Phlebotomy frequency to reduce Hemoglobin numbers

TheDude · Dec 31, 2020

Went to donate the other day and my hemoglobin was 20.3. They didn’t let me donate. They recommended I get doctor’s orders to do therapeutic phlebotomies weekly until my numbers were within range then go back to doing bi-monthly or quarterly donations. Anyone else had to do this?

madman · Dec 31, 2020

TheDude said:
Went to donate the other day and my hemoglobin was 20.3. They didn’t let me donate. They recommended I get doctor’s orders to do therapeutic phlebotomies weekly until my numbers were within range then go back to doing bi-monthly or quarterly donations. Anyone else had to do this?

Therapeutic Phlebotomy (oregon) - Excel Male Health Forum

I can’t find anywhere to do therapeutic phlebotomy in Oregon. I tried donating blood yesterday but my hemoglobin was 21... that’s like 63 hematocrit. Because it’s so high I went to the walk-in clinic at the hospital where my PCP works. They saw me and all they did was try lecturing me on the...

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The only way to know where your hemoglobin/hematocrit truly sit on such protocol (dose T/injection frequency) is lab work as I would not rely on the finger prick test.

They tend to overestimate.

Regardless your hemoglobin was 20.3 even if that is overestimated your levels would still most likely be high (labs).

What is your trt protocol (dose T/injection frequency) and where does your trough TT/FT level sit.

If you find that you are constantly struggling to manage elevated hematocrit on such protocol then depending on where your trough FT sits you may very well need to lower your T dose slightly if your FT level is too high.

Otherwise, you are going to be stuck on that merry-go-round caught upon donating too frequently which will be a surefire way to crash your ferritin/iron which can lead to many other issues.

madman · Dec 31, 2020

Post up your protocol/most recent labs?

TheDude · Dec 31, 2020

20 mg Test and 20 mg of Nandrolone daily.
500 IU HCG twice weekly
2 clicks of Test cream to scrotum daily

Last labs were from August.
1210 Total Test
19.2 Free T
52 DHT

Hemoglobin at that time was 18.6 and I donated blood at that time.

madman · Dec 31, 2020

TheDude said:
20 mg Test and 20 mg of Nandrolone daily.
500 IU HCG twice weekly
2 clicks of Test cream to scrotum daily

Last labs were from August.
1210 Total Test
19.2 Free T
52 DHT

Hemoglobin at that time was 18.6 and I donated blood at that time.

Looking over your previous threads you have low SHBG and with a TT in the 1200s your FT let alone e2/free e2 would be high.

Not sure where your FT level truly sits as you did not post reference range let alone the testing method used?

You would need to have your FT tested using an accurate assay (Equilibrium Dialysis or Ultrafiltration) to know where your FT level truly.

I would not rely on the direct or calculated linear law-of-mass action as they can over/underestimate.

Would put money on it that your FT level is too high as you are running a TT 1200 ng/dL on dailies.

Why the 140 mg/week dose of ND?

50-100 mg/week ND is the dose prescribed for joint pain.

Going above such is not needed.

madman · Dec 31, 2020

Even then if one is adding ND to a protocol then you should be testing TT using (LC/MS-MS) and FT using (Equilibrium Dialysis or Ultrafiltration).

TheDude · Dec 31, 2020

25 is the high limit on the Free T.

ive just been going off what Defy recommended.

madman · Dec 31, 2020

TheDude said:
20 mg Test and 20 mg of Nandrolone daily.
500 IU HCG twice weekly
2 clicks of Test cream to scrotum daily

Last labs were from August.
1210 Total Test
19.2 Free T
52 DHT

Hemoglobin at that time was 18.6 and I donated blood at that time.

This is 4 months ago you need labs as of now to know where your TT/FT/e2 levels sit let alone FT needs to be tested using Equilibrium Dialysis or Ultrafiltration.

madman · Dec 31, 2020

TheDude said:
25 is the high limit on the Free T.

ive just been going off what Defy recommended.

This is most likely piss poor direct immunoassay from Labcorp reference range 8.7-25.1 pg/mL.

Definitely would not rely on this assay when it comes to FT.

Your SHBG is low and again with a TT 1200 ng/dL, you can rest assured that your FT/e2/free e2 is high.

Retest using Equilibrium Dialysis or Ultrafiltration and you will see where it truly sits.

madman · Dec 31, 2020

TheDude said:
20 mg Test and 20 mg of Nandrolone daily.
500 IU HCG twice weekly
2 clicks of Test cream to scrotum daily

Last labs were from August.
1210 Total Test
19.2 Free T
52 DHT

Hemoglobin at that time was 18.6 and I donated blood at that time.

Clear as the day your hemoglobin is high which means hematocrit is high due to high FT and that is on daily injections yet you are caught up on this donating merry-go-round to control it!

madman · Dec 31, 2020

TheDude said:
25 is the high limit on the Free T.

ive just been going off what Defy recommended.

You have been on this forum since 2017 yet you are still testing FT using the piss poor inaccurate direct immunoassay?

madman · Dec 31, 2020

TheDude said:
20 mg Test and 20 mg of Nandrolone daily.
500 IU HCG twice weekly
2 clicks of Test cream to scrotum daily

Last labs were from August.
1210 Total Test
19.2 Free T
52 DHT

Hemoglobin at that time was 18.6 and I donated blood at that time.

These labs are old and I would get them done again using accurate assays as you need to know where your FT level truly sits on your current protocol.

This is critical!

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