr Crisler's new beliefs:

High and Low Hematocrit Increase Cardiovascular Risks

Dr Justin Saya said:

I've long disagreed with Rouzier's stance on estradiol and also this stance on increases in hematocrit.

You wouldn't see me walking around for too long with a HCT > 52-53.

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The Q is a simple one for me, what evidence is he basing the position on? A total reliance on data while ignoring clinical experience and evidence is bad, but a total reliance on clinical experience is really no better. A total reliance on clinical experience often translates into "because I said so" and that's just bad science and poor medicine.