Elevated hematocrit and hemoglobin, not all physicians have the same opinion ..........

[Another Great Day]

About 2 weeks ago I had my labs drawn at Labcorp and I was surprised that my hemoglobin and hematocrit were this elevated with a 786 testosterone level. Each week I take a total of 90 mg/ml of cypionate by taking daily subcutaneous injections. My recent labcorp labs:

Blood Pressure 122/72
Hemoglobin: 18.7 range: 13.0-17.7
Hematocrit: 56.7 range: 37.5-51.0
platelet: 157 range: 150-450
ferritin: 161 range: 30-400
Testosterone total: 786.7 range: 264.0- 916

Providers with different thoughts.
A week ago I paid a visit to my local ED because based upon these labs and an unusual pain in my calf I thought I had a DVT. I showed the ED provider my labs and commented on my elevated Hct and Hb. She looked at the labs and said those are not high and she moved on to another topic. After 4 1/2 hours in the ED I learned that I did not have DVT.

Today I followed up with my primary care doctor. Again, I showed him the labs, and he too said, those are not very high and he said that my testosterone was not that high.

This goes against what I thought was "correct" for many years.......

I am a patient at a well known HRT clinic. In the past when my Hct and Hb would be elevated at these levels I would receive an urgent email with an order for therapeutic phlebotomy along with instructions to take large amounts of fish oil.

My question: Are my current Hct and Hb levels so high that it warrants therapeutic phlebotomy and do these providers simply have different opinions on what is "high" or am I missing something?

 

[Systemlord]

My question: Are my current Hct and Hb levels so high that it warrants therapeutic phlebotomy and do these providers simply have different opinions on what is "high" or am I missing something?

When I was on TRT, I hematocrit of 57%. My endocrinologist freaked out and ordered monthly phlebotomies. After a little more than a year, the hematologist at the infusion center who reviews everyone’s blood pressure readings, hemoglobin and hematocrit for the infusion center contacted my endocrinologist.

The hematologist asked my doctor, why are you choosing to phlebotomize this man? My blood pressure numbers were <120/60. With increased testosterone, nitric oxide increases and expands the vasculature, expanding, widening of the veins to account for the increase in viscosity.

The hematologist is the authority on the matter. Some men will have issues with hematocrit at 52% while others won’t and we don’t know why. One could argue the man that does have issues may already have some type of vascular damage or maybe lacks the adaptation to deal with the thicker blood.