Looking for honest advice on hematocrit

[smash528]

Good afternoon, been on TRT since 2018. I am very active not a bodybuilder but more of a hybrid athlete. Run a ton, hike, walk 18-27 holes of golf 3-4 times a week and do a performance based workout. My testosterone dose has always been 160 mg a week split into 2 doses. My hematocrit always hovered in the 48-49 range. My bloods last year had be at 50. This winter i dabbled in dosing every other day and believe I was at around 200mg-220 a week. when i got my bloods I was called and told I needed to immediately donate that I was at high risk of stroke due to my levels. They said hematocrit was 55 and hemo of 18.5. 2 weeks later i went to a hospital to get the phlebotomy. They did another quick test before they even did it and the nurse came out and goes looks good 48 and 16. I asked her what that was and she said hematocrit and hemoglobin. They did the donation and I honestly felt like crap for a few days. My provider wanted me to do another follow up blood test and I got it yesterday. I now have an email with another prescription for phlebotomy saying my hematocrit or hemoglobin is slightly elevated and I need another donation. Any idea how my hematocrit and hemoglobin could go from 55 and 18 to 48 and 16 in two weeks and how could it be high again. Sort of confused on what is going on here and how dangerous is this ?

 

[Guided_by_Voices]

Good afternoon, been on TRT since 2018. I am very active not a bodybuilder but more of a hybrid athlete. Run a ton, hike, walk 18-27 holes of golf 3-4 times a week and do a performance based workout. My testosterone dose has always been 160 mg a week split into 2 doses. My hematocrit always hovered in the 48-49 range. My bloods last year had be at 50. This winter i dabbled in dosing every other day and believe I was at around 200mg-220 a week. when i got my bloods I was called and told I needed to immediately donate that I was at high risk of stroke due to my levels. They said hematocrit was 55 and hemo of 18.5. 2 weeks later i went to a hospital to get the phlebotomy. They did another quick test before they even did it and the nurse came out and goes looks good 48 and 16. I asked her what that was and she said hematocrit and hemoglobin. They did the donation and I honestly felt like crap for a few days. My provider wanted me to do another follow up blood test and I got it yesterday. I now have an email with another prescription for phlebotomy saying my hematocrit or hemoglobin is slightly elevated and I need another donation. Any idea how my hematocrit and hemoglobin could go from 55 and 18 to 48 and 16 in two weeks and how could it be high again. Sort of confused on what is going on here and how dangerous is this ?

Is it possible you were under-hydrated for the test where your HCT was higher? That could do it.

 

[smash528]

Is it possible you were under-hydrated for the test where your HCT was higher? That could do it.

I thought of that. My blood tests have always been in the morning. My donation was noon so I would have had more time to hydrate prior to getting there. I have my consult with my clinic this week.

 

[madman]

Good afternoon, been on TRT since 2018. I am very active not a bodybuilder but more of a hybrid athlete. Run a ton, hike, walk 18-27 holes of golf 3-4 times a week and do a performance based workout. My testosterone dose has always been 160 mg a week split into 2 doses. My hematocrit always hovered in the 48-49 range. My bloods last year had be at 50. This winter i dabbled in dosing every other day and believe I was at around 200mg-220 a week. when i got my bloods I was called and told I needed to immediately donate that I was at high risk of stroke due to my levels. They said hematocrit was 55 and hemo of 18.5. 2 weeks later i went to a hospital to get the phlebotomy. They did another quick test before they even did it and the nurse came out and goes looks good 48 and 16. I asked her what that was and she said hematocrit and hemoglobin. They did the donation and I honestly felt like crap for a few days. My provider wanted me to do another follow up blood test and I got it yesterday. I now have an email with another prescription for phlebotomy saying my hematocrit or hemoglobin is slightly elevated and I need another donation. Any idea how my hematocrit and hemoglobin could go from 55 and 18 to 48 and 16 in two weeks and how could it be high again. Sort of confused on what is going on here and how dangerous is this ?

Chances are 160 mg T split twice-weekly already had your trough FT high-end/high.

Even then going from 160--->200-220 mg T/week split EOD is a whopping weekly dose of T and would easily drive up your TT and more importantly FT which will drive up your hematocrit.

Post your labs TT/FT/estradiol/SHBG from your previous protocol 160 mg T/week split 80 mg twice-weekly and when your were banging 200-220 mg T/week split EOD.

Most men on T-therapy are injecting 100-200 mg T/week whether once weekly or split into more frequent injections.

The majority of men can easily hit a healthy let alone high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

200 mg of T/week is overkill as in OVERMEDICATED for the MAJORITY of men!

Yes there are those outliers who may need the higher-end dose but it is far from COMMON as in RARE!

Post in thread 'They won't let me give blood....'

May 7, 2025

Hi Guys

Blood lab turned me away for having Haemoglobin of 198. Apparently the limit is 185(Here in New Zealand)

I am currently on 80mg(split twice a week 40+40)of test cyp deep IM. Have been on this for 4 months and going well. Can't do and form of subq as gives me anxiety insomnia and gummyworm dick.

Should I lower my dose?

Latest labs below

Thanks

Prolactin 489mU/L(65-400)(taking cabergoline quarter of a 0.5mg tablet per week)
Total testosterone 22nmol/L(8.6-29)
Free testosterone 667pmol/L(220-680)
SHBG 17pmol/L(13-49)
Estradiol 143pmol/L(0-190)
Ferritin 46ug/L(30-500)...

• madman

• 

Thread 'From Phlebotomy to Formulation: Optimizing Hematocrit Control in Testosterone Therapy'

Apr 1, 2025

Figure 1. Effects of exogenous testosterone on red blood cell production. Testosterone increases EPO production in the kidneys, increasing red blood cell and erythroferrone production in bone marrow, leading to decreases in hepcidin and increased iron uptake, triggering an increase in red blood cells.

https://academic.oup.com/smr/advance-article-abstract/doi/10.1093/sxmrev/qeaf013/8092310?redirectedFrom=fulltext

Abstract

Introduction

Testosterone replacement therapy is gaining more and more popularity among hypogonadal men. The positive...

• madman
• hypogonadism; testosterone; hematocrit; cvd
• Replies: 4
• Forum: Testosterone Side Effect Management

• 

Post in thread 'High Testosterone on only 80mg/week'

Jun 22, 2024

Based on the comments you made here about a hematocrit of below 54 being safe are you willing to stand liable for giving out this false information if the OP has a stroke or heart attack?

Also please enlighten us on where you attended medical school and where you got your degree in endocrinology?

If you are having to give blood to reduce the hematocrit, you are not on "TRT" you are taking a small steroid cycle and calling it TRT.

As for my advice to the poster, I know personally of two people I have given similar advice to, both had strokes under the age of fifty. One with a...

• madman

• 

 

[madman]

Good afternoon, been on TRT since 2018. I am very active not a bodybuilder but more of a hybrid athlete. Run a ton, hike, walk 18-27 holes of golf 3-4 times a week and do a performance based workout. My testosterone dose has always been 160 mg a week split into 2 doses. My hematocrit always hovered in the 48-49 range. My bloods last year had be at 50. This winter i dabbled in dosing every other day and believe I was at around 200mg-220 a week. when i got my bloods I was called and told I needed to immediately donate that I was at high risk of stroke due to my levels. They said hematocrit was 55 and hemo of 18.5. 2 weeks later i went to a hospital to get the phlebotomy. They did another quick test before they even did it and the nurse came out and goes looks good 48 and 16. I asked her what that was and she said hematocrit and hemoglobin. They did the donation and I honestly felt like crap for a few days. My provider wanted me to do another follow up blood test and I got it yesterday. I now have an email with another prescription for phlebotomy saying my hematocrit or hemoglobin is slightly elevated and I need another donation. Any idea how my hematocrit and hemoglobin could go from 55 and 18 to 48 and 16 in two weeks and how could it be high again. Sort of confused on what is going on here and how dangerous is this ?

I would tread lightly when it comes to getting caught up on that donating too frequently merry go round as it is a surefire way to crash your iron/ferritin which can open up another can of worms!

Also need to pay attention to where your trough FT truly sits as running too high a trough/steady-state FT can easily put you in a situation where you end up struggling with hematocrit.

More importantly pay attention to your trough FT/injection frequency as there is a big diffence between one running a high-end/high trough FT injecting daily vs twice-weekly (every 3.5 days) vs once weekly!

Unfortunately many end overmedicated on T from the get-go let alone get caught up on that more T is better sheep mentality BULLS**T

 

[Systemlord]

Any idea how my hematocrit and hemoglobin could go from 55 and 18 to 48 and 16 in two weeks and how could it be high again.

Donating blood only decreases hemoglobin and hematocrit for 2 to 3 weeks anyways and it’s right back to being elevated.

There’s no mystery here. Get off this marry go round and change your dose.

 

[Seagal]

Change your doc/provider and be honest about your dosage.

 

[madman]

Good afternoon, been on TRT since 2018. I am very active not a bodybuilder but more of a hybrid athlete. Run a ton, hike, walk 18-27 holes of golf 3-4 times a week and do a performance based workout. My testosterone dose has always been 160 mg a week split into 2 doses. My hematocrit always hovered in the 48-49 range. My bloods last year had be at 50. This winter i dabbled in dosing every other day and believe I was at around 200mg-220 a week. when i got my bloods I was called and told I needed to immediately donate that I was at high risk of stroke due to my levels. They said hematocrit was 55 and hemo of 18.5. 2 weeks later i went to a hospital to get the phlebotomy. They did another quick test before they even did it and the nurse came out and goes looks good 48 and 16. I asked her what that was and she said hematocrit and hemoglobin. They did the donation and I honestly felt like crap for a few days. My provider wanted me to do another follow up blood test and I got it yesterday. I now have an email with another prescription for phlebotomy saying my hematocrit or hemoglobin is slightly elevated and I need another donation. Any idea how my hematocrit and hemoglobin could go from 55 and 18 to 48 and 16 in two weeks and how could it be high again. Sort of confused on what is going on here and how dangerous is this ?

I just replied to your PM and seeing as you are hitting a very high trough TT chances are your trough FT is high/absurdly high depending on TT/SHBG sits!

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

You need to know where your trough FT truly sits and in order to know such you would need to have it tested using the most accurate assay the gold standard Equilibrium Dialysis.

Otherwise you would need to use/rely upon the linear law-of-mass action Vermeulen (cFTV).

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