climbing hct

[buggies100]

Good evening gentlemen! I am a 54 yo manand have been following for several months, great imformation. Have posted under different name but cannot sign back in with that name.
Long story short my internal med dr had me on 200 mg test C every two weeks, started in spring 2014, things have been great. Hematocrit had climbed, been 55-56 for a couple years, i had no odea that was bad. It jumped up to 62 in early nov on my second annual visit. He asked me to come off and start 50 mg clomid every day.
I started research, found this forum, and spoke with defy medical. They sent me script for phlebotomy. After first draw in early dec hct was 54! I am guessing 62, from a different lab, was incorrect. I reduced dosage to 40 mg every 3.5 days in late dec. Been feeling like poo, anxious, drop in energy and motivation, but trying to get hct down. Got script for phlebotomy changed to every 4 weeks, and did a drawn down today at red cross. She red my hemoglobin ay 20.7!!
Was told by defy i need to get hct down to 51 before they will take me as a patient. So i am in a pickel. Should i go back to my dr and do the clomid. My lh was low on initial blood work ant total T was under 300, so if i was not making lh then how could clomid do me any good now.

 

[Dr Justin Saya MD]

Good evening gentlemen! I am a 54 yo manand have been following for several months, great imformation. Have posted under different name but cannot sign back in with that name.
Long story short my internal med dr had me on 200 mg test C every two weeks, started in spring 2014, things have been great. Hematocrit had climbed, been 55-56 for a couple years, i had no odea that was bad. It jumped up to 62 in early nov on my second annual visit. He asked me to come off and start 50 mg clomid every day.
I started research, found this forum, and spoke with defy medical. They sent me script for phlebotomy. After first draw in early dec hct was 54! I am guessing 62, from a different lab, was incorrect. I reduced dosage to 40 mg every 3.5 days in late dec. Been feeling like poo, anxious, drop in energy and motivation, but trying to get hct down. Got script for phlebotomy changed to every 4 weeks, and did a drawn down today at red cross. She red my hemoglobin ay 20.7!!
Was told by defy i need to get hct down to 51 before they will take me as a patient. So i am in a pickel. Should i go back to my dr and do the clomid. My lh was low on initial blood work ant total T was under 300, so if i was not making lh then how could clomid do me any good now.

Not to sound unsympathetic, but the elevated hematocrit (especially to the degree you've seen possibly high 50's or low 60's) is a SAFETY priority above and beyond current symptoms. If they told you at the blood center that your hemoglobin was 20.7, the hematocrit is typically approximately 3x the hemoglobin, so that would put you back up at around 62 for hematocrit (estimated)!

If the hematocrit keeps climbing despite your currently reduced TRT dosage it is likely that one or more of the following are also contributing: SLEEP APNEA, smoking, high iron intake/levels, living at high altitude. The root cause needs to be addressed and assuming your hematocrit is elevated to the degree it appears, in all honesty your TRT should be discontinued until such a time. Safety must come first for you.

 

[Vince]

buggies, do you think you need a real TRT doctor?

 

[buggies100]

Most certainly I do. There is a men's clinic about an hour drive from me, obsidian. I ma making an appt tomorrow

 

[buggies100]

Thanks Dr Saya,
i realize this number is dangerously high. i do not live at altitude, do not smoke, do not eat an excess of iron, wife is a NP and dietician, and as far as i know have no sleep apnea. Wife has never heard me stop breathing or gasping for air or wake up panicking. Coul dbe worth testing i guess. I do wake up at night a couple times. I will stop T, due tomorrow until i can get in to see dr. I will have to take xanax for next bit of time as anxiety roars thru me without the T.

 

[Dr Justin Saya MD]

Thanks Dr Saya,
i realize this number is dangerously high. i do not live at altitude, do not smoke, do not eat an excess of iron, wife is a NP and dietician, and as far as i know have no sleep apnea. Wife has never heard me stop breathing or gasping for air or wake up panicking. Coul dbe worth testing i guess. I do wake up at night a couple times. I will stop T, due tomorrow until i can get in to see dr. I will have to take xanax for next bit of time as anxiety roars thru me without the T.

Have your currently treating physician (or your wife as an NP) check iron studies for you to assess for hemochromatosis: serum iron, % saturation, TIBC, ferritin. Keep us posted. Start taking fish oil 4g daily and stay VERY well hydrated in the mean time.

 

[Vince Carter]

In this situation it could seem advisable to stop all TRT and donate until such time as you get HCT/HGB in an acceptable range. It's a super common side effect for most guys but you're as you now know is dangerously high. Phlebotomy, a Dr prescribed phlebotomy is good but should you not have a prescription for it, most blood banks will not accept you if your HGB is I think it's over 20.

 

[buggies100]

Hey Vince, you are correct , thank you. I was due for shot today ad did with out it. I do have a script for theraputic phel every four weeks. Yesterday was day 1. I got back labs today taken last week. Total T was 883! Hct was 59.4. Funny as i went from 200 mg per two weeks to 40 mg twice a week understanding more frequent shots would be better. Ha, my T has never been 883, usually comes in 350-450 tested every 6 month. At least i can see that hct was following the testosterone. Have appt at mens health clinic next week and will not take any T until i hear from them.