Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 About 6 to 12 months ago there was a discussion about hematocrit in this group. I did a medline search which indicated that raising T to supraphysiologic levels (i.e., over the top of the normal range) causes elevated hematocrit, but restoration of T to normal levels with TRT does not cause elevated hematocrit. TRT and Hematocrit > > > I've been on TRT for several years. About a year ago I went from > using Testoderm, no longer available, to 2 packets of AndroGel per > day (5g equivalent T). > > At an " annual physical " in November 2004 it was shown that my > hematocrit had risen to 55% from a baseline over the years of around > 50. My PCP flipped out and sent me to a hematologist/oncologist. > Hematologist almost immediately decided that I have " polycythemia > vera, " which can be pretty serious. The radiologist who interpreted > the bone marrow biopsy disagreed, having the opinion that the > condition was " reactive, " that is, a reaction of the body > to " something. " > > I started to wonder, what could that " something " be? I take a > number of prescription drugs, for hypertension, hyperlipidemia, ED, > as well as low testosterone. The hematologist said she " supposed " > she could look up the known side effects of all of these, but gave > the impression that it would be beneath her to go to that trouble. > > Did an internet search and came up with the following: > > " Testosterone stimulates the bone marrow production of erythrocytes. > The result is an increased hematocrit in some men, with the > possibility of hyperviscosity side effects (63). The hematocrit > should be determined every 6 months for the first 18 months and then > yearly thereafter if it is stable and normal. Testosterone therapy > should be decreased or discontinued if the hematocrit increases to > above 50%. " This is from the ever-popular " AACE Guidelines. " > > Neither the pcp nor the hematologist seem to have the slightest > awareness of this. > > Am wondering if other members of this forum have run into the > hematocrit problem, how high the numbers got, what actions were > taken, and what was the resolution of the problem. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 On Fri, 18 Feb 2005 10:42:05 -0500, you wrote: > > >About 6 to 12 months ago there was a discussion about hematocrit in this >group. I did a medline search which indicated that raising T to >supraphysiologic levels (i.e., over the top of the normal range) causes >elevated hematocrit, but restoration of T to normal levels with TRT does >not cause elevated hematocrit. But TRT does raise levels. 50% was already a high end of normal. Any increase at all would put this fellow quite high. Some of us give blood regularly to deal with this issue. That may help. - - - - Just another albino black sheep Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 > >About 6 to 12 months ago there was a discussion about hematocrit in this > >group. I did a medline search which indicated that raising T to > >supraphysiologic levels (i.e., over the top of the normal range) causes > >elevated hematocrit, but restoration of T to normal levels with TRT does > >not cause elevated hematocrit. > > > But TRT does raise levels. The studies I've seen show that T shots raise the risk of excess hematocrit, but gels/creams & patches don't. The interpretation I've seen for this result is that shots produce supraphysiologic T levels. Theorectically gels/creams could do the same if used in excess. > 50% was already a high end of normal. Any > increase at all would put this fellow quite high. Good point. Although we don't know what " baseline " means. Was that before TRT? If so, that indicates some other cause that should be investigated. > Some of us give blood regularly to deal with this issue. That may > help. Good suggestion. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 On Fri, 18 Feb 2005 12:27:41 -0500, you wrote: >> But TRT does raise levels. > >The studies I've seen show that T shots raise the risk of excess >hematocrit, but gels/creams & patches don't. The interpretation I've >seen for this result is that shots produce supraphysiologic T levels. >Theorectically gels/creams could do the same if used in excess. Androgel raised my hematocrit about 5 points. - - - - Just another albino black sheep Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 Hi, Yes the TRT is causing it to go up. I receive hormone pellet therapy which provides very constant amounts of T dissolving from the crystaline pellets and the body tolerates this additional T very well. With other forms of therapy the body sees a daily or weekly spurt of T added to the system and frequently the body's hormone regulation system kicks in and causes some reaction to the T ramping up. It can also cause the conversion of T to E2 which several here have mentioned as a bad experience. I get checked every 4 months when I get new pellets and giving blood is one way of bringing it down. My level has never been a problem. ernestnolan > > I've been on TRT for several years. About a year ago I went from > using Testoderm, no longer available, to 2 packets of AndroGel per > day (5g equivalent T). > > At an " annual physical " in November 2004 it was shown that my > hematocrit had risen to 55% from a baseline over the years of around > 50. My PCP flipped out and sent me to a hematologist/oncologist. > Hematologist almost immediately decided that I have " polycythemia > vera, " which can be pretty serious. The radiologist who interpreted > the bone marrow biopsy disagreed, having the opinion that the > condition was " reactive, " that is, a reaction of the body > to " something. " > > I started to wonder, what could that " something " be? I take a > number of prescription drugs, for hypertension, hyperlipidemia, ED, > as well as low testosterone. The hematologist said she " supposed " > she could look up the known side effects of all of these, but gave > the impression that it would be beneath her to go to that trouble. > > Did an internet search and came up with the following: > > " Testosterone stimulates the bone marrow production of erythrocytes. > The result is an increased hematocrit in some men, with the > possibility of hyperviscosity side effects (63). The hematocrit > should be determined every 6 months for the first 18 months and then > yearly thereafter if it is stable and normal. Testosterone therapy > should be decreased or discontinued if the hematocrit increases to > above 50%. " This is from the ever-popular " AACE Guidelines. " > > Neither the pcp nor the hematologist seem to have the slightest > awareness of this. > > Am wondering if other members of this forum have run into the > hematocrit problem, how high the numbers got, what actions were > taken, and what was the resolution of the problem. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 > >> But TRT does raise levels. > > > > The studies I've seen show that > > T shots raise the risk of excess > > hematocrit, but gels/creams & patches > > don't. The interpretation I've > > seen for this result is that shots produce > > supraphysiologic T levels. > >Theorectically gels/creams could do > > the same if used in excess. > > Androgel raised my hematocrit about 5 points. How high did your T go? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 Here is a good link on CBC. http://www.lymphomation.org/CBC-blood-counts.htm Phil retrogrouch@... wrote: On Fri, 18 Feb 2005 12:27:41 -0500, you wrote: >> But TRT does raise levels. > >The studies I've seen show that T shots raise the risk of excess >hematocrit, but gels/creams & patches don't. The interpretation I've >seen for this result is that shots produce supraphysiologic T levels. >Theorectically gels/creams could do the same if used in excess. Androgel raised my hematocrit about 5 points. - - - - Just another albino black sheep --------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 I have had a high hematorit as long as I have been on TRT with all the gels, patches and shots and I have to watch my red blood cell count, I have a simple test done at the lab to see if I need to have some taken off, I do this every month and sometimes it gets rather high around 60, that high they take off two bottles 55 to 58 one bottle, when red cross comes to town I give to them so far I am close to a three gallon donor in about 7 years. My DR says it is a trade off stop TRT and you all know what that does, giving blood to the red cross is much needed due to the war, stopping TRT is not a option for me by any means. Lynn Re: TRT and Hematocrit > > Here is a good link on CBC. > http://www.lymphomation.org/CBC-blood-counts.htm > Phil > > retrogrouch@... wrote: > On Fri, 18 Feb 2005 12:27:41 -0500, you wrote: > >>> But TRT does raise levels. >> >>The studies I've seen show that T shots raise the risk of excess >>hematocrit, but gels/creams & patches don't. The interpretation I've >>seen for this result is that shots produce supraphysiologic T levels. >>Theorectically gels/creams could do the same if used in excess. > > > Androgel raised my hematocrit about 5 points. > > - - - - > Just another albino black sheep > > > > --------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 Very interesting, Lynn. Some references seem to imply that HCT of 60 would in and of itself be strong evidence of Polycythemia Vera. Has PV been clearly ruled out by the physicians managing your case? Thanks Lynn <ssp@...> wrote: I have had a high hematorit as long as I have been on TRT with all the gels, patches and shots and I have to watch my red blood cell count, I have a simple test done at the lab to see if I need to have some taken off, I do this every month and sometimes it gets rather high around 60, that high they take off two bottles 55 to 58 one bottle, when red cross comes to town I give to them so far I am close to a three gallon donor in about 7 years. My DR says it is a trade off stop TRT and you all know what that does, giving blood to the red cross is much needed due to the war, stopping TRT is not a option for me by any means. Lynn Re: TRT and Hematocrit > > Here is a good link on CBC. > http://www.lymphomation.org/CBC-blood-counts.htm > Phil > > retrogrouch@... wrote: > On Fri, 18 Feb 2005 12:27:41 -0500, you wrote: > >>> But TRT does raise levels. >> >>The studies I've seen show that T shots raise the risk of excess >>hematocrit, but gels/creams & patches don't. The interpretation I've >>seen for this result is that shots produce supraphysiologic T levels. >>Theorectically gels/creams could do the same if used in excess. > > > Androgel raised my hematocrit about 5 points. > > - - - - > Just another albino black sheep > > > > --------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2005 Report Share Posted February 18, 2005 I did all the specialist DR' s with out a conclusive answer from any of them, I gave up on all that and now do the shots 100mg a week instead of 200 or 300mg every two weeks and this has helped allot with the red blood cell count seems the the higher rate of the shots gives me more of a increase in the count. I am going in for a test today and will post here what I find, has been two months sense the last donation so I best see this post reminded me thanks. Re: TRT and Hematocrit > > >> >> Here is a good link on CBC. >> http://www.lymphomation.org/CBC-blood-counts.htm >> Phil >> >> retrogrouch@... wrote: >> On Fri, 18 Feb 2005 12:27:41 -0500, you wrote: >> >>>> But TRT does raise levels. >>> >>>The studies I've seen show that T shots raise the risk of excess >>>hematocrit, but gels/creams & patches don't. The interpretation I've >>>seen for this result is that shots produce supraphysiologic T levels. >>>Theorectically gels/creams could do the same if used in excess. >> >> >> Androgel raised my hematocrit about 5 points. >> >> - - - - >> Just another albino black sheep >> >> >> >> --------------------------------- >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 19, 2005 Report Share Posted February 19, 2005 On Fri, 18 Feb 2005 14:33:46 -0500, you wrote: >> >> But TRT does raise levels. >> > >> > The studies I've seen show that >> > T shots raise the risk of excess >> > hematocrit, but gels/creams & patches >> > don't. The interpretation I've >> > seen for this result is that shots produce >> > supraphysiologic T levels. >> >Theorectically gels/creams could do >> > the same if used in excess. >> >> Androgel raised my hematocrit about 5 points. > >How high did your T go? 1100, I cut back to 750. But the hematocit has stayed up. For me its only about 49 though. - - - - Just another albino black sheep Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 19, 2005 Report Share Posted February 19, 2005 <snip> I was told I had poly 5 years ago. At that time I had severe head & muscle aches. My level was 59. I was weak & sleepy all the time. I was on the patch & had not donated blood for over 6 months. I was told that the body needs red blood cells to get Oxygen to the body cells, if not enough O2 is getting to the body cells, more red are produced, the blood gets thicker so less O2 gets to the body cells & it produces more red blood cells. Catch 22. This continues until the blood get so thick it can not get to the brain & a stroke is produced. I was within a few hours of that stroke. I lost a lot of brain cells during those last few months. I had to change jobs. I can no longer visualize in 3-D & rotate objects in my head to see all views of it along with multi-tasking thoughts. I lost about 30 IQ points. I was a automation software designer. I can not even write computer software any more in any of the 7 computer languages that I had used before. But my sex life is much better now & I feel thankful each morning that I get out of bed. Afte they drained, sucked out, one pint of the thick blood I felt better. The head & musclw aches were gone after a 1/2 pint was sucked out. It was not a fluid, it was a stringy stuff that clumped to the sides of the jar they squirted it in. Then a pint every 2 weeks for a while, then a pint every month, now I just donate a pint to the Red Cross every 2 months. I stay in the upper end of the " normal " range now. I also changed to AndroGel when it was discovered, I now use a compounded 2% testosterone gel. It is about 1/5 the price. I get the Red Blood Cell count blood test every 6 months. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 19, 2005 Report Share Posted February 19, 2005 My red blood cell count last night at the lab was 54.6 after two months and she drew a bottle off, one thing about giving to red cross is they do a cell count before donating just ask for the number. I do not think our high hematocrit is poly however it is a form of it as poly is a disease that is not curable ours is caused by TRT, the red cross will not take blood if you have poly. I explained to the head nurse what caused mine and she said that was not the same as poly so I am able to donate. I live in Idaho at a high altitude and that seems to add to it too. If more on here has had this happen to them please speak up we need to compare notes about it. Lynn Re: TRT and Hematocrit > > > <snip> > > I was told I had poly 5 years ago. At that time I had severe head & > muscle aches. My level was 59. I was weak & sleepy all the time. I > was on the patch & had not donated blood for over 6 months. > > I was told that the body needs red blood cells to get Oxygen to the > body cells, if not enough O2 is getting to the body cells, more red > are produced, the blood gets thicker so less O2 gets to the body > cells & it produces more red blood cells. Catch 22. This continues > until the blood get so thick it can not get to the brain & a stroke > is produced. I was within a few hours of that stroke. I lost a lot > of brain cells during those last few months. > > I had to change jobs. I can no longer visualize in 3-D & rotate > objects in my head to see all views of it along with multi-tasking > thoughts. I lost about 30 IQ points. I was a automation software > designer. I can not even write computer software any more in any of > the 7 computer languages that I had used before. > > But my sex life is much better now & I feel thankful each morning > that I get out of bed. > > Afte they drained, sucked out, one pint of the thick blood I felt > better. The head & musclw aches were gone after a 1/2 pint was sucked > out. It was not a fluid, it was a stringy stuff that clumped to the > sides of the jar they squirted it in. Then a pint every 2 weeks for > a while, then a pint every month, now I just donate a pint to the Red > Cross every 2 months. I stay in the upper end of the " normal " range > now. > > I also changed to AndroGel when it was discovered, I now use a > compounded 2% testosterone gel. It is about 1/5 the price. > > I get the Red Blood Cell count blood test every 6 months. > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 19, 2005 Report Share Posted February 19, 2005 Very interesting. May I ask, what testing was done in order to rule out PV? Of course, it would be possible to have both PV and effects of TRT. That is the uncertainty that I am dealing with at the moment. My hematologist isn't giving me straight answers when I try to pin her down on that, seems it is just her " clinical judgment " that I have PV. For many years, the standard approach to nailing down a PV diagnosis was the whole-body blood volume analysis, where they determine the absolute amount of blood and its components in your body, rather than HCT which is a percentage. This has to be done by nuclear medicine departments in major medical centers, using cr51. But it has largely fallen into disuse because they don't do it often enough to maintain proficiency, which translates into inaccuracy of results, and because it costs more than they can get paid. I undertstand that Mayo Clinic no longer does it. Nevertheless, my hematologist believes that a nearby dept. does do this test, so I may yet get it. I wonder if she really knows. I take it that your HCT was 54.6 before the draw; from past experience, what effect would you expect the draw to have on that number? Mine started at 54.9 and went down to 49.6 as measured a week after phlebotomy, which withdrew 500cc. Lynn <ssp@...> wrote: My red blood cell count last night at the lab was 54.6 after two months and she drew a bottle off, one thing about giving to red cross is they do a cell count before donating just ask for the number. I do not think our high hematocrit is poly however it is a form of it as poly is a disease that is not curable ours is caused by TRT, the red cross will not take blood if you have poly. I explained to the head nurse what caused mine and she said that was not the same as poly so I am able to donate. I live in Idaho at a high altitude and that seems to add to it too. If more on here has had this happen to them please speak up we need to compare notes about it. Lynn Re: TRT and Hematocrit > > > <snip> > > I was told I had poly 5 years ago. At that time I had severe head & > muscle aches. My level was 59. I was weak & sleepy all the time. I > was on the patch & had not donated blood for over 6 months. > > I was told that the body needs red blood cells to get Oxygen to the > body cells, if not enough O2 is getting to the body cells, more red > are produced, the blood gets thicker so less O2 gets to the body > cells & it produces more red blood cells. Catch 22. This continues > until the blood get so thick it can not get to the brain & a stroke > is produced. I was within a few hours of that stroke. I lost a lot > of brain cells during those last few months. > > I had to change jobs. I can no longer visualize in 3-D & rotate > objects in my head to see all views of it along with multi-tasking > thoughts. I lost about 30 IQ points. I was a automation software > designer. I can not even write computer software any more in any of > the 7 computer languages that I had used before. > > But my sex life is much better now & I feel thankful each morning > that I get out of bed. > > Afte they drained, sucked out, one pint of the thick blood I felt > better. The head & musclw aches were gone after a 1/2 pint was sucked > out. It was not a fluid, it was a stringy stuff that clumped to the > sides of the jar they squirted it in. Then a pint every 2 weeks for > a while, then a pint every month, now I just donate a pint to the Red > Cross every 2 months. I stay in the upper end of the " normal " range > now. > > I also changed to AndroGel when it was discovered, I now use a > compounded 2% testosterone gel. It is about 1/5 the price. > > I get the Red Blood Cell count blood test every 6 months. > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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