T Nation

Does RBC/Hematocrit Matter?

The question I have is do RBC and Hematocrit really matter if blood pressure is good, and pulse is good?

My thought is that if RBC is high, pulse and BP should go up. Same thought with Hematocrit. With a mechanical system, we would expect pressure drop to go up with a thicker fluid, and we would expect to have to run the pump motor faster to get the same flow (higher pressure and higher flow or pulse).

Maybe I am missing something here (why I started the thread).

On TRT at least I have a good bit of margin before I am considered too high for RBC and Hematocrit. I just wanted to know if this is reasonable line of thought or if I am missing something. For future cycles monitoring BP and Pulse is easier.

Great questions. I put most of my thoughts and analysis on the matter in this thread that was closed. If you search my name in the thread all the posts will show up. Never got a thoughtful rebuttal. I don’t share the same opinion as Rouzier, Nichols and the “what U-shape trend between Hct and mortality rate?”

Blood viscosity is a complex function of multiple blood parameters so you better be sure of your individual health status before running Hct above 50. In the post below I show why Hct of XX can mean a very different serum viscosity for two different people.

If you can keep blood pressure low and RHR decent on high levels of AAS then be thankful and that’s still not the end of it. Autonomic dysfunction is a real thing, and what happens in a few years down the road when one wakes up one night with atrial fibrillation? Do you have preexisting arrythmia or thyroid issue? Think cumulative effects. It happens.

Hope this helps.

Arrythmia no. Thyroid I have high RT3. I take cytomel 20 mcg per day. I am losing weight, and once I get to a lean composition, I am going to try to wean off of the cytomel and retest RT3 as I don’t want to be on it. I am 5’10" 215 lbs (down from about 225 lbs), and I would estimate 18-22% BF. I don’t have a front picture readily available, but here is a back picture at around 220 lbs (cursed by the arm gods I guess).

I guess with high AAS, the heart can get hypertrophy without extra effort in pumping blood as the heart is a muscle with androgen receptors. I don’t plan on blasting anything in crazy doses though.

I basically, want to have the mental benefits of TRT, but with a body that is a bit past natural. I am not interested in running grams of gear, and probably won’t do much past a beginner cycles.

Just thinking I would like to monitor BP more in the future (has been good in the past at the doctor). I do measure pulse pretty regularly, and have pretty low pulse for a fat guy (about 55-65 depending on the day at rest).

Not completely hijacking thread just offering something to think about…constant balance between performance, “gainz”, and longevity. Good luck with the body recomposition and keep it up. I like your thinking regarding long term use of thyroid preparations in the absence of thyroid disease and would make sure you are testing TSH, free T4, and free T3 under the supervision of a qualified medical professional.

I have measured RT3 methodically over years and spoke with many MDs about its utility outside the context of acute illness. All honest folks will admit they don’t know.

I’d keep up the calorie deficit and find a long term sustainable strategy for you at the bodyfat level you desire.

If I could go back and speak with younger version of myself, I’d emphasize caution with simultaneously manipulating testosterone and thyroid levels without fully evaluating cardiac status. Even then you never know. It’s not fun when you run into problems and you are being admired by the paramedics asking “where you work out man? Damn Bro!” while they prep to do electroversion on the way to the ER. You think to yourself, “was all this worth it?” Not trying to scare, just true story.

The Compression of Morbidity

Decline in the function of multiple organs may be considered in the context of preservation of homeostasis. Reserve function is required when the organism is stressed in order to restore the normal homeostatic equilibrium. As the reserve of individual organs declines in a linear fashion, the ability to maintain homeostasis in the face of a threat of a given magnitude declines exponentially (Strehler 1960); hence, the observations of physiology and the actuarial observations of Gompertz are reconciled (Figure 2). Natural death must ensue, without disease, when the reserve function has declined below that point, probably about 20 percent above basal levels, at which routine daily perturbations cannot be weathered. A transition from premature death to natural death occurs as the characteristics of the host resistance (homeostatic reserve) become more important than the specific nature of the insult to the equilibrium. The concepts of premature death (due to disease or accident) and natural death (due to senescent frailty) are complementary rather than antagonistic, and any dividing line must be an arbitrary one.

image.png

Figure 2

Linear Decline in Multiple Organs Exponentially Decreases the Area within Which Perturbations May Be Restored as Shown Here for Two Organs. Reprinted with permission from J.F. Fries and L.M. Crapo, Vitality and Aging (San Francisco: W.H. Freeman, 1981).

It needs to be balanced for sure. Thinking I could be 240-250 lean, without consequences would be foolish. I do know individuals shorter than me that fit that description. I think later in life they may regret their decisions, and I don’t want to be regretting decisions in regards to longevity.

The more I read about it the less appealing it seems. I worry about heart attack, stroke, and other conditions, and it seems too much T3 can contribute to it. I don’t have an actual reason for concern (no health scares, and I want to keep it that way).

It does seem that a correlation between lowering RT3 and weight loss is present. However, lowering RT3 most commonly involves T3 supplementation, so that confuses things a bit.

Totally understand your thought process. I was on 25 mcg (now 20 mcg), I think I’ll try 15 mcg and see how I feel. Lower it from there, until I don’t feel good. Maybe I’ll feel good on 0.

Good point. My highest measured RT3 (22 ng/dL) was pre-TRT /pre-thyroid meds after having done hard dieting down to 7% BF. Very difficult to keep on muscle mass at this BF level with borderline serum T levels around 400 ng/dL and high SHBG.

First started with T4 monotherapy and couldn’t keep my TSH dialed in given Hashimoto’s. Combination therapy (T4 + T3) resulted in some improvement but then adding in TRT (physiologic levels of Test) helped me titrate TSH very precisely and resulted in gradual reduction in RT3. Androgen usage associated with improved conversion of T4 to T3 and modulation of TBG levels. TRT also added significant muscle mass at already low BF level. Things went south when I experimented with supra-physiologic T levels (using what some around here consider very modest dosage of Test Cyp - 350 mg/week). Experiments don’t come without risk and I won’t be going back there. Best wishes.

1 Like

My HCT has been elevated for years and it hasn’t been an issue. If you lived in Denver you’d be where I am, numbers wise. Most people living at altitudes don’t drop dead because their HCT went above 54.

I wonder if this guy is reassured that most people living in Denver are not dropping dead because their Hct went above 54? :slight_smile:

At some point you were clearly not comfortable with where your Hct was?

Where was it?

IMO, BP and HR are probably better indicators of heart work load. I’m not a doctor, but it makes intuitive sense.

1 Like

It was 58 at that point, which even I had to admit was too high.