Metformin decreases high hematocrit

[BlatantDisregard]

So I will get my labs drawn this week but I've come across something that seems worth asking about. Now my current protocol of TRT has made my hematocrit go high, average around 54-56 range. So I was going for my therapeutic phlebotomy a week before my labs and was told my hematocrit was at 46. The only thing that I've done differently is I started to take metformin 6 weeks ago at only 1,000 mg a day. After a few quick google searches it looks like metformin can lower hematocrit as a side effect.

i was wondering if anyone has any experience with this or done any in depth research. I'll post my full labs when I get them next week.

 

[Vince]

I've never heard that metformin can lower hematocrit, and I wasn't able to find any studies on it either. Hopefully someone will chime in.

 

[Vince Carter]

Interesting...if that's true it can make a lot of our lives so much easier with this very common side effect.

 

[BlatantDisregard]

Yes but it's a bit concerning as some of the search results returned as metformin and anemia. But I'm hoping that would be only if things went unchecked.

 

[Vince]

Metformin been around forever, it's a very benign drug. The only side effect that I know, risk of vitamin B12 deficiency, so I have my levels checked.

 

[Hoosier52]

A natural form of Metaformin is berberine. Wonder if it has the same effects on hematocrit. Mine is high but I live at a mile high elevation.

 

[Vince]

We have some members and threads on Berberine, I'm not a fan of Berberine. But if it works for you, I would use it.

 

[Hoosier52]

We have some members and threads on Berberine, I'm not a fan of Berberine. But if it works for you, I would use it.

I not using Berberine but am researching it. What do you see wrong with it? If it does what Metaformin does for HCT levels, I would probably try it. But. Dr. Crisler's comments on HCT tell me it may not be a big deal. Dr. Saya and I discussed my levels and he agreed that high altitude has an impact and that athletes train at high altitudes to increase their performance. Kinda hard to see how it could be good for an athlete and bad for a TRT user.

 

[Nelson Vergel]

Diabetes Care. 2012 Apr;35(4):731-7. doi: 10.2337/dc11-1299.

Long-term safety, tolerability, and weight loss associated with metformin in the Diabetes Prevention Program Outcomes Study.
Diabetes Prevention Program Research Group
Collaborators

Author information

Abstract

OBJECTIVE:
Metformin produced weight loss and delayed or prevented diabetes in the Diabetes Prevention Program (DPP). We examined its long-term safety and tolerability along with weight loss, and change in waist circumference during the DPP and its long-term follow-up.

RESEARCH DESIGN AND METHODS:
The randomized double-blind clinical trial of metformin or placebo followed by a 7-8-year open-label extension and analysis of adverse events, tolerability, and the effect of adherence on change in weight and waist circumference.

RESULTS:
No significant safety issues were identified. Gastrointestinal symptoms were more common in metformin than placebo participants and declined over time. During the DPP, average hemoglobin and hematocrit levels were slightly lower in the metformin group than in the placebo group. Decreases in hemoglobin and hematocrit in the metformin group occurred during the first year following randomization, with no further changes observed over time. During the DPP, metformin participants had reduced body weight and waist circumference compared with placebo (weight by 2.06 ± 5.65% vs. 0.02 ± 5.52%, P < 0.001, and waist circumference by 2.13 ± 7.06 cm vs. 0.79 ± 6.54 cm, P < 0.001 in metformin vs. placebo, respectively). The magnitude of weight loss during the 2-year double-blind period was directly related to adherence (P < 0.001). Throughout the unblinded follow-up, weight loss remained significantly greater in the metformin group than in the placebo group (2.0 vs. 0.2%, P < 0.001), and this was related to the degree of continuing metformin adherence (P < 0.001).

CONCLUSIONS:
Metformin used for diabetes prevention is safe and well tolerated. Weight loss is related to adherence to metformin and is durable for at least 10 years of treatment.

 

[djpreef]

I not using Berberine but am researching it. What do you see wrong with it? If it does what Metaformin does for HCT levels, I would probably try it. But. Dr. Crisler's comments on HCT tell me it may not be a big deal. Dr. Saya and I discussed my levels and he agreed that high altitude has an impact and that athletes train at high altitudes to increase their performance. Kinda hard to see how it could be good for an athlete and bad for a TRT user.

I tried Berberine at my doctor's recommendation for something else. It was so hard on my stomach that I gave up on it.

 

[BlatantDisregard]

Thanks Nelson! I guess another reason I'm glad I gave metformin a try.

 

[Philthethrill]

Is this only for people with Diabetes??

 

[Hoosier52]

Would doctors prescribe Metaformin for high Hematocrit?

 

[GA8314]

Most Dr's will hardly Rx the med for people with strong family Hx of DM and fasting BG in the 90's (just Pre Pre-Diabetes) which is what the study that Nelson linked suggests is safe and effective. So, I am quite sure you will not find too many (and the data doesn't support it even) who would Rx it for polycythemia.

 

[Hoosier52]

Most Dr's will hardly Rx the med for people with strong family Hx of DM and fasting BG in the 90's (just Pre Pre-Diabetes) which is what the study that Nelson linked suggests is safe and effective. So, I am quite sure you will not find too many (and the data doesn't support it even) who would Rx it for polycythemia.

My dad and grandfather both had Type 2 diabetes.

 

[Vince]

You could consider buying metformin without a script, but remember to have proper labs. https://www.excelmale.com/forum/showthread.php?4002-where-to-buy-metformin-without-a-script

 

[Hoosier52]

Just had my consult with Jill from Defy. My A1c test shows that I in the range of prescribing Metaformin. She will pass the info on to Dr. Saya and it will be up to him. If approved, I'm anxious to see if it will lower my hematocrit.

 

[GA8314]

Guys, I really think that relying on Metformin to lower TRT associated polycythemia is overstreaching a bit. Metformin is a great drug, but if you need to control Hct, then phlebotomy seems like a reasonable and safe way to do it. God bless you if you want to try, but I would not get my hopes up.

 

[webaj]

Did your doc write script for phlebotomy? Did insurance cover it? Trying to convince my doc to. He wants me to get off TRT.
ugh

 

[Vince Carter]

Did your doc write script for phlebotomy? Did insurance cover it? Trying to convince my doc to. He wants me to get off TRT.
ugh

There's no need to do any of that when the Red Cross and any other blood bank will take your blood, for free. Assuming you're eligible to donate. Last I knew, with a script, blood banks will do a phlebotomy but charge you $30-60 (or more) each time.