Thick blood can decrease peripheral circulation and in vascular internal organs: liver, kidneys and brain for example. Hematocrit, HTC, is the critical number affecting blood flow.
Mini aspirin make RBC's smoother and they then flow better.
Fish oil may be helpful too.
Do you hear pulse in your ears?
Do not get dehydrated as that concentrates blood increasing HTC.
You might notice some negative effects from some high salt intake meals.
Avoid iron fortified breads, cereals, pasta etc and to not use vitamins that list iron.
Long term, you really do not want to be in that space.
That been said: hemocrit 46.9 is perfectly fine. So maybe you only need to monitor and avoid added iron.
T spikes will make things worse. Suggest injecting twice a week, SC with insulin syringes which will create smoother T levels and smaller peaks.
So, otherwise, how are you feeling and what progress? Focus on the good things too!