Very Scary Situation

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Avidtrainer

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I had a very concerning experience recently and I hope someone out there can offer some ideas. My doctor sent me for a phlebotomy to avoid a high hematocrit level since I'm on TRT. My hematocrit level was 48.8 but he wanted me to go as a precaution before it creeped up past the normal level. I go once a year. He advised me to keep going until the hemoglobin level was at 15.5. Last year it was down to 15.5 after three phlebotomies and I stopped. This year I had four phlebotomies within 22 days and the hemoglobin level didn't change. My doctor advised me to keep going until the level was down to 15.5. After the fourth phlebotomy which took four pints of blood in 22 days I was feeling weak and sick and knew something was not right so I went online and did a little research. I found that I gave 40% of my total blood volume in 22 days and if I had given that much all at once it could have been fatal.


I was very upset so contacted my doctor. He said that plasma replaces itself in 24-48 hours and that is what is crucial. Had I lost that much plasma all at once then there would have been a problem. He said red blood cells take about four weeks to regenerate and the only danger there would be that I would feel lethargic. So I went back to the blood bank a fifth time. This time I wasn't going to give blood no matter what the hemoglobin level was, I was just curious if the level had changed. This time it had plummeted to 14.3. My doctor could offer no answer why the level stayed the same after four pints of blood were taken then suddenly plummeted except that the blood bank had faulty equipment or the phlebotomists didn't run the test correctly. I contacted the blood bank about this and of course they denied having faulty equipment or employees who didn't know how to perform the test. The blood bank said they only allow an individual to give blood once every 56 days and the only reason they took four pints from me in 22 days was because I had an order from a doctor asking for that.


I know these phlebotomies are necessary but I don't want to go through the hell next year that I went through this year. If anyone has any idea how this could have happened and how to avoid it next year please let me know. Thank you.
 
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Nelson Vergel

Founder, ExcelMale.com
Avidtrainer

In my 25 years working in this field, I have never seen anyone give as much blood as you. Frequent phlebotomies deplete ferritin and iron, and it may take weeks to get them to normalize. Low ferritin and iron cause severe fatigue. It does not improve in 2 weeks on their own.

You started a low hematocrit level which made matters worse.

Management of excessive red cell production caused by TRT is NOT done based on hemoglobin but on the amount of red blood cells in your blood. The cut off many doctors use is 52 to trigger need for phlebotomy. At this level, you should only donate 1 unit of blood per month until your hematocrit is down to 48 (your starting value!).

Do not get discouraged. You may want to take iron and vitamin C supplements to normalize your ferritin and iron and stop when they are normalized. You can have your doctor check them or use DiscountedLabs.com

Most guys do not need more than 3 phlebotomies a year. And the good thing is that hematocrit may stabilize after that.
 
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Avidtrainer

New Member
Nelson, thanks so much for your reply. I'm going to send you a private message on facebook with some further details I believe you may be interested in.
 
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