Trt and high red blood cell count

[Wilson7]

Been a long time since I posted here, HRT is something I'm pretty familiar with. Anyway, keep HCT <52%. Either donate if you're not on a 5ARI or get a therapeutic phlebotomy if you are. 500 ml of blood should drop your Hb by about 0.8 g/dl depending on your size, about 2.5% decrease in HCT. There is not enough data available yet on high HCT and stroke, DVT risk in healthy men on HRT. Guys in Denver on HCT may have HCTs close to 60% and do fine but I wouldn't push it and you can't compare secondary polycythemia from HRT to a disease like polycythemia vera. Not the same. You can't base dosing on erythrocytosis, everyone is different and it depends on the route of administration of T. Gels don't have near the effect the IM route does bc of the spike in blood T levels after an inj. The older you get, the more robust response you get relative to increase in Hb. Hepcidin produced in the liver (androgens suppress it increasing iron uptake) along with EPO production in the kidneys are the drivers. Often times you'll get robust erythrocytosis and blood levels of T averaging 400, not enough to even start to make a difference in how you feel. Stopping T for 30 days makes no sense and you'll feel like shit in about 2 weeks when T levels bottom out and not much will change with HCT in 4 weeks, figure out based on lab work how often you need to donate or get a phlebo at X dose of T to keep your HCT between 48 - 52 upper limit. I have to get 550 ml removed every 10 weeks. T dosing should be based on how you feel, not a number or variable side effect like RBC production that can be easily managed with blood removal.

 

[Hojo42701]

Been a long time since I posted here, HRT is something I'm pretty familiar with. Anyway, keep HCT <52%. Either donate if you're not on a 5ARI or get a therapeutic phlebotomy if you are. 500 ml of blood should drop your Hb by about 0.8 g/dl depending on your size, about 2.5% decrease in HCT. There is not enough data available yet on high HCT and stroke, DVT risk in healthy men on HRT. Guys in Denver on HCT may have HCTs close to 60% and do fine but I wouldn't push it and you can't compare secondary polycythemia from HRT to a disease like polycythemia vera. Not the same. You can't base dosing on erythrocytosis, everyone is different and it depends on the route of administration of T. Gels don't have near the effect the IM route does bc of the spike in blood T levels after an inj. The older you get, the more robust response you get relative to increase in Hb. Hepcidin produced in the liver (androgens suppress it increasing iron uptake) along with EPO production in the kidneys are the drivers. Often times you'll get robust erythrocytosis and blood levels of T averaging 400, not enough to even start to make a difference in how you feel. Stopping T for 30 days makes no sense and you'll feel like shit in about 2 weeks when T levels bottom out and not much will change with HCT in 4 weeks, figure out based on lab work how often you need to donate or get a phlebo at X dose of T to keep your HCT between 48 - 52 upper limit. I have to get 550 ml removed every 10 weeks. T dosing should be based on how you feel, not a number or variable side effect like RBC production that can be easily managed with blood removal.

Thank you


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