T Nation

Hematocrit: How High is Too High?

29 year old male. I’ve been on TRT for around 1.5 years, with me trying Clomid for a couple of months prior to that. Overall, I feel it has helped a bit. It is not a miracle drug that makes me want to run a marathon or bench press a car, but it has helped in a more subtle way. I take 110mg weekly via injection and take .5mg Anastrazole the day afterwards to help control E2 (mine did increase, hence me taking it at all). I also take some Grapeseed Extract at 200mg.

Anyway, my labs have been off a bit lately. I mean, my T is fine, but my Ferritin has come back low - very low. I think it was a 5 a few weeks ago, so I’ve started taking an oral supplement.

My Hematocrit has been quite high lately, too. I just got a call and it is a 54, whereas my doctor likes it at or below 50. I did therapeutic phlebotomy several times over the past year, with my last one being done at the office of a Hematologist. That was only ~3 weeks ago.

Has anyone else dealt with chronic high Hematocrit? It worries me; I feel like I may have a heart attack or something. The PA said to just take some baby aspirin and drink a lot of water before I can dump blood this Thursday at the office.

Please post all lab work with ranges. Include everything.

Some guys have high HTC when on TRT. How were things before TRT.

Low ferritin and high HTC is a bit odd. Could be that kidneys are not seeing enough oxygen and are then releasing https://en.wikipedia.org/wiki/Erythropoietin

Note that high HTC can damage vascular organs or reduce blood flow three. Please see the vicious circle in the kidneys, high HTC reduced blood flow, kidneys increase erythropoietin which increases HTC.

Males hoard iron, because the female blueprint does this to compensate for iron loss during fertile years. When males have low iron status, one has to be concerned with the possibility of a GI blood loss. You need an occult blood test to see if there is any blood in your poop.

Please discuss any digestive or gut issues that you have.

Baby aspirin and fish oil. Do not get dehydrated and also in prep for fasting lab work.

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Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

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Hello KSman,

Thank you for the in-depth, informative response. I honestly was not expecting this!

I can try and get my labs on Thursday from my TRT doc. I have some at home somewhere, but I am not there at the moment and my last batch went missing somehow.

Before TRT is was never brought up as an issue. I don’t know if it was ever checked though, to be honest. I’ll have to see if my doc has bloodwork from a long, long time ago before TRT. I may have that laying around as well. I saw a Chiro years ago that ran bloodwork that seemingly covered everything under the sun and then some.

Yeah, the Ferritin is quite concerning to me. I went to the Hematologist and she wanted me to cease the TRT or to do every other week and take iron infusions on the off week. My TRT doc was not having that, especially since my dose isn’t exactly high at 110mg. So for now my TRT doc said to take an oral supplement. I see the Hematologist this Friday.

I saw a GI last year about the low Ferritin. He ran an at home Stool Test (not sure of the correct name, but I basically use a stick to rub fecal matter on this little areas, seal it up, and sent it into him) that came back negative on blood. He also did an Endoscopy and Colonoscopy, the former showing some minor erosion and the latter being completely clear. He just said to take some over the counter anti-reflux meds, which I take sometimes before bed. By that time my Ferritin climbed up a bit. I didn’t even give it a second thought.

When I had a wide array of bloodwork a month ago is when the issue arose once again. That’s what prompted the Hematologist appointment.

One thing my TRT doc (they’re actually PAs that work under a doctor) states is that it could be my sleep apnea. I was diagnosed and have a CPAP machine. The mask isn’t exactly comfortable, but I do use it to the best of my ability. I usually wake up with it off. I did call the CPAP distributor today and asked them to send me a different mask that may be more comfortable, so we’ll see what happens with that.

I am unsure of any digestive issues. I mean, I get some reflux from time to time, but it isn’t chronic. I’ve tried supplements for gut health in the past, but it seemed like a waste of money. Probiotics were my go-to, but with all of the other supplements it was a ton of money to keep up with everything. This is especially true when I’d read often times how they do not even do much of anything, since they seemingly get destroyed in the stomach.

When I get home I am going to take a baby aspirin. I take Fish Oil daily usually, so I will continue to take this at night. I drink a lot of water and am ensuring of this as well.

I will look into the thyroid basics sticky. Can iodine deficiency be found via bloodwork? I am from the USA, but I don’t eat much dairy or bread.

Once again, thank you for the informative and fast response. I will try and get those labs this week and post them.

yes, as elevated TSH which should be close to 1.0
thyroid lab ranges are mostly useless
and T3, T3m fT3, fT3 could be below mid-range.

We can tell a lot from your discussing your history of using iodized salt and posting oral body temperatures. Do this now.

There isn’t any iodine in bread now [USA and Canada].

Heartburn meds can cause multiple mineral deficiencies by reducing absorption. Some iron supplements do create constipation.