Can blood work be incorrect?? Really confused

[JetSpyder]

I am one of the guys that deals with erythrocytosis and I have been for years. I have lowered my T dose to 70 mg per week. 20 mg EOD. Over the past year I have really been struggling with the cycle of donating, then crashing my ferritin levels.

In April of this year my HCT got up to 53.2 and I wasn’t feeling very good. Constant heart palpitations and a struggle to sleep. Figured it would be beneficial to donate. I did a Double Red donation. This took my HCT down to a 48 but also the cycle of destroying my ferritin levels. However my ferritin levels went from a 36 down to a 21 (38 - 380 ng/ml scale). Came across the Vorck Protocol: Rapid Ferritin Restoration and decided to give it a try.

I’m not sure if I messed something up but it didn’t work great for me. I mean it did work well to raise my ferritin up to a 52 ng/ml but also brought my HCT back up to a 53.2 again. I started feeling the heart palpitations again and trouble sleeping for several weeks so I decided to try it again. I had another blood donation to get my HCT back down and try the protocol again. This time the results were better but still not great. I did a 7 day protocol and got my blood checked the day after (7/11/25.)

July 11.
HCT - 50.4
Ferritin - 52 (38 - 380) LOW NORMAL
Iron, Total - 299 (50 - 180 mcg/dl) HIGH
% saturation 73% (20 - 48%) HIGH

So I thought maybe I should have waited a little longer to get my blood checked instead of the day after. I waited 3 weeks from after I finished the protocol and I had my blood tested again. And HERE is why I am writing this. I’ve dealt with erythrocytosis for years while being on TRT but here are the results I just got back below. I am completely dumbfounded and confused AF. How is it possible for my HCT to drop to a 33 and Ferritin to a 3!!! Does this seem more likely that the lab screwed this up then these levels actually being correct?? Has anyone else seen this before?

 

[Guided_by_Voices]

For results that extreme, my approach is to immediately test again if possible and assuming no symptoms. I had elevated HCT for a while and I can say that it is essential that you be fully hydrated to get an accurate test. I would schedule your tests late morning and drink at least half a gallon of water before the test.

 

[Vince]

When I first started TRT I donated blood every 8 weeks. I did that for 2 years and never gave it a second thought after 2 years. My HCT stabilized and I never donated again.

I wonder if we worry about our levels more than we need to?

 

[JetSpyder]

For results that extreme, my approach is to immediately test again if possible and assuming no symptoms. I had elevated HCT for a while and I can say that it is essential that you be fully hydrated to get an accurate test. I would schedule your tests late morning and drink at least half a gallon of water before the test.

I'm wondering if that has been the case for a while. For this test I was fully hydrated. I gave blood at 930 am after I fasted all night and morning. Drank about a half-gallon after I got up that day. However, my other tests over the years I was probably not adequately hydrated. But I'm def going to test again before I jump to any conclusions.

 

[JetSpyder]

When I first started TRT I donated blood every 8 weeks. I did that for 2 years and never gave it a second thought after 2 years. My HCT stabilized and I never donated again.

I wonder if we worry about our levels more than we need to?

I wish that was the case for me. The past year or so has been when my HCT has been the highest. I've been on TRT for 12 years now and honestly, I've never felt great from it. I'm constantly chasing one thing after another. But also, who the F knows what I should be feeling like at this age since I've been on it for so long. I don't know what it feels like to not be on it.

If it wasn't for the heart palpitations, hot flashes and lack of sleep I could accept the rest. But getting into my mid 40's and struggling with this is becoming frustrating at best. I've lowered my dosage down to 70 mg per week so the next step is to just get off of it.

 

[Phil Goodman]

When I first started TRT I donated blood every 8 weeks. I did that for 2 years and never gave it a second thought after 2 years. My HCT stabilized and I never donated again.

I wonder if we worry about our levels more than we need to?

I consider this as well, and I’ve talked about the homeostasis aspect on other fronts but I also think it may apply here for many people. For lots, they get on trt and if their levels jump up a few points(which should be somewhat expected in the first 3-6 months… warning, madman might freak out after reading this post) they immediately start dumping blood instead of letting it adapt which it usually does, or at least stabilizes. So of course when the body dumps blood the first thing it wants to do is restore all the blood it lost. Then it’s off to the races in a vicious cycle of ramping up blood and dumping it over and over. Basically keeping the body in a constant state of “all hands on deck, more red blood cells needed!”. I could be wrong in this one, but I don’t see how that could be healthier than letting your body adapt to be a few points above the top of the range (within reason of course).

 

[Vince]

I wish that was the case for me. The past year or so has been when my HCT has been the highest. I've been on TRT for 12 years now and honestly, I've never felt great from it. I'm constantly chasing one thing after another. But also, who the F knows what I should be feeling like at this age since I've been on it for so long. I don't know what it feels like to not be on it.

If it wasn't for the heart palpitations, hot flashes and lack of sleep I could accept the rest. But getting into my mid 40's and struggling with this is becoming frustrating at best. I've lowered my dosage down to 70 mg per week so the next step is to just get off of it.

I would do daily injections.