Does TRT Cause High Hematocrit?

Are you on TRT and worried about your hematocrit, hemoglobin and other things surrounding your red blood cells? Maybe you haven't really checked before, and your hematocrit levels are really, really high. In this video we look at this question, does t r t cause high hematocrit and what some of the reasons are behind TRT causing increased hematocrit levels?

So does TRT cause high hematocrit? Yes, it does, but it doesn't seem to happen to everyone. So testosterone replacement therapy, also known as T R T, can increase hematocrit levels. And if you don't know, hematocrit is basically the. Percentage of red blood cells in any given sample of blood. It's basically the amount of red blood cells compared to the amount of fluid or liquid part of your blood.

So normal or optimal is gonna be around 50%, 50% red blood cells, 50% fluid part, or a little bit less. Elevated levels of hematocrit can increase the risk for blood clots and potentially other health issues.

So regular monitoring of your hematocrit is important when you're on t r t to make sure it doesn't go much above that 50% threshold. Why do some people seem to get this and others don't?
It's not really a hundred percent clear, but the answer may lie in the mechanism of how testosterone causes an increase in hematocrit levels. Testosterone causes an increased production of something called E P O, also known as erythropoietin..

This molecule stimulates the bone marrow to increase red blood cell production. It's always being produced to some capacity, but in some individuals, that amount is actually higher. Now there are other things that influence erythropoietin production. So if you live at Elevation, you're gonna have a higher EPO level naturally, and there may be other things that affect this. So I think that the amount of E P O that you're producing as a result of being on testosterone replacement therapy may be playing a big role in your hematocrit levels.

It's also important to note that most people don't actually feel anything when they have high hematocrit, so that's why it's important to be tested on a regular basis and even if you think you feel when you have high hematocrit. It's still better to verify than to assume. Also wanted to point out that sometimes when people have high hematocrit levels. While on this topic of kind of understanding what really is going on with your hematocrit, it's also important to point out that hematocrit is not the same as hemoglobin, and hemoglobin is not the same as iron. All these things are related, but they're not really interchangeable.

So if you have a high hematocrit, oftentimes you will have high hemoglobin, but you could have low iron levels at the same time. So what do you do if your hematocrit levels get too high? We'll leave that full discussion for another video, but typically it's going to mean a dose reduction in your testosterone or a blood donation, to bring those levels down into a safe range.

There's a few other tips and strategies that I'll discuss on increased hematocrit while on TRT. This is an important topic when you're on testosterone replacement therapy. It's one of the, things that's important to manage and make sure your levels aren't getting too high. So you want to make sure you're getting regular checkups that you're not overdoing it in terms of keeping your hematocrit levels in check.

[johnlowe]

Another good point to make is that TRT can cause and/or worsen Obstructive Sleep Apnea (OSA) in some patients which in turn can increase the level of Red Blood Cell production in the body; as your body tries to compensate for the lack of o2 circulating in the body. If you have high hematocrit levels even after multiple phlebotomies you should ask your physician to preform a sleep study to rule out OSA. This is what happened in my case and thanks go an extremely vigilant and smart endocrinologist I now have a CPAP machine and get routine blood draws and I am doing much better. Thanks for your insight.

[ennigmaa]

Hi Doc! I gained around 35kgs over 5 years after an accident, I have taken time off to work on my fitness(used to lift weights, do some martial arts, hike etc before). I am 44 and after consulting with a doctor I started TRT a week ago. I am using it hoping it will help me recover faster between training sessions, give more energy etc. What happens if I stop this in a month? (I am unable to continue for various reasons)Will I be able to get back to normal/maintain if I lift weights, eat clean etc or do I have to go through any other program?

[tward]

​ @swintegrative I am being told that although red blood cells have increased that platelets are not affected. My hematocrit is 55.3 and hemoglobin is 18.8. I am getting mixed information. One that I need to reduce TRT and the other is that I am fine and just experiencing erythrocytosis. PLT were on the low end of the reference range @132 (132-344). Would you comment on this please? Should I seek another opinion? Thank you! I understand fully you are not interested in giving medical advice.

[MacGiollaCostigan]

What about MCHC level? My MCHC level is the only thing that's not in normal range. Its 37.2 normal range is 33-36. And I'm having symptoms of difficulty breathing, high blood pressure, weakness/fatigue, arrhythmia. I've been to ER 3 times this week and they've done x-ray, ct scan, EKG, and they say everything looks good and normal. The only thing not normal is my MCHC level. But they are telling me it's not a big deal. Do i just need to donate red blood cells to get my MCHC down? Or a blood thinner ? I'm already on blood pressure medicine Lisinopril

[LordDirus]

I am on TRT and have high Hemocrit Levels, but I feel fine. Good Blood Pressure and Pulse rate.

[mattlawrence]

I do have high hematocrit and i am having trouble finding someplace to donate blood. One place wont allow me in their facility because i have a pacemaker and the Red Cross has very limited availability that will require me to take at least a few hours off of work as well as schedule over a week in advance. Any suggestions?

[nema]

Can low T cause anemia or make it worse?
Can TRT be used to improve low hemocrit?

[jasonk]

A lot of people are claiming donating blood does zero to lower 🤔

[raymcphatter]

Been on TRT since June 2023. Went from 215 to 800+ with 5 injections. Gave a double red. While checking my hemoglobin it was 19+. My has always been around 14-15. Was talking to the look lady while donating and she mentioned that mine high. I told her I taking TRT and she said that could be the reason. Then she said it would come down after the donation. Blood pressure was up too. Does TRT elevate BZp also?

[niles]

I’m 68, under a new doctor. I have been using a testosterone compound for some time. My latest test hemoglobin 17.7, humorist 52.6, and normal ESR, are these numbers high enough to be worried about?

[junkmauler]

TRT turned my blood into jello, had to do blood draws constantly to get it down. Apparently my doctor had never seen it hop so high before in anyone. So this is not a normal issue, will only affect a few people. Going off TRT and going to try a different way of elevating my TRT levels.

[ballareal]

Does HFE genes cause any issue with TRT? I have 2 of the HFE genes. I have slightly high iron serum, but ferritin is low-normal (50s). My T is low though.

[BuggKnuckle]

I went from 48% to 43%… but i also workout a lot more, eat better, and hydrate better

[jamessantos]

Can’t someone just start taking blood thinners to thin the blood and do away with clot risks?

[privatbruker]

It's more important to watch you're platelets just saying.

Donate blood when ever you need and if it's really dangerously high use low dose asprin for abit Aswell as donate blood right away