TRT effect on Thrombocytopenia and platelet counts

[jdthoosier]

When I started TRT roughly 10 years ago, I was diagnosed with Thrombocytopenia due to my low platelet counts. For the first few years of TRT my counts were around the 75-90 range consistently, where 150 is considered normal.

But since those first few years, my platelet counts have gradually improved. Late last year, my count was around 140, the highest ever.

What my PCP cannot figure out is why? Why would they gradually rise over time? Is it the TRT? Could it be changes in my diet? At the same time, all my other CBC numbers have been consistent. Only the platelets have been changing.

Any thoughts?

 

[FunkOdyssey]

I've had mild thrombocytopenia basically forever, with a count around 120-130 typically. I suspect it is some kind of minor autoimmune thing. TRT has had no effect on it so far.

 

[Nelson Vergel]

I found this.

Testosterone has been found to have complex effects on platelet function. Some studies suggest that testosterone and dihydrotestosterone reduce platelet activation and reactivity in older men and women, indicating an inhibitory action on blood platelets[1]. However, other research has demonstrated that testosterone increases human platelet thromboxane A2 receptor density, which may contribute to enhanced thrombus formation[2][3]. Additionally, physiological concentrations of testosterone have been shown to stimulate endothelial cell growth and inhibit platelet aggregation through its direct action on endothelial nitric oxide production[4]. Furthermore, testosterone administration has been associated with a significant increase in the platelet count[5]. These findings indicate that the relationship between testosterone and thrombocytopenia is complex and may involve multiple mechanisms.

Citations:
[1] Testosterone and dihydrotestosterone reduce platelet activation and reactivity in older men and women
[2] https://www.ahajournals.org/doi/full/10.1161/01.cir.91.11.2742
[3] Effects of Exogenous Androgens on Platelet Activity and Their Thrombogenic Potential in Supraphysiological Administration: A Literature Review
[4] https://joe.bioscientifica.com/downloadpdf/view/journals/joe/213/1/77.pdf
[5] https://onlinelibrary.wiley.com/doi/full/10.1111/andr.12834

 

[FunkOdyssey]

Furthermore, testosterone administration has been associated with a significant increase in the platelet count[5].

It does seem to increase platelet count but the magnitude is small and the increase appears to max out at a relatively low dose.

 

[jdthoosier]

Thanks for the replies. I would say my increase is fairly significant. I just hope it's not to my eventual detriment.

 

[FunkOdyssey]

Thanks for the replies. I would say my increase is fairly significant. I just hope it's not to my eventual detriment.

Well, you began with concerningly low levels that we label as the disease state of thrombocytopenia, and you now have levels that are just barely within the normal range at the low end. Idiopathic thrombocytopenia is often suspected to be autoimmune in nature. It seems possible to me that if TRT did affect your platelet count, it may have either cured you or suppressed a pathological immune reaction that was destroying your platelets. It is hard for me to imagine how that could be a detrimental effect.

 

[jdthoosier]

Well, you began with concerningly low levels that we label as the disease state of thrombocytopenia, and you now have levels that are just barely within the normal range at the low end. Idiopathic thrombocytopenia is often suspected to be autoimmune in nature. It seems possible to me that if TRT did affect your platelet count, it may have either cured you or suppressed a pathological immune reaction that was destroying your platelets. It is hard for me to imagine how that could be a detrimental effect.

Well that is interesting. There may be a bigger picture here. The whole TRT odyssey began when I started having digesting issues and lost nearly 30 pounds in a very short period of time. I was struggling to eat and sustain weight. After months of inconclusive tests, I was sent to a dietician who specialized in weight/eating issues. Her conclusion was that I had gluten intolerance or celiac. So I was started on a GF diet.

At the same time, a NP had the idea to test a number of things - including my hormone levels because I was clearly deteriorating mentally and physically. They found that my total TRT was dirt low - in the low 100's. So she started me on gels. The conclusion was that the sudden weight loss and inability to obtain adequate nutrition was the root cause of the low T.

It took probably 2 years but eventually I found Defy, dumped the gels and started injections and eventually got dialed in and felt great. About this time, my digestive system also started to return to some normal. I still adhere to a GF diet and do not cheat. I think the big benefit is that it forced me to consistently eat clean, as the dietician preached avoiding GF products and focusing on whole foods.

So I feel like all this was tied together in some way.