Does donating plasma have the same effect as donating blood on HCT? Be nice to get paid for improving HCT.
How much blood needs to be donated for a noticeable effect? 0.5 L?
What is the consensus level for HCT to do a donation? anything over 50? 52? 54?
With plasma donations, they return the red blood cells so it won’t help with HCT. Opinions vary on when to donate. Most would agree 50 is normal. Some suggest over 52. Others including my doctor, don’t worry about it until 54/55.
All of the ranges for hematocrit are arbitrary, 50, 51, 52 and especially 54%. The latter one was written by a doctor for the Endocrine Society, and when I asked why he chose 54% as the cut off for men on T replacement by Dr. Abraham Morgentaler, his reply was, it seemed like a safe number.
So the next time somebody says 55% is too high, for who?
I was at 55 and 57% and a hematologist put a stop to my monthly phlebotomies. I had no symptoms.
The same thing went down for the endocrine society choosing <300 ng/dL to be eligible for TRT, it’s arbitrary and not based on any medical science.
Maybe someday, we will be able to look at our genetics and find out what each individual’s limits are for everything.
Thanks for the excellent info. Amazing and more than a little scary how little the “medical community” can offer on AAS and so many other topics
I guess I will just keep posting all this until in sinks in. There is a very good reason something above 54% is flagged. Reasonable risk. Focus on blood viscosity not just hematocrit. See all my threads on this interested reader. If you dabble in AAS, I would recommend considering low dose aspirin.
When applying Poiseuille’s Law to the cardiovascular system, one must consider the radius and the length of the vessels, and the viscosity of the blood. The dimensions of the vascular system (most notably the radius, which is raised to the fourth power) play a more important role in determining vascular resistance than blood viscosity does. However, several works conducted in the past 10–15 years have shown that, in a physiological context, the parameters of this equation cannot be considered to be truly independent of each other. This is because vessels are not rigid tubes; they can change their diameters in response to various physiological stimuli. One of the most important molecules that promotes an augmentation in vascular diameter (i.e., vasodilation) is nitric oxide (NO). Martini et al. (2005), Tsai et al. (2005), Intaglietta (2009), and Sriram et al. (2012) showed that mild to moderate increases in hematocrit and blood viscosity did not result in a rise in vascular resistance or blood pressure, but actually caused the opposite effect. They also showed that increasing blood viscosity promoted the activation of endothelial NO-synthase through shear stress-dependent mechanisms, resulting in higher NO production, compensatory vasodilation, and decreased arterial pressure. However, evidence shows that these vascular adaptations can only occur in a functioning vascular system with a healthy endothelium. When vascular dysfunction is present, vasodilation is impaired. Therefore, a rise in blood viscosity is not accompanied by an increase in vasodilation. As a result, vascular resistance and arterial pressure increase (Vazquez et al., 2010; Salazar Vazquez et al., 2011). Although the role of blood viscosity in vascular adaptations is often ignored, these studies clearly demonstrate that vascular geometry and blood viscosity should not be considered separately when studying the regulation of vascular resistance in healthy populations or in people with cardiovascular diseases.
No sh*t.
How’s that for individual variability?
https://www.nature.com/articles/s41598-020-68319-1
Remember the only important data point is yours.
Great data! Is the left ventricular hypertrophy commonly attributed to AAS use at least partially caused by Hct, Hb and RBCs out of the sweet spot range?
What would you recommend as a course of action, for example, for Hct at 51% while Hb and RBCs in normal range?
I am going to add low dose aspirin daily, a preventative addition also suggested regularly by my cardiologist. Thanks.
Leave it and take the baby aspirin. That is as high as I will run after considering my health issues. Smart Doc I use agrees.
Used to have two separate very liberal TRT mill Docs who would prescribe most anything. Both were former cardiologists. They were fine will orals but neither one would endorse Hct above 52 or so. They were adamant.
I gave up the blood donation thing. Regular donation is 16 g. Double red is 18g needle but then you get a shitload of plasticizer back to thank you for your trouble. No thanks.
Best wishes.
I’d say increase in HCT, HB, and RBCs from AAS are an indirect cause of left ventricular hypertrophy. I’d say it is indirect because it seems the BP and heart rate are what matter (from my understanding). If the increase in HCT for example causes BP to go up too much, you will cause LVH.
I could be wrong on this. My understanding is that LVH without AAS is caused by extreme exercise (which makes the heart work hard), or the heart having to work harder than it should absent extreme exercise (BP and heart rate are directly correlated to how hard the heart is working). AAS can directly cause LVH as the heart is a muscle and AAS will cause growth there as well as the biceps (and other muscles).
So for me, if BP and heart rate are at a good spot, I wouldn’t fret too much over HCT being a bit elevated. Perhaps I am missing something, but to measure the work load of a pump, we have pressure and flow rate. Long life of the pump occurs when it’s not required to pump a high flow rate and when it doesn’t have to create large pressures. I don’t see how the contents of what is being pumped matters much as long as flow rate and pressure are good. Disclaimer, there is an argument of incredulity on my part here. I don’t understand everything. I am looking at it from an engineering perspective. For example, perhaps the texture of blood wears the surfaces of the heart or something in which case high HCT could matter.
As an engineer as well, I appreciate your analytical response! Ya I was thinking along the lines of elevated HCT causing the heart to work harder, which in turn enlarges the heart and causes LVH. Keeping all levels - Hct, Hb, RBCs, BP and heart rate sound like keys to minimization of negative results.
And dose reduction or ceasation above 52…
Former
I’d say the latter two are more important. Easier to measure as well.
Measuring the former would be something I’d do if BP or heart rate were high as they may be the cause. If BP and heart rate are good, I’d pretty much ignore the former unless they were quite high (HCT 55+ or something).
Nice engineering summary. In addition you have to consider the biological nature of pump and pipes…the serum concentration of the AAS which can be toxic to the pump itself (myocardium) resulting in fibrosis, autonomic dysfunction, and diastolic dysfunction. Same with pipes. The latter is really sinister since the heart itself cant relax fully on diastole and significantly increases workload per unit volume of blood pumped. Dose dependent and person dependent.
Hence while BP and HR are good metrics, regular ECG and Echo are also crucial to monitor change over time.
For example I shared a couple of wrestler autopsy results on here. Direct damage to myocardium and stiff heart. Hard to decouple effects of stimulants vs AAS plus all other stuff that may be taken.
My own echo results were also shared showing mild diastolic dysfunction over time. If your heart gainz are better than your skeletal muscle gainz you are F’ed. Crap shoot.
If the myocardium is damaged and electrical signals dont flow right anymore you are also F’ed.
It makes sense that AAS could directly cause hypertrophy to the heart muscle (mostly seen in LVH).
Are you saying having a low diastolic pressure would be good? Would it be good at the cost of increasing the distance between systolic (I think this is called pulse pressure, which I hear is bad to have a big pulse pressure?)?
Based on my last trip to the cardiologist, I’m not F’ed yet!
No. Wide PP or very narrow both bad.
Wide PP a hallmark of compromised arterial elasticity. Narrow PP indicates heart not pumping blood properly. Heart failure/valve disease.
I’ve heard the ladies like the wide PPs 
. Thanks for the follow up!
Yeah. Must be nice 
.
I’m loving everyone’s engineering-based thoughts on this, but regarding the above statement my immediate engineering mind thought about an engine, naturally I thought of a hot rod engine! And thinking about the engine like a pump, I also immediately thought of…the OIL in the engine and the corresponding analogy of oil to blood. So, if you have MUCH thicker blood due to high hemocrit values, I thought about it like a very heavy weight oil vs. a much lighter weight oil. Now taking out diesel engines from this (since unfortunately our hearts are NOT as robust and impervious to high pressures/heavy beatings like a diesel can take) and just thinking about gasoline hot rod engines, you usually (ha, let’s not digress this into a true engine discussion where we factor in weather, lubricity agents, detergents, etc lol)want a pretty “light”, very viscous type of engine oil. Because with much thicker, heavier weight oils, the engine[heart] has to work much harder to circulate it throughout the entire engine[body].
So having much less viscous, thicker blood will directly correspond to much greater stress placed upon the heart out of the mere fact that your heart will have to increase in size to get strong enough to adequately circulate blood throughout your entire circulatory system…end result, you have higher blood pressure AND a thicker heart as a result.
Personally I like to play it safe and donate blood 2-3x a year. I do the double-red donations, and I just make sure to take a quality daily multivitamin that has QUALITY chelated minerals and overall the most bioavailable/absorbable forms of vitamins/minerals [and for sure Iron!] and I also have been taking the supplement NATTOKINASE which I read about several months back here on T-nation. If those of you following this thread haven’t read up on this heart healthy supplement it’s a highly suggested reading. This supplement is supposed to be VERY beneficial for your heart and blood and really the whole circulatory system.
I’ll step away and leave this discussion to be carried by the much more medically inclined contributors in this thread, but I just thought that thinking of the blood/heart/etc as an engine in a car might help others visualize the importance of hemocrit levels and having healthy blood markers.
