New Labs; High Hematocrit and High BP

[joetown2001]

I got my first full lab work done in almost 6 months, and got the results back today. For almost 7 weeks before these labs, I lowered my weekly dose from 100mg, to 84. I inject three times a week. This blood draw was done at a 49 hour trough after my last injection. You can see my total T has dropped, but it’s still good, the same with my free T. Since you’re dropping the dosage, I feel better, my mood is much better and I haven’t lost any strength in the gym or muscle mass. Actually feel a little leaner over the past month and a half or so.

Some of you chimed in on another thread I have going about my blood pressure and my struggle with medication right now. My BP shot up in August after I had contracted Covid. However, I suspected that my hematocrit was getting high, and was the main factor behind my rising blood pressure in November. I had a CBC draw done, but I feel like it’s not accurate because it was done in the late afternoon and I’ve been drinking a lot of water that day. On Friday when I had my blood drawn, I drank 20 ounces of water in the morning before I had my 830 labs done.

I know some of you are against giving blood and less absolutely necessary due to iron depletion, but I’m going to go give blood tomorrow afternoon. I scheduled an appointment with one blood before a huge snowstorm hits here in North Carolina and shuts everything down this weekend.

I’ve loved this site for giving me feedback, and people in the same or similar situations to bounce thoughts off of. I am currently on 40 mg of Telmisartan, but my dosages have been going up and down as me and my doctor have been trying to find a dosage that will control my BP. After I donate, I want to see what my BP will be without any medication in me. Also, the BP medicine has affected my erection quality and libido, even while taking 5 mg of daily Cialis and 6 grams of citrulline a day. I have been on TRT since the beginning of May, and I gave blood on Father’s Day weekend due to rising BP, and a hematocrit that was at 48.7 before I started therapy.

Would love to hear some of your guys’s thoughts and feedback, as I want to keep my dosage where it’s at right now because I feel a lot better. I just wanna get my BP under control possibly without meds, and get my libido and erection issues stabilized.

 

[WhiteMale]

51.5 is hardly worth being concerned over but you can be proactive and donate and be ahead of it and have your peace of mind. I do think Hydration to an extent can influence HCT values. Most likely not why your BP is high. I'd sure be taking more Arginine/Citrulline/Beet Root and drop that BP medication if at all possible.

You said 6mg of Citrulline which should be 6 GRAMS to be close an effective dose and I assume your mg is a typo as 6mg is worthless.

 

[joetown2001]

51.5 is hardly worth being concerned over but you can be proactive and donate and be ahead of it and have your peace of mind. I do think Hydration to an extent can influence HCT values. Most likely not why your BP is high. I'd sure be taking more Arginine/Citrulline/Beet Root and drop that BP medication if at all possible.

You said 6mg of Citrulline which should be 6 GRAMS to be close an effective dose and I assume your mg is a typo as 6mg is worthless.

It was a typo. I take 6 grams a day

 

[madman]

I got my first full lab work done in almost 6 months, and got the results back today. For almost 7 weeks before these labs, I lowered my weekly dose from 100mg, to 84. I inject three times a week. This blood draw was done at a 49 hour trough after my last injection. You can see my total T has dropped, but it’s still good, the same with my free T. Since you’re dropping the dosage, I feel better, my mood is much better and I haven’t lost any strength in the gym or muscle mass. Actually feel a little leaner over the past month and a half or so.

Some of you chimed in on another thread I have going about my blood pressure and my struggle with medication right now. My BP shot up in August after I had contracted Covid. However, I suspected that my hematocrit was getting high, and was the main factor behind my rising blood pressure in November. I had a CBC draw done, but I feel like it’s not accurate because it was done in the late afternoon and I’ve been drinking a lot of water that day. On Friday when I had my blood drawn, I drank 20 ounces of water in the morning before I had my 830 labs done.

I know some of you are against giving blood and less absolutely necessary due to iron depletion, but I’m going to go give blood tomorrow afternoon. I scheduled an appointment with one blood before a huge snowstorm hits here in North Carolina and shuts everything down this weekend.

I’ve loved this site for giving me feedback, and people in the same or similar situations to bounce thoughts off of. I am currently on 40 mg of Telmisartan, but my dosages have been going up and down as me and my doctor have been trying to find a dosage that will control my BP. After I donate, I want to see what my BP will be without any medication in me. Also, the BP medicine has affected my erection quality and libido, even while taking 5 mg of daily Cialis and 6 grams of citrulline a day. I have been on TRT since the beginning of May, and I gave blood on Father’s Day weekend due to rising BP, and a hematocrit that was at 48.7 before I started therapy.

Would love to hear some of your guys’s thoughts and feedback, as I want to keep my dosage where it’s at right now because I feel a lot better. I just wanna get my BP under control possibly without meds, and get my libido and erection issues stabilized.

You just lowered your dose 7 weeks ago and as you can see your TT, FT and estradiol have come down.

Your doctor/clinic is out to lunch when it comes to testing the most critical fraction free testosterone!

I would pay no attention to your results for FT as again you never had it tested using an accurate assay.

You are still using/relying on the known to be inaccurate direct immunoassay which no one should be using!

Need to have your FT tested using the gold standard Equilibrium Dialysis to know where it truly sits especially in cases of altered SHBG.

Otherwise you are just shooting in the dark here.

If we use the next best method the go to calculated linear law-of-mass action Vermeulen with your previous high-end trough TT 793 ng/dL, lowish SHBG 18.8 nmol/L and Albumin 4.3 g/dL your trough cFTV 23.6 ng/dL was high-end.

Your most recent labs has you hitting a robust healthy trough TT 659 ng/dl, lowish SHBG 20.6 nmol/L and Albumin 4.6 g/dL your 49 hr post-injection trough cFTV 17.5 ng/dL is healthy.

Keep in mind that your tested 49 hrs post-injection which is not your true trough.

You are injecting 3X weekly (M/W/F) so your true trough would be Monday morning (72 hrs) post-iinjection.

Top it all off that cFTV will give a good approximation but it tends to slightly overestimate FT so if you had your FT tested using the most accurate assay the gold standard ED it would most likely be a little lower than the cFTV 17.5 ng/dL.

Again this is 49 hrs post-injection so your true trough (72 hrs) post-injection would be a little lower.

Would not get too caught up on where your hematocrit sits as you just lowered your dose 7 weeks ago and although hematocrit should be coming down if you lowered your trough/steady-state FT it will take time to see where it truly ends up as the lifecycle RBCs is 120 days.

Way to early to jump the gun here especially when it comes to relief/improvement of low-T symptoms as you will need to give your body a few more months to adapt to its new set-point!

No harm in donating which you have already done but it is a dead end road for trying to manage elevated hematocrit as most end up crashing their iron/ferritin which can open up another can of worms.

Have you finally taken action on testing for OSA?

Something that needs to be addressed here otherwise it will be a constant struggle especially when it comes to how you feel overall and as you should very well know by know lack of quality sleep can wreak havoc on ones libdio/erctile function!

Throw elevated BP in there too!

Post in thread 'First set of Follow Up Labs since Starting TRT. Looking for Feedback'

Jul 16, 2025

So I just got back my first follow up labs since starting TRT a little over two months ago. I was pretty pleased for the most part, as a lot of my numbers improved from a non-hormone standpoint. I was happy to see the drop in my hematocrit, and a lot of that has to do is me stopping iron supplements for a hemorrhoid bleed that I had. I believe those numbers were just elevated with my initial labs because I have been taking supplements for a long time.

I have been suffering from some mild prostate discomfort and inflammation off and on, and I was happy to see that it was not...

• madman

• 

 

[joetown2001]

You just lowered your dose 7 weeks ago and as you can see your TT, FT and estradiol have come down.

Your doctor/clinic is out to lunch when it comes to testing the most critical fraction free testosterone!

I would pay no attention to your results for FT as again you never had it tested using an accurate assay.

You are still using/relying on the known to be inaccurate direct immunoassay which no one should be using!

Need to have your FT tested using the gold standard Equilibrium Dialysis to know where it truly sits especially in cases of altered SHBG.

Otherwise you are just shooting in the dark here.

If we use the next best method the go to calculated linear law-of-mass action Vermeulen with your previous high-end trough TT 793 ng/dL, lowish SHBG 18.8 nmol/L and Albumin 4.3 g/dL your trough cFTV 23.6 ng/dL was high-end.

Your most recent labs has you hitting a robust healthy trough TT 659 ng/dl, lowish SHBG 20.6 nmol/L and Albumin 4.6 g/dL your 49 hr post-injection trough cFTV 17.5 ng/dL is healthy.

Keep in mind that your tested 49 hrs post-injection which is not your true trough.

You are injecting 3X weekly (M/W/F) so your true trough would be Monday morning (72 hrs) post-iinjection.

Top it all off that cFTV will give a good approximation but it tends to slightly overestimate FT so if you had your FT tested using the most accurate assay the gold standard ED it would most likely be a little lower than the cFTV 17.5 ng/dL.

Again this is 49 hrs post-injection so your true trough (72 hrs) post-injection would be a little lower.

Would not get too caught up on where your hematocrit sits as you just lowered your dose 7 weeks ago and although hematocrit should be coming down if you lowered your trough/steady-state FT it will take time to see where it truly ends up as the lifecycle RBCs is 120 days.

Way to early to jump the gun here especially when it comes to relief/improvement of low-T symptoms as you will need to give your body a few more months to adapt to its new set-point!

No harm in donating which you have already done but it is a dead end road for trying to manage elevated hematocrit as most end up crashing their iron/ferritin which can open up another can of worms.

Have you finally taken action on testing for OSA?

Something that needs to be addressed here otherwise it will be a constant struggle especially when it comes to how you feel overall and as you should very well know by know lack of quality sleep can wreak havoc on ones libdio/erctile function!

Throw elevated BP in there too!

Post in thread 'First set of Follow Up Labs since Starting TRT. Looking for Feedback'

Jul 16, 2025

So I just got back my first follow up labs since starting TRT a little over two months ago. I was pretty pleased for the most part, as a lot of my numbers improved from a non-hormone standpoint. I was happy to see the drop in my hematocrit, and a lot of that has to do is me stopping iron supplements for a hemorrhoid bleed that I had. I believe those numbers were just elevated with my initial labs because I have been taking supplements for a long time.

I have been suffering from some mild prostate discomfort and inflammation off and on, and I was happy to see that it was not...

• madman

• 

Thanks for your detailed feedback as always. Believe me, I don’t want to be donating blood very often, and my goal with this donation is to get my hematocrit down to a good level in the 40s, and then try to address the possibility of having obstructive sleep apnea. I’m going to see my primary care doctor, hopefully next week weather pending. I’m trying to get a sleep study scheduled. I had one about seven years ago, and the result came back that I do not have sleep apnea. Of course I know things can change, so I’d like to have another one.

I’m also thinking about going to injecting every other day, instead of Monday, Wednesday Friday. I have noticed the last couple Sundays that I haven’t felt as good as I felt in the past on Sundays. First things first, I want to get my blood pressure under control. I do have the wheels in motion on dealing with all the things that you mentioned in your post, thank you.