High Erythropoietin

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Michael D

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I'm 58 and have been on TRT for 8 years. Currently using hydrogel from Empower. I've been struggling to manage high hematocrit caused by the TRT. I've been undergoing periodic phlebotomies. My lab results keep showing a high lever of Erythropoietin (33); I'm wondering if that's from the TRT or is that my body recovering from the blood loss?

I've also had really, really high blood pressure lately. Can TRT cause that?? I've had relatively high BP my entire life (genetic), but in recent months it's been 180's over 90's. And very hard to control. I'm not overweight, I eat healthy food and I don't smoke. I play tennis 3-4 times per week. Yes, I have a drink or two in the evening, but by all means not a heavy drinker. One coffee in the morning.
 
Defy Medical TRT clinic doctor
high lever of Erythropoietin
Can you show us your lab results? I don't know any doctor that measures EPO. EPO increases with TRT, so it will always be high.

How frequently are you giving blood?

 
I've attached my lab results. I've only had 2 phlebotomies. My doctor told me they were too invasive and he said I have to stop TRT. I disagreed. He dropped me. I just found a new doctor who seems more interested in trying to manage my health in a way that doesn't require me to walk around with T levels of zero! So the new doc is having lots of tests done. He wanted to confirm that I don't have p. vera...which I think he's done now. But he's also trying to figure out why my blood pressure is dangerously high. He's ordered a kidney ultrasound...just waiting for it to be scheduled.
 

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Doctors should know that TRT's main side effect is increased hematocrit (portion of red blood cells in blood go up). I am sorry that you had to go through this.




Your kidney function is low. Are you taking any supplements containing creatine? If not, the use of a blood pressure medication like telmisartan with or without a diuretic will help your kidney function and blood pressure. TRT can increase water retention that can increase blood pressure.


Telmisartan Improves Insulin Resistance: A Meta-Analysis


Renoprotective effects of telmisartan in patients with advanced chronic kidney disease


You may have some metabolic issues. Are you overweight? Do you know if you have sleep apnea?
 
I really appreciate you looking into my situation. I live on the Big Island, where health care is really poor. But it's a price we pay to live in paradise.

I was put on Amlodipine. I was on it for two weeks and had to stop. It raised my pulse from a normal resting rate of 72 to near 100. I was completely exercise intolerant. Any physical activity and I felt like I was going to black out. And yet it did not significantly lower my BP. I was also put on lisinopril combined with a diuretic. A few days ago I was switched to a beta blocker (metoprolol). Wow! What a huge difference! I played tennis today and never once had to put my hand up and sit down, which is what I was doing while on Amlodipine. My heart is not racing. My BP has come down to the 140s-50s/80s.

I'm not overweight. 5'10" 185 with a relatively stocky frame. Well, I could lose 5 pounds...like a lot of people my age, but you're not going to look at me on the street and think that I'm fat. I'm not a body builder. I'm on TRT because my body just quit making it. I used to consult with Dr. Crisler (now deceased) and he said I'm a very odd case. He had me take a 24-hour urine sample and there was almost no testosterone in the sample, despite the fact I was on TRT. I'm not sure where it goes...my body seems to metabolize it somehow? I'm currently on 4 clicks of the Empower Pharmacy hydrogel, applied to scrotum, and it only raises me total T to about 500.

I have a problem with chronic dehydration. I just don't get thirsty so I don't drink much water. Something I try to work on but it's hard to remember to drink when I'm not thirsty, and it makes me have to urinate constantly when I do remember.

I hope those details answer some of your questions.
 
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