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HRT and controling RBC/Hemog/Crit

demon

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Anybody else on HRT and having trouble keeping these in an acceptable range? Ive been donating blood the past 2 years and the numbers never seem to lower. Latest bloods hemoglobin 17/Hemocrit 51/RBC 6.2. for the most part my hrt dosages are 125mg a week except for the summer months when I ramp it up a little.
 
It's the nature of the beast, rather sucks. Essentially what is happening under normal circumstances is, we have a part of our liver that controls our Iron levels, it's referred to as Hepcidin.
Testosterone is known to suppress Hepcidin therefore increasing Iron uptake in blood, hence the elevation of Hemoglobin. It seems that as we age the use of Exogenous Testosterone further suppress Hepcidin more so than in younger aged males, unless they (younger males) are predisposed to hereditary Hemochromatosis, in which this is believed to be a congenital defect with Hepcidin regulation.

Another possibility that those on TRT tend to ignore is OSA, sleep apnea is common place for increased Testosterone levels. In the presence of sleep apnea, Hypoxic hypoxia is a result of insufficient oxygen available to the lungs during sleep hours, when this happens our body sends a signal to our bone marrow to increase Red Blood Cell production.

So with all that said, there's possibly a few other causes that's raising your HH, ie; Iron intake or some other underlying cause such as heart and lung diseases, smoking, dehydration ect, ect.

Some feel that cardio helps lower HH, for me, not so much, as I've run anywhere from 3-4 miles every morning. What helped me from having monthly phlebotomies was being diagnosed with OSA and wearing my CPAP religiously every night.
 
Last edited:
Thanks Stewie for the info. You helped me out earlier in the year regarding some questions I had.

I was hoping it was sleep apnea causing the high numbers so this past summer I had the sleep study done. However the dr indicated the results showed I didnt have apnea. So I guess I can rule that out.

Not really sure what my iron intake is. I guess I could start watching that. To my knowledge I dont have heart and lung disease or have a history of it in my family. I know I dont drink enough water. Ithink I drink about 60oz a day so I could to a better job.

My hrt dr just gives me the run around, he wants me to try a T gel. Ive thought about coming off for awhile but am concerned about my T levels getting low and what that would mean health wise.



It's the nature of the beast, rather sucks. Essentially what is happening under normal circumstances is, we have a part of our liver that controls our Iron levels, it's referred to as Hepcidin.
Testosterone is known to suppress Hepcidin therefore increasing Iron uptake in blood, hence the elevation of Hemoglobin. It seems that as we age the use of Exogenous Testosterone further suppress Hepcidin more so than in younger aged males, unless they (younger males) are predisposed to hereditary Hemochromatosis, in which this is believed to be a congenital defect with Hepcidin regulation.

Another possibility that those on TRT tend to ignore is OSA, sleep apnea is common place for increased Testosterone levels. In the presence of sleep apnea, Hypoxic hypoxia is a result of insufficient oxygen available to the lungs during sleep hours, when this happens our body sends a signal to our bone marrow to increase Red Blood Cell production.

So with all that said, there's possibly a few other causes that's raising your HH, ie; Iron intake or some other underlying cause such as heart and lung diseases, smoking, dehydration ect, ect.

Some feel that cardio helps lower HH, for me, not so much, as I've run anywhere from 3-4 miles every morning. What helped me from having monthly phlebotomies was being diagnosed with OSA and wearing my CPAP religiously every night.
 
Just got my hemoglobin checked today. It cam back at 16.9. The dock said that was ok Recommended to start drinking more water and that should lower it a bit. If it gets close to 18 they said to just donate some blood. That's on 120 ml/week test depot.
 
Yep, it's tough to keep the hemo in range. It's just part of the deal. I donate blood every two months. At my preferred HRT dose, 200 per week, it only takes me about a month to be up over 17 again. I can lower my HRT dose and the hemo will stay below 17 ... but I start feeling crappy again.
 
I had a w/d yesterday and hemoglobin 21.4. I am probably going to have this done every 3 mos instead of every 5-6 mos.
 
Yep, that’s high. You don't want your blood that thick. Definitely donate more often – every 2-3 months like you said. Keep in mind most blood donation places like the Red Cross have an upper limit on hemo. If it gets too high (like up in the 20’s) they won’t take the donation (apparently there is some risk of clotting as the numbers get up there). If that happens you can always get a Phlebotomy prescription from your doc and they will draw some blood and dump it.
 
I think at my RC they said over 19 they wont take your blood....I'm always around a 17 when I donate and thats on 125mg...


I had a w/d yesterday and hemoglobin 21.4. I am probably going to have this done every 3 mos instead of every 5-6 mos.
 
I have Anti-phospholipid syndrome which means my blood is thick anyway. I get symptoms of anemia if it drops below 17 but it is hard to keep it at 17-18 without it going over but dr has me taking 2 aspirin per day. I can tell when it gets to 20 because I go from feeling good to not so good.
 
Yeah, hemo up in the 20’s is not ideal. Your blood is thick so the heart is definitely working overtime pumping that stuff. Your hemo probably goes right back up after blood donation - within a few weeks. Most places require two months (56 days) between whole blood donations or 4 months (112 days) for a double red blood cell donation. You could probably get a prescription to donate more frequently. Do what you can to keep the numbers down.
 
I have a script and go to blood bank. Because of this they won't use my blood any more so all w/d are therapeutic these days. I could go every week but when I have tried going back to back weeks I have gotten sick and had heart palpitations and overall it was'nt good so this time I am giving it 30 days then going back in to have checked and if high I will get another pint taken out.
 
I have a script and go to blood bank.

Yep, your circumstances are very difficult. Hang in there. You just have to do the best you can balancing between donating too often and not enough. This is obviously not that easy in your case.

I guess the rest of us on HRT don’t have it too bad. I can wait two months between donations, but not much more. The hemo is up in the 17-18 range after 2 months. This is not great, but it’s tolerable. Donating more often has it’s down sides … definitely tough on the veins. On the plus side, I feel good after donating. I definitely don’t need the extra red blood cells.
 
The funny thing is I have donated blood twice a yr my entire adult life. Never a problem now when I donate it takes me 2 days to feel back to normal because I notice I get tired more easily. Yeah my vascularity has taken a hit this wk. Bf at 7-8% but looks better when a little lower.
 
Besides a Dr. Prescribed phlebotomy, is the Red Cross the only option for donating blood? They won't take me due to living out of the country.
 
You can google this information ... but there are several places in my area that will accept blood donations - local hospitals and other organizations that collect blood. I tend to spread the love around a bit. By donating to more than one place it is possible to donate more frequently than every 56 days since they don't seem to cross check (although I have not needed to do this). They all have a screening process and ask questions about travel outside the US ... one of them may work for you since my sense is that the Red Cross is pretty darn strict.
 
I have read some guys get results with the supplement Bromelain.
 
Thx Stewie!! Not remaining properly hydrated has always plagued me... I keep reading so much good stuff here. Thanks again!!
 

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