Double Red Cell Donation

[BrooklynJerry]

I'm 71yo and have concerns about HCT levels.I currently using testosterone cream on the scrotum. It is 200mg/gm strength
I was using 1/2gm twice a day for 2 months. They just increased the dosage to 3/4gm twice a day. I had 2 times over the past few years used 2x a week injectables, but quit over concerns of high blood pressure, cholesterol and HCT.
I had whole donated blood in August, my HCT was 50. I went to donate yesterday, they first asked if I wanted to donate platelets, I knew this doesn't lower HCT so I said no. Then was asked about double red donation, I accepted.
When the technician began the procedure he said it was good that I did this because my number was high (didn't get #). I guess they take quite a bit since you can't donate anything for 4 months.I have a regular check up scheduled in Nov. I'm hoping the results show the HCT is lower. Anyone here has done or heard of this?

 

[Systemlord]

Why are you donating blood with an HCT at 50%?

That's not even high enough to warrant a blood donation.

My HCT runs in the 54-56% range on TRT, blood pressure is 106/66 and I have tried donating blood which only drops ferritin to the point where I struggle with tiredness and fatigue for 4-5 weeks as I slowly build up my iron stores.

 

[MarkM]

Over the years I've given "double red" a few times. It removes twice the red blood cells that a normal whole blood donation does. The "double red" will lower your HCT more so than that normal donation. So yes, it will definitely reduce your HCT from its current levels. However, it will also pull more iron from your blood and reduce both your iron and ferritin levels. So keep your eyes on that. I've read that the older we get the more iron we tend to build up in our bodies and some get iron overload. So, it you have high iron levels it won't hurt for the iron levels to dip a little bit. When my iron is high my HCT is typically high too. So, you might want to watch your iron levels.

For years, maybe 20 years or more, my HCT was well over 50. My doctors never seemed to concerned about my HCT and never said anything about it until it was over 56 and then it was just a casual mention of it. I've had numerous doctors over the years because I was constantly relocating and most thought it was more related to erythrocytosis verse polycythemia. I'm not saying that a higher HCT is not something to watch, it is, but I'm not going to get excited personally unless mine hits the 58 range or higher on a consistent basis. That's just me.

I read somewhere that they were considering raising the top of the range to 54 but I can not locate where I read that. Last time I gave blood at I asked them what the cut off was on HCT for donation purposes and they said that as long as it is below 54 they would take it.

I always ask the technician what my HCT is when they check it before the donation.

 

[madman]

I'm 71yo and have concerns about HCT levels.I currently using testosterone cream on the scrotum. It is 200mg/gm strength. I was using 1/2gm twice a day for 2 months. They just increased the dosage to 3/4gm twice a day. I had 2 times over the past few years used 2x a week injectables, but quit over concerns of high blood pressure, cholesterol and HCT.
I had whole donated blood in August, my HCT was 50. I went to donate yesterday, they first asked if I wanted to donate platelets, I knew this doesn't lower HCT so I said no. Then was asked about double red donation, I accepted.
When the technician began the procedure he said it was good that I did this because my number was high (didn't get #). I guess they take quite a bit since you can't donate anything for 4 months.I have a regular check up scheduled in Nov. I'm hoping the results show the HCT is lower. Anyone here has done or heard of this?

I'm 71yo and have concerns about HCT levels.I currently using testosterone cream on the scrotum. It is 200mg/gm strength. I was using 1/2gm twice a day for 2 months.They just increased the dosage to 3/4gm twice a day

Should have posted your labs with reference ranges/assays used for TT, FT, estradiol, SHBG let alone CBC which includes (RBCs/hemoglobin/hematocrit).

SHBG is critical to know as it will have a significant impact on TT/FT.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Critical to know where your trough FT level sits on such protocol.

Many doctors let alone men on trt make the mistake of using/relying upon the piss poor direct immunoassay which is known to be inaccurate let alone are using the older outdated cFTV.

I would not rely upon such especially in cases of altered SHBG.

How did you feel overall on 100 mg T applied scrotal 2X/day?

Why are they increasing your dose.....lacking improvement in low-t symptoms, free T not high enough?

Again need to see your labs.


I had 2 times over the past few years used 2x a week injectables, but quit over concerns of high blood pressure, cholesterol and HCT.
I had whole donated blood in August, my HCT was 50. I went to donate yesterday, they first asked if I wanted to donate platelets, I knew this doesn't lower HCT so I said no. Then was asked about double red donation, I accepted. When the technician began the procedure he said it was good that I did this because my number was high (didn't get #). I guess they take quite a bit since you can't donate anything for 4 months.I have a regular check up scheduled in Nov. I'm hoping the results show the HCT is lower. Anyone here has done or heard of this?

When it comes to donating it is critical to know where your iron/ferritin levels sit.

You last donated in August when your hematocrit was 50% which I would not consider too high.

You just recently donated (DRBC) and the technician told you at the time it was high but you do not know the #.

Big mistake as you should have just done your regular donation.

Every time you donate blood especially when it is too often as in more than 2-3 times/year you will increase the chance of crashing your iron/ferritin which can open up a can of worms.

Although double red will have a bigger impact on lowering hematocrit it will also drive down your ferritin more.

Regarding those struggling with high hematocrit here is my reply from another thread:

When using exogenous T RBCs/hemoglobin/hematocrit will increase within the 1st month and can take up to 9-12 months to reach peak levels.

T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).

Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.

Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.

3–18% with transdermal administration and up to 44% with injection.

In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.

Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.

As again running very high TT/FT levels will have a stronger impact on driving up HCT.

Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.

Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.

How high an FT level you are running is critical.

It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.

Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.

If you are struggling with such blood markers then in most cases finding the lowest FT level you can run while still maintaining the beneficial effects may very well be the solution.

Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.

Mind you some are lucky and never have an issue or levels tend to stabilize over time.

Others will continue to struggle until the cows come home.

Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!

 

[Cooper]

I'm 71yo and have concerns about HCT levels.I currently using testosterone cream on the scrotum. It is 200mg/gm strength
I was using 1/2gm twice a day for 2 months. They just increased the dosage to 3/4gm twice a day. I had 2 times over the past few years used 2x a week injectables, but quit over concerns of high blood pressure, cholesterol and HCT.
I had whole donated blood in August, my HCT was 50. I went to donate yesterday, they first asked if I wanted to donate platelets, I knew this doesn't lower HCT so I said no. Then was asked about double red donation, I accepted.
When the technician began the procedure he said it was good that I did this because my number was high (didn't get #). I guess they take quite a bit since you can't donate anything for 4 months.I have a regular check up scheduled in Nov. I'm hoping the results show the HCT is lower. Anyone here has done or heard of this?

How do you like the cream so far?

 

[pedromillie]

They offer me the double red every time I donate. My iron and red cells are always high and donating keeps me in the healthy range. I even had to reduce red meat because it was getting elevated even with donating a few times a year.

 

[JimGainz]

Hematocrit by itself is not an accurate score to predict risk of blood thickening. Basically any athlete training at high altitude, like in Colorado, will have high hematocrit. What you want to watch out for is the high platelet count to go along with it. Unfortunately most doctors do not understand this nuance, and will freak out, or even take a man off of testosterone to bring down the hematocrit.

I typically give blood every 3 to 4 months or in a two month interval if I am stacking some anabolics along with the TRT – but it is only to avoid having these unpleasant discussions with doctors. You have to understand what their approach and protocol is. Even well seasoned TRT doctors from wellness clinics will have someone stop temporarily if hematocrit reaches a certain point. That’s why I just continue to give blood regularly and the hematocrit usually goes up to around 49 or 51 at the time of donation and drops down to 46 -47.

 

[madman]

Hematocrit by itself is not an accurate score to predict risk of blood thickening. Basically any athlete training at high altitude, like in Colorado, will have high hematocrit. What you want to watch out for is the high platelet count to go along with it. Unfortunately most doctors do not understand this nuance, and will freak out, or even take a man off of testosterone to bring down the hematocrit.

I typically give blood every 3 to 4 months or in a two month interval if I am stacking some anabolics along with the TRT – but it is only to avoid having these unpleasant discussions with doctors. You have to understand what their approach and protocol is. Even well seasoned TRT doctors from wellness clinics will have someone stop temporarily if hematocrit reaches a certain point. That’s why I just continue to give blood regularly and the hematocrit usually goes up to around 49 or 51 at the time of donation and drops down to 46 -47.

This is overkill for most and would most likely result in crashing ferritin.

 

[Dicky]

What you want to watch out for is the high platelet count to go along with it. Unfortunately most doctors do not understand this nuance, and will freak out, or even take a man off of testosterone to bring down the hematocrit.

What number platelet count is too high? The ref range for platelets on my CBC profile was 150-450. So something higher than 450?

 

[BrooklynJerry]

Why are you donating blood with an HCT at 50%?

That's not even high enough to warrant a blood donation.

My HCT on TRT runs in the 54-56% range on TRT, blood pressure is 106/66 and I have tried donating blood which only drops ferritin to the point where I struggle get out of bed in the morning for longer than a month as I slowly build up my iron stores.

Why are you donating blood with an HCT at 50%?

That's not even high enough to warrant a blood donation.

My HCT on TRT runs in the 54-56% range on TRT, blood pressure is 106/66 and I have tried donating blood which only drops ferritin to the point where I struggle get out of bed in the morning for longer than a month as I slowly build up my iron stores.

I was under the impression that 50% was high.I know that before I was on TRT it was 47%.

 

[BrooklynJerry]

How do you like the cream so far?

Seems to be working well.The only drawback is the timing of application vs possibly of having sex and showers.

 

[JimGainz]

What number platelet count is too high? The ref range for platelets on my CBC profile was 150-450. So something higher than 450?

Well first of all I’m not a doctor but I would be looking out for the platelet count of anything towards the upper end of that range and if I hit that or came within 400 or more I will give blood immediately. For what it’s worth I typically have high HCT but my platelet count is still in the mid range so I was told it’s nothing to worry about.

 

[Systemlord]

I was under the impression that 50% was high.

The internationally recognized top end of the ranges for hematocrit is 54%. The funny thing is depending on which lab you go, the ranges could be 40-50%, 40-52% and even up to 54%.

The problem is no one can agree what is high hematocrit.

 

[Gman86]

Well first of all I’m not a doctor but I would be looking out for the platelet count of anything towards the upper end of that range and if I hit that or came within 400 or more I will give blood immediately. For what it’s worth I typically have high HCT but my platelet count is still in the mid range so I was told it’s nothing to worry about.

Does donating blood lower platelets too, or just RBC’s?

 

[Gman86]

Around 50% for HCT is literally perfect, imo, for overall health and performance and the body being optimally oxygenated. I wouldn’t of donated unless ur iron is too high and u need to lower it. Just don’t donate for a while, again unless ur iron levels become very elevated for some reason. U definitely want to build ur HGB and HCT levels back up, especially after doing a double red. A guy did his labs before and after doing a double red and the double red donation dropped his HCT by 7 points. So I would assume ur around 45%, or possibly below atm, which isn’t where I would personally want my HCT level to be. I personally think around 50% is literally the perfect HCT level for overall health and performance

 

[madman]

I was under the impression that 50% was high.I know that before I was on TRT it was 47%.

Take home points:

*the clinical significance of a hematocrit >54% is unknown

*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%




post #13

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

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Recommendations on the diagnosis, treatment, and monitoring of testosterone deficiency in men (2021)


Hematocrit

*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. However, these recommendations are based on assumptions – the clinical significance of a hematocrit >54% is unknown

*The lack of increase in cardiovascular events with elevated hematocrit may be due to the fact that T acts as a vasodilator and has anti-atherosclerotic effects [223]. In addition, testosterone is able to decrease plasma concentrations of procoagulatory substances such as fibrinogen and PAI-1 as well as Factor XII [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

*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%

*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.

 

[madman]

Around 50% for HCT is literally perfect, imo, for overall health and performance and the body being optimally oxygenated. I wouldn’t of donated unless ur iron is too high and u need to lower it. Just don’t donate for a while, again unless ur iron levels become very elevated for some reason. U definitely want to build ur HGB and HCT levels back up, especially after doing a double red. A guy did his labs before and after doing a double red and the double red donation dropped his HCT by 7 points. So I would assume ur around 45%, or possibly below atm, which isn’t where I would personally want my HCT level to be. I personally think around 50% is literally the perfect HCT level for overall health and performance

Still talking out your ass!

Many men function just fine let alone are in stellar health with a hematocrit <50%.

Young healthy males in their prime are running around with levels much less.

Labcorp: Hematocrit reference range for Men: 37.5-51%

 

[BrooklynJerry]

I want to thank all that took time to reply. I was worried that the double red was going to make me feel like crap I worked out with weights yesterday and it didn't seem to weaken me. I do have a cardiologist visit in November,he doesn't know that I'm on TRT, but I'll see what he says after my lab work comes back

 

[tareload]

Still talking out your ass!

Many men function just fine let alone are in stellar health with a hematocrit <50%.

Young healthy males in their prime are running around with levels much less.

Labcorp: Hematocrit reference range for Men: 37.5-51%

I've discussed on here why such a blanket statement such as "50% HCT is perfect" can be detrimental depending on individuals inflammation status. HCT on its own doesn't determine whole blood viscosity, which is also strongly driven by plasma viscosity.

 

[FDV70]

Hi all, I do double red donations all the time without fear of crashing ferritin. This problem has literally been solved now (ferritin can be recovered in a few days). I posted the answer in another forum; here's the link:

Raising ferritin FAST (a how-to, not a question)

Hi all, I started TRT in 2001 and have been giving blood over the years and have always had issues with recovering my ferritin. Long story short, I got tired of waiting for others to do the research, so I did it myself, created a protocol, hired a hematologist in May 2021 who thought it could...

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