How often do you donate blood to keep hematocrit levels in a healthy range?

[muscle96ss]

I meant to add this within my last response. Busy day.

I'm not directing this at you specifically, Maldorf. Moreso, since you brought to discussion about eliminating iron through a multivitamin. I've had this same conversation with several people as well different physicians with mixed opinions. I personally stand behind supplementation if one's Fe status is subpar- deficient. Not saying you should. In general.

The better part of a year ago on my way to work, as usual I'm tuning in to one of my go-to stations on Sirius XM, Doctor radio. It's a live show that hosts different discussions about interdisciplinary medicines, from ER, urology, dermatology, cardiology to oncology-hematology as well as several other hourly segmented shows. You can call in with whatever questions pique your interest.

I happened to catch the oncology-hematology hour, which the topic was about myeloproliferative disorders, such as PV, ect. The hosts were discussing different treatment strategies, so on and so forth. Phlebotomizing was one of the topics discussed. So, I called in asking their opinions on routinely phlebotomizing and supplementation of iron in someone who's pushed their iron status in the dirt. Both of the hematologists on the show agreed that with secondary erythrocytosis (worlds apart from the topic at hand of myeloproliferative disorders) there's detriments if over phlebotomized and untreated iron deficiency. Given their clinical experience, it's not advisable to push the envelope to continuously phlebotomize. As it comes with consequence in itself, if you punch the patients Fe status in the dirt (obviously I'm paraphrasing, with accurate context) this creates more issues for the patient. Their response to supplemental Fe if one happened to become iron deficient, even without anemia. By supplemental iron, this addresses the secondary by symptoms related to iron deficiency, which these issues generally correct itself with supplemental iron. At the same time, for reference, one of the hematologist referred me to an interview that was done that's accessible online by one of his colleagues, -Josef T. Prchal, MD, PhD (Professor Division of Hematology and Hematologic Malignancies. Department of Internal Medicine at the University of Utah).


Keep in mind, Dr. Prchal commentaries are lined around individuals with PV (polycthemia vera) which is worlds apart from secondary erythrocytosis. PV is a myeloproliferative disorder, in which is all hematopoietic cells are increased (platelets, white blood cells, and red blood cells) through increased cell proliferation, hence, myelo-(marrow derived) proliferative-(abnormal cell production). Bad.

With secondary erythrocytosis, only erythrocytes (red blood cells) are increased to a ceiling point given ones genetics and other factors that may be related to oxygen sensing. The prevalency of thromboembolism is much higher in individuals with PV than those with secondary erythrocytosis. Which the latter is quite rare in isolation without a secondary etiology (abnormal condition). Given the commentary below by, Dr. Prchal, we can conclude his concerns are as equally important to treat Fe deficiency-WITHOUT-anemia. Nevertheless.

Diagnosing or Ruling Out Polycythemia Vera in Patients With Erythrocytosis – Hematology & Oncology

www.hematologyandoncology.net

What number is this station? All I listen to in the car is XM; mostly Hair Nation and Prime Country. I didn't know they had anything like that on there.

 

[Stewie]

What number is this station? All I listen to in the car is XM; mostly Hair Nation and Prime Country. I didn't know they had anything like that on there.

Hair Nation and Lithium are my other favorites!


110 is Dr. Radio. There's some pretty interesting commentaries by a vary large array of well known physicians and PhD's that are guests on different segmented topics.

It's in realtime, which makes it nice if you happen to have medical questions regarding the topics discussed.

Doctor Radio | SiriusXM

Your chance to talk directly to some of the top doctors in the world. Powered by NYU Langone Health.

www.siriusxm.com

 

[maldorf]

I know we've talked about this openly on here from time-to-time. I'd like to believe you're in a different category than the general population given the nature of your unfortunate event.

American College of Cardiology seems to believe, replenishing Fe status is beneficial for individuals such as yourself with reduced ejection fraction-HF.

Iron Deficiency in Heart Failure - American College of Cardiology

Supriya Shore, MD

www.acc.org

Iron Therapy in Heart Failure: Ready for Primetime?

There is an increasing awareness of the prevalence of iron deficiency (ID) in patients with heart failure (HF) and its contributory role in the morbidity and mortality of HF. It is important to note that many HF patients have ID without being anaemic, ...

www.ncbi.nlm.nih.gov

Or so the guys dressed up in white-coats with a bunch of abbreviations after their names can't quite come to agreements to favor one-way or the other.

I know there's different schools of thought on the potentials or lack thereof in the presence of lackluster Fe status.

In an otherwise healthy individual, myself being one of them that beat the bejesus out of my Fe status from over phlebotomizing. I struggled gasping walking up a flight of stairs or anything strenuous took a toll on me. My cognitive function for memory recall sucked in school and day to day life. My heart rate was constantly hovering around 90-100 BMP at rest. Amongst several other feeling like doo-doo thingys. This was all under the guidance years ago by one of my old treating clinicians for T replacement to phlebotomize routinely once my HH hit 18/54. This was 8-9 years ago. That lasted a better part of a year. He's nothing but a faded memory today. Not we'll versed. However.

I might donate once per year now, primarily when I get constant phone calls from the local blood bank. Otherwise, I don't hyperfixate on my HH levels. At the same time, they hover around 17/18+/- 52/54%. I don't blink an eye at it. I'll check my chem panel, punch in my osmolality. Sure enough, I wasn't sufficiently hydrated at that time of my labs. Others flip out thinking their going to stroke out our flop over from a MI. All-in-all that stressing out over a meaningless value that fluctuates widely throughout the day isn't good for our overall health

All I know is that having my hemoglobin down between 15 and 16 I feel fine. Iron is on the low end too.

I had my heart attack, blood clot, back when my hemoglobin was up at 20.

 

[Bobik]

I meant to add this within my last response. Busy day.

I'm not directing this at you specifically, Maldorf. Moreso, since you brought to discussion about eliminating iron through a multivitamin. I've had this same conversation with several people as well different physicians with mixed opinions. I personally stand behind supplementation if one's Fe status is subpar- deficient. Not saying you should. In general.

The better part of a year ago on my way to work, as usual I'm tuning in to one of my go-to stations on Sirius XM, Doctor radio. It's a live show that hosts different discussions about interdisciplinary medicines, from ER, urology, dermatology, cardiology to oncology-hematology as well as several other hourly segmented shows. You can call in with whatever questions pique your interest.

I happened to catch the oncology-hematology hour, which the topic was about myeloproliferative disorders, such as PV, ect. The hosts were discussing different treatment strategies, so on and so forth. Phlebotomizing was one of the topics discussed. So, I called in asking their opinions on routinely phlebotomizing and supplementation of iron in someone who's pushed their iron status in the dirt. Both of the hematologists on the show agreed that with secondary erythrocytosis (worlds apart from the topic at hand of myeloproliferative disorders) there's detriments if over phlebotomized and untreated iron deficiency. Given their clinical experience, it's not advisable to push the envelope to continuously phlebotomize. As it comes with consequence in itself, if you punch the patients Fe status in the dirt (obviously I'm paraphrasing, with accurate context) this creates more issues for the patient. Their response to supplemental Fe if one happened to become iron deficient, even without anemia. By supplemental iron, this addresses the secondary by symptoms related to iron deficiency, which these issues generally correct itself with supplemental iron. At the same time, for reference, one of the hematologist referred me to an interview that was done that's accessible online by one of his colleagues, -Josef T. Prchal, MD, PhD (Professor Division of Hematology and Hematologic Malignancies. Department of Internal Medicine at the University of Utah).


Keep in mind, Dr. Prchal commentaries are lined around individuals with PV (polycthemia vera) which is worlds apart from secondary erythrocytosis. PV is a myeloproliferative disorder, in which is all hematopoietic cells are increased (platelets, white blood cells, and red blood cells) through increased cell proliferation, hence, myelo-(marrow derived) proliferative-(abnormal cell production). Bad.

With secondary erythrocytosis, only erythrocytes (red blood cells) are increased to a ceiling point given ones genetics and other factors that may be related to oxygen sensing. The prevalency of thromboembolism is much higher in individuals with PV than those with secondary erythrocytosis. Which the latter is quite rare in isolation without a secondary etiology (abnormal condition). Given the commentary below by, Dr. Prchal, we can conclude his concerns are as equally important to treat Fe deficiency-WITHOUT-anemia. Nevertheless.

Diagnosing or Ruling Out Polycythemia Vera in Patients With Erythrocytosis – Hematology & Oncology

www.hematologyandoncology.net

so simply put, isn't it a problem to eat enough beef when I have a higher H / H? Due to the higher H / H, I tried to reduce the intake of iron in the diet. Thank you

 

[Stewie]

so simply put, isn't it a problem to eat enough beef when I have a higher H / H? Due to the higher H / H, I tried to reduce the intake of iron in the diet. Thank you

Unless you have hemochromatosis, I personally wouldn't worry about limiting the amount of iron enriched foods.

 

[maldorf]

Unless you have hemochromatosis, I personally wouldn't worry about limiting the amount of iron enriched foods.

That's what my hematologist told me. Although, he did want me to change my multivitamin to a senior version so it has no iron.

 

[alfresco]

I appreciate the reply. I will ask my doctor about getting these tests done. my hematocrit was 54% and hemoglobin was 18.2 a couple of weeks ago. I live at 5500ft elevation so that could be contributing to it also. My doctor wants me under 54%, otherwise he will discontinue my use of TRT. Getting blood drawns tomorrow to see if it went down from the donation i made yesterday.

FYI . . . regarding elevation, for what is worth, there are mine workers
in South America (think Andes) who routinely work at very very high
altitudes for long periods of time and it does indeed really elevate their
hematocrit to no ill effect that I am aware of. You at 5,500ft me thinks
the effect of that altitude would not be a significate factor. But hey,
what do I know. Maybe somebody here with a bigger brain than mine
(easy) can chime in on this.

PS. My doctor wants me under 52 (lab specs), preferably lower, like 50,
or even a bit lower. Even on a very low dose TRT mine still climbs enough
to warrant donating blood.

 

[Stewie]

Highlanders have evolutionary genetic adaptations to lower oxygen levels. Some of their hematological markers are mid physiological levels, such as their RBC's-HH. There's several well documented literatures describing this.

Although, some of these highlander do unfortunately develop chronic mountain sickness. I believe there's other previous etiological manifestations that compound this. In other words, from my understanding it's the secondary comorbidity that develops chronic mountain sickness, IIRC.

I know there's individuals in different FB circles that erroneously try to compare testosterone induced erythrocytosis to highlanders. I've given my personal rebuttal to this. They're not comparable with each other.

 

[maldorf]

This study shows hematocrit in relationship to where the person lives. You can see the effects of altitude. There is a table you can click on.

(PDF) Hematocrit levels in elite athletes

PDF | Haemoglobin-concentration and haematocrit-values can be increased to non-physiological values with injections of recombinant human erythropoietin.... | Find, read and cite all the research you need on ResearchGate

www.researchgate.net

 

[j4ever]

Highlanders have evolutionary genetic adaptations to lower oxygen levels. Some of their hematological markers are mid physiological levels, such as their RBC's-HH. There's several well documented literatures describing this.

Although, some of these highlander do unfortunately develop chronic mountain sickness. I believe there's other previous etiological manifestations that compound this. In other words, from my understanding it's the secondary comorbidity that develops chronic mountain sickness, IIRC.

I know there's individuals in different FB circles that erroneously try to compare testosterone induced erythrocytosis to highlanders. I've given my personal rebuttal to this. They're not comparable with each other.

holy shit, im glad somebody knows

 

[alfresco]

Highlanders have evolutionary genetic adaptations to lower oxygen levels. Some of their hematological markers are mid physiological levels, such as their RBC's-HH. There's several well documented literatures describing this.

Although, some of these highlander do unfortunately develop chronic mountain sickness. I believe there's other previous etiological manifestations that compound this. In other words, from my understanding it's the secondary comorbidity that develops chronic mountain sickness, IIRC.

I know there's individuals in different FB circles that erroneously try to compare testosterone induced erythrocytosis to highlanders. I've given my personal rebuttal to this. They're not comparable with each other.

Thank you for the above. Interesting.

And then there was that Winter Olympic cross country team member
who's hematocrit was really really high which numbers disqualified
him from medaling (gold?) when he was tested. He was able to prove
that it was indeed genetic (I think his brother has the same thing).
And he had zero negative effects from it. Perhaps it was a bodily
adaptation but was indeed genetic. I think he got his medal back
and / or competed again and medaled and kept it. I am sure there
is some literature on it . . . hope I did not get the story wrong

 

[hollaback6]

Highlanders have evolutionary genetic adaptations to lower oxygen levels. Some of their hematological markers are mid physiological levels, such as their RBC's-HH. There's several well documented literatures describing this.

Although, some of these highlander do unfortunately develop chronic mountain sickness. I believe there's other previous etiological manifestations that compound this. In other words, from my understanding it's the secondary comorbidity that develops chronic mountain sickness, IIRC.

I know there's individuals in different FB circles that erroneously try to compare testosterone induced erythrocytosis to highlanders. I've given my personal rebuttal to this. They're not comparable with each other.

yea my last hemoglobin not on trt back in September was 17.7g/dl and hematocrit was 48.4%. i just got blood pulled today so lets see what they come up with. i honestly feel like utter shit not on trt so i hope they dont discontinue it.

 

[hollaback6]

This study shows hematocrit in relationship to where the person lives. You can see the effects of altitude. There is a table you can click on.

(PDF) Hematocrit levels in elite athletes

PDF | Haemoglobin-concentration and haematocrit-values can be increased to non-physiological values with injections of recombinant human erythropoietin.... | Find, read and cite all the research you need on ResearchGate

www.researchgate.net

This chart makes my levels look pretty normal for my elevation actually.

 

[maldorf]

This chart makes my levels look pretty normal for my elevation actually.

I think when someone lives at higher altitudes the body reaches a different point of homeostasis and regulates everything to be healthy. If that didn't happen then we would see more blood clots in folks that live at higher altitudes. I don't think that is the case, never read about increased clots for those people.

 

[beast405]

I do it myself normally after I finish up a cycle

 

[SteroidJet.com]

Once every two years. Like to help others but not very enthusiastic about it

 

[Kaladryn]

I've had some experience with donating blood seeming to cause a higher hematocrit over time than not donating at all.

I also get good results returning hematocrit to normal with just a few months off/at 'actual' TRT doses.

I once had elevated iron levels from taking 1g of vitamin C every night with my red meat meal, C will increase iron absorption, I guess by a lot in my case, I moved my C to morning and iron returned to normal.

 

[nicocujo]

I donate every 8 weeks. It's good for the people that need it and it's helps to keep my h&h low as well as dropping my blood pressure. Last donation my hemoglobin was 14.1, which is good.

 

[maldorf]

It is crazy how low hemoglobin level can get before they get worried about you. I had a bowel bleed and mine got down to 10. They said they would not give me a transfusion until I got down to 9.

 

[Sides]

It is crazy how low hemoglobin level can get before they get worried about you. I had a bowel bleed and mine got down to 10. They said they would not give me a transfusion until I got down to 9.

Their threshold for transfusions can be amazingly low.

My eldest stepdaughter was put in the hospital a couple weeks ago after she kept fainting and passing out and couldn't keep her balance. Anytime she tried to eat, she vomited it back up. She has always had trouble eating as she has an eating disorder called ARFID (Avoidant Resistant Food Intake Disorder) as well as PTSD and MDD, partly due to the abusive relationship she suffered under her mother, my ex-wife. They diagnosed severe anemia, as her hemoglobin was too low to be measured (<2), hematocrit 7, WBC 3.9, platelets 55, iron low, potassium low, etc. They kept her several days and did several blood transfusions, red blood cells and platelets, until her hemoglobin reached their threshold for transfusions, which is 7. Then they said she was strong enough to be released to go home.

She was still weak as a kitten, but thankfully due to a change in her meds, she has been eating a lot more and is feeling much stronger and has much more energy now.