Elevated Hematocrit (erythrocytosis)
People are asking...
When we're talking H&H, where does you cutoff fall for discontinuation of therapy? There is a lot of debate around secondary vs primary causes of eryt...
There shouldn't be a cut off if you are requiring therapeutic phlebotomy and doing so. If you're not doing it and you're getting into the mid and high fifties with your hematocrit we should just have ... See Full Answer
Could switching to testosterone propionate help with lowering hematocrit, because of the short ester?...
Potentially. Normally endogenous testosterone levels peak in the early morning and drop 30% by late afternoon. This means that in the morning, erythropoietin (EPO) levels are stimulated and released, ... See Full Answer
I've been on 120ml/ week test c for about a year. Once I got through initial phase, all has been well except my hematocrit has been very high. The las...
Options to control hematocrit elevations/erythrocytosis on TRT are relatively limited. Lower TRT doses do sometimes help lower the red blood cell count. But if you are in the 3-5% of men who develop h... See Full Answer
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The most frequently reported adverse reaction to testosterone replacement therapy is erythrocytosis, an abnormal elevation of hemoglobin (greater than 18.5 g/dL) or hematocrit (greater than 52%). However, no studies to date have demonstrated a link between testosterone replacement therapy-induced erythrocytosis and cardiovascular (CV) events or venous thromboembolism (VTE or “blood clots”).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346330/
Testosterone therapy is the cornerstone in the care of men with hypogonadism and transgender males. Gel and intramuscular injections are most frequently used and are registered and included in the international guidelines. The specific preparation should be selected according to the patient’s preference, cost, availability, and formulation-specific properties. As the majority of men with hypogonadism and transgender males require lifelong treatment with testosterone, it is important to utilize a regimen that is effective, safe, inexpensive, and convenient to use with optimal mimicking of the physiological situation. This systematic review reviews current literature on differences between the three most used testosterone preparations in adult men with hypogonadism and transgender males. Although it appeared hardly any comparative studies have been carried out, there are indications of differences between the preparations, for example, on the stability of testosterone levels, hematocrit, bone mineral density, and patient satisfaction. However, there are no studies on the effects of testosterone replacement on endpoints such as cardiovascular disease in relation to hematocrit or osteoporotic fractures in relation to bone mineral density. The effect of testosterone therapy on health-related quality of life is strongly underexposed in the reviewed studies, while this is a highly relevant outcome measure from a patient perspective. In conclusion, current recommendations on testosterone treatment appear to be based on data primarily from non-randomized clinical studies and observational studies. The availability of reliable comparative data between the different preparations will assist in the process of individual decision-making to choose the most suitable formula.
Have a question? Ask us.
At AlphaMD, we're here to help. Feel free to ask us any question you would like about TRT, medical weightloss, ED, or other topics related to men's health. Or take a moment to browse through our past questions.
People are asking...
When we're talking H&H, where does you cutoff fall for discontinuation of therapy? There is a lot of debate around secondary vs primary causes of eryt...
There shouldn't be a cut off if you are requiring therapeutic phlebotomy and doing so. If you're not doing it and you're getting into the mid and high fifties with your hematocrit we should just have ... See Full Answer
Could switching to testosterone propionate help with lowering hematocrit, because of the short ester?...
Potentially. Normally endogenous testosterone levels peak in the early morning and drop 30% by late afternoon. This means that in the morning, erythropoietin (EPO) levels are stimulated and released, ... See Full Answer
I've been on 120ml/ week test c for about a year. Once I got through initial phase, all has been well except my hematocrit has been very high. The las...
Options to control hematocrit elevations/erythrocytosis on TRT are relatively limited. Lower TRT doses do sometimes help lower the red blood cell count. But if you are in the 3-5% of men who develop h... See Full Answer
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