My hematocrit went up to 60 slowly but surely on just low ish doses and I still didn't donate. My platelets were in range so I felt I had a little bit of time to work with it. I was determined to try to figure out how to get it lower. First I started taking nattokinase 4,000 FU per day. This won't lower it but it can mitigate some of the symptoms of high HCT. Here's what worked OK for me to actually get it down (from 60 --> 54). I added more cardio (from 120 mins/week to 180 mins/week) and I dropped my GH dose and added berberine/GHK-cu/BPC157 to lower inflammation. I lost water weight (10 pounds), my joints felt better with lower inflammation, and my HCT started trending down over 6 months. I'm hoping its still trending down but I'm totally happy with 54 HCT and platelets in range so if it plateaus here I'm fine.
I recently added low dose retatrutide to see if I can bleed a little more inflammation off. My theory is that higher levels of inflammation promote higher HCT. Primary concern if you want to live long is to lower inflammation. There are many scientific studies that support this theory and if you have high hematocrit and you suspect you have high inflammation levels also from diet, lack of cardio, anabolic drugs, etc then its probably worth starting there to fix that issue and watch the positive cascade happen in your own body.