T Nation

Hct, Hgb, RBC, How High Can You Go?


#1

How far past the standard range can you go with these numbers before it gets really dangerous ? How worried should I be about this ? At what point do I say enough is enough and order some IV catheters and start doing do it yourself Phlebotomies in the kitchen sink ?
My Hct is 58.1% (40-53%)
My Hgb is 19.6 (13.5-17.7)
My RBC is 6.44 (4.40-5.90)

Neither of my doctors seems all that worried about it. They just keep telling me to donate blood to the red cross, and cut back on testosterone. I donate blood every 56 days, and have cut way back on the testosterone…(100mg per week now) yet the numbers keep climbing.
46.5 -(90 days)-52.4 -(90 days)-56.8 -(45 days)-58.1 These are my Hct numbers. blood donations every 56 days during this time. .


#2

I have the same problem but now quite as bad as yours. Donating blood will only lower your hematocrit by about 4%. (FYI- hematocrit is always 3 times the hemoglobin level). The rbc that are donated are replenished quickly. For donating blood to be effective you would have to give more regularly than every 8 weeks. Your doctor can give you a prescription for a therapeutic phlebotomy. My insurance will not cover that.
There is another route but your doctor will not go for it I’m sure. You could take a low dose blood thinner. Not warfarin but maybe xarelto.
I got a leg clot 8 years ago due to high hematocrit and sitting on a plane for 8 hours.
you could cut your trt back to zero but I get the feeling you run a high hematocrit anyway. So…take a baby aspirin in the am and pm, get a lot of fish oil, wear compression sox to keep away a leg clot, and stay extremely well hydrated.
I’m not surprised the doc said cut back on the test. That’s the easy way out. A lot of things in life are two steps forward and one backward. Does that mean you have to eliminate the 2 forward because of the one backward? Maybe, but sometimes you can just deal with the one backward.
Hope that helps.


#3
 I do take the 81mg aspirin, and do the fish oil thing. But obviously I am still worried because the numbers are so high. 

My doctor won’t give me a script for a therapeutic phlebotomy because he wants to take the easy way out and just have me cut back or stop testosterone altogether until everything comes down to a safe level. It just seems weird that he won’t give me a script for a therapeutic phlebotomy when the numbers are high RIGHT NOW. Even if I just stopped testosterone it would take months for those numbers to go down. Red blood cell lifespan can be up to 120 days. That means for the next few months I will be walking around being paranoid about having a blood clot or heart attack or something.

I don’t think I’m willing to go back to the way I felt with low testosterone. So, perhaps I should just order up the IV catheters and just do it myself in between the Red cross donations. It’s probably my best option at this point.


#4

Do something before you find out!

Vascular organs such as the liver and kidneys can be damaged, permanently.


#5

I went in to the Red Cross today to donate blood. They turned me down and would not let me donate. Their upper hemoglobin limit is 20. They measured me at 20.1 I was over by 1/10th of a percent.
I guess I will move on to plan B, I’ll just do it myself.


#6

How old are you? Any comorbidities like diabetes? Vascular problems/history of family heart/stroke issues?

Personally I think phlebotomy should be a last resort and that the doc is doing right by you. When you say “I had to cut WAY back to 100mg/wk” seems to me is the original issue. Go low, go slow is my moto. Yeah it will take time for your marrow to ease up and your RBCs to be recycled but I think you should follow the doc on this. my 2 cents.


#7

Yes, too much testosterone was what caused the problem in the first place. I do realize that the Hgb will go back down on it’s own after I have been on a lowered dose for a while. However I’m concerned with the fact that it is high RIGHT NOW. I’m kinda stressing out about the fact that it is over 20, which is way over the standard chart range. I feel like a ticking time bomb. I want it down now, not three months from now.

I think getting it back down into the safe range with several phlebotomys would at least put my mind at ease. At that point I could at work on finding the sweet spot for a testosterone dose that kept me feeling good, while at the same time not raising the Hgb so fast that it got to this point again.
I have been on Iron supplementation at my doctors request because my ferritin was low (10) It’s now at (88). I wonder if this may be part of the problem. ?


#8

Once I went in to donate and my hematocrit was too high. The thing is I had been to the gym earlier and sweated a lot and had not got rehydrated. After they turned me down to donate, I went and drank two bottles of Gatorade and came back in and all was well.
So…obviously I can’t say that your turn down to donate was lack of hydration but the point is to always be hydrated well.


#9

Yeah hydration status can change your hct a LOT. Next lab drink several glasses of water over a few hours and let your kidneys drain off excess. Then test.


#10

I usually donate when I get at the 49 or 50 level. For sure would donate if you can find a place who will let you. I got turned away from Lifesource once for being too high. Since then my doc does it.

Btw, did not see it mentioned here but do not take any iron supplements and double check your multi-vitamin to make sure it does not contain iron. This will up your number big time. Maybe cut back on iron rich food too until you get your numbers down.

Good for you keeping on top of this. I cringe when I hear guys up at 60 levels, are beet red and refuse to donate. Wtf? you don’t mess with heart valves!


#11

Well, I ended up cutting the testosterone down to 70mg per week because the Red Cross kicked me to the curb because my HGB was too high. They measured it at 20.1. Their cut off limit is 20.
I went in again two weeks later, very much more hydrated and pulled a 19.8. Yay, I got to donate blood. !
I will probably keep the test at 70mg for the rest of the January… then ramp it back up to 100mg or so in February. Surprisingly I actually feel okay in normal everyday life at 70mg, and my libido is still good. However I am way down on power at the gym.
I did order IV catheters, got them in the mail today. I may just start doing an extra Phlebotomy at home in between the Red Cross Donations… at least until I get things to the middle of the standard range.