CONCLUSIONS:
In the first year after starting testosterone therapy, development of secondary polycythemia significantly increases the risk for MACE and VTE in a matched cohort of men. To our knowledge, this is the first study that demonstrates secondary polycythemia as a possible underlying etiology associating TT and major adverse cardiovascular events. Physicians should counsel men on the small but real risk of MACE and monitor hematocrit among men receiving T therapy.
Substitute the word erythrocytosis for polycythemia in the article above.
See this paper below for more discussion of why this may be an issue. In the first year on TRT, you'd essentially be fitness testing the cardiovascular system by artificially increasing Hct in those who are susceptible (hemochromatosis carriers, those whose Hct is sensitive to exogeneous Testosterone). Those whose vasodilation capacity can't overcome Hct/viscosity increase (inflammation status, etc.) will lose.
Hence, Hct guidelines are not arbitrary ([USER=40983]@Jurek Kletsy[/USER]), they are based on reference range for humans at rest. Going above that may help those achieve better peak performance, but what if the individual's heart in question (or their cardiovascular system) is not in a position to support that higher power output?
[URL unfurl="true"]https://www.excelmale.com/forum/threads/high-hematocrit-hemoglobin-what-to-do.24723/post-216250[/URL]
Thanks for sharing [USER=3]@Nelson Vergel[/USER].