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+ 13 Why you may not need to give blood/phlebotomize

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Why you may not need to give blood/phlebotomize

My experience: I remember when I got my first bloods taken by my TRT doc and my Hemoglobin was 17.9 and Hematocrit was 50.4. This was before I did any testosterone. I posted my blood work and everyone was screaming at me to donate. So, I did. And ever since then I have been working on it and on my most recent bloods I was able to get them down to Hemoglobin: 15.4 and Hematocrit: 44.4. But, was it really necessary?

For those of us that get bloodwork we are constantly keeping an eye on hemoglobin and hematocrit. As we all know anabolics will raise these levels and if they are raised we are told we are at risk for clots, strokes or heart attacks because our blood is too thick. In this podcast Dr. Crisler describes why in most cases this is not true.

Dr Crisler explains that there is difference between erythrocytosis and polycythemia Vera which is what doctors are really worried about.
He says erythrocytosis is the production of healthy red blood cells which helps carry more oxygen through the body and polycythemia is the production of all types of blood cells which will increase the blood thickness and is the real risk of clot, heart attack or stroke.

Erythrocytosis is very common in people living at altitude. For example people living in Denver often have a hemoglobin of 19 and above and people living in the Andes mountains have a hemoglobin of 21. We do not phlebotomize these people and they are at no extra risk of clot, heart attack or stroke. These people live perfectly healthy lives with elevated hemoglobin and hematocrit levels. There are also many medical conditions that cause erythrocytosis says The Dr and we still do not phlebotomize these people.

The Dr says the real risk of clotting is polycythemia. Which is elevated levels of all types of blood cells making the blood too thick.

So then what should we be looking for in our blood tests. Dr says Platelet count is what we should be focused on as this will indicate clotting risk so keep an eye on your platelet levels.

So in conclusion TRT will not raise the risk of blood clots unless you already have polycythemia. Hemoglobin and Hematocrit are not markers for blood clot or blood thickness, platelet levels are. You may not have to donate or phlebotomize but, it is still good for you as long as your ferritin levels do not go too far down. This is by no means the definitive absolute truth and I urge you all to do your own research and make your own decisions and listen to your doctors.

Links:

to Dr Crisler pod cast interview:
https://youtu.be/ynHXydSGRR0

To Polycythemia Vera:
https://www.webmd.com/cancer/polycythemia-vera#1-1

To Erythrocytosis:
https://www.merriam-webster.com/medical/erythrocytosis

GreatSpear's picture

Great info, good food for thought.

Protein4breakfast's picture

Thanks for posting bro!

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exoticnfit's picture

I've read an article that mentioned donating also causes the opposite effect of what we are there because of the actual donation itself.

Looking forward to reading that article you posted. Thanks

Armwrestlingfiend's picture

Yes I have also heard that donating will cause our bodies to compensate for the loss of blood and actually make even more. Not too sure though. Thanks for your input.

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Manshit's picture

I’ve brought my hemocrit down 5 points into three months.RBC in complete check after two donations and has not shot back up.

Dacky's picture

I’ve seen this with myself. HCT/RBC goes down and then shoots up before going back down and slowly climbs again. My endo has said not to worry so long as the HCT stays below 0.54.

growthman's picture

Interesting read.

My cardiologist told me not to donate because I thought my #’s were high, despite being just within range.

Hydrate imo.

Manshit's picture

What’s his opinion on using steroids?

MegaT883's picture

Good to know.+.

Armwrestlingfiend's picture

Thanks megat

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MegaT883's picture

One thing to keep in mind though is that this is Dr Crisler's opinion and has NOT been accepted by the medical community as a whole. There is an increase in stroke and heart attack in T users vs non users that has not been explained. The FDA was concerned where they now put a warning label on T. My point is this there are guys who are not in perfect health who still use steroids and should continue to give blood.

https://wayback.archive-it.org/7993/20170112031612/http://www.fda.gov/Dr...
https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/085635s040lbl.pdf
https://www.simmonsfirm.com/blog/health-canada-flags-testosterone-replac...

Armwrestlingfiend's picture

I definitely agree mega especially for guys on steroids. I think he is just referring to TRT though

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fusebox's picture

Good read. Thanks ++

Armwrestlingfiend's picture

Thank you fuse!

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johnmarshall12's picture

Very good post. Very informative as well. The information should help a lot of members. +

Armwrestlingfiend's picture

Thanks John!

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Manshit's picture

Man this turned into a good post!Good info from everyone.Shows why this site is so great!

Sam I Am's picture

Personally I donate every 8 weeks.

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Armwrestlingfiend's picture

I do too Sam. I believe it’s really good for you whether you need to or not plus it feels good helping/saving someone else’s life. And hopefully they enjoy some high levels of testosterone from us all too haha

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addicted.to.pain's picture

lol x2

Slowly's picture

Bro, my hemoglobin is 17.9, hematocrit 52.5. I just finished a cycle of Sustan. I'm thinking of donating blood.

Armwrestlingfiend's picture

We’re you well hydrated before the blood test. I would donate just to be careful it can hurt. Also, I drink a half a gallon of water before I get bloods taken it will make a significant difference as you could just be dehydrated. Donate drink water retest bro.

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MegaT883's picture

Good point on hydration. I know I have seen a change in my results just from doing just that. No more flags on creatinine.

Armwrestlingfiend's picture

Ya mega it’s made a huge difference for me also! Crazy how our bodies react when we’re not hydrated well.

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GreatSpear's picture

Thank you for sharing your story with us, I have an appointment to donate in the morning! Do you donate whole blood or double red?

Sam I Am's picture

That's a good post. I stored a picture of that link.

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Armwrestlingfiend's picture

I agre dehydration definitely skews the results and I was probably dehydrated my first couple of tests. I drink half a gallon of water before now on. That’s crazy shit rust you still have the blood clot in your stomach? How did they find it and would giving blood have prevented that?

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Armwrestlingfiend's picture

Damn that’s unfortunate rust. Did the blood tests show elevated platelets? Just wondering as that’s what the dr said we should look out for. Anyway best of luck in the future bro stay healthy.

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Manshit's picture

Two things.People at altitude are not at as high of risk of stroke because they are altitude.Those in the Andes will also chew coca leaves to push blood pressure up as well, because it helps them deal with altitude.The other thing is something you didn’t mention at all.Prolonged conditional high RBC and hemocrit causes left ventricle expansion,Aka as enlarged heart.So Maybe stroke is not the issue in some cases.I do agree with you that in some cases,bleeding may not be needed,especially for the endurance athletes.After all,they train at Big Bear for a reason.
+ 1 for thinking outside the box!

helloBrooklyn's picture

100% true about the Incas in the Andes. The Peruvian government has tried and failed to seize those coca leaves many times, but it just won’t happen. Good for the Natives, I say. That’s actually quite ingenious of them to figure that out. They’ve been doing it for thousands of years!

Armwrestlingfiend's picture

Those are interesting points bro I didn’t know at all. I just heard this podcast and because since I’ve started TRT I’ve been mega worried about hemoglobin hematocrit I thought this would help some people put their minds at ease. I did suggest people do more research as I should do myself. Thanks for the added info bro. Thank you appreciate the encouragement. I’m glad I posted because we can all come together and put all the info together here.

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Manshit's picture

Yes sir!Some Md’s are more concerned than others about this problem.I For one can feel in my head when my hemocrit is too high,but admittedly I do not do enough cardio and carry too much body fat.One thing though is bleeding will bring it down fast.The real question is how low is too low?Great post to get us thinking!

Armwrestlingfiend's picture

Ya crazy enough my doctor didn’t even mention my h/h everyone here told me I needed to donate. Definitely need more research and I’m curious as to the actual numbers of people getting stroke with only high h/h and not elevated platelets. Also, i believe donating and phlebotomy are actually good for us anyway just maybe sometimes not necessary. Thank you brotha hopefully I can come up with more posts like this in the future.

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Fred G.Sanfords's picture

Good read, My doctor Believes I have polycythemia due to severe sleep apnea, I have to donate 500CC’s of blood every other month Or so, I cannot use the CPAP machine due to my septum in my nose being broken several times and an enlarged soft palate in my throat. My airways are pretty much cut off , I’m going to have surgery in the near future to correct this I hope and then I should be able to use the CPAP and that should correct the problem.

Fred G.Sanfords's picture

Man I’ve tried every CPAP mask in on the market and I haven’t had any luck. My doctor told to sleep propped up until I can get the surgery done, My ENT doctor told me I’m in for a world of hurt for about two weeks after the surgery but if it helps then I’m all for it. Thanks

Armwrestlingfiend's picture

Thanks Fred! Damn that’s crazy I’m sorry to hear that. What did your platelet levels come back at just wondering. Also donating that much how are your ferritin levels? Anyway I hope you stay healthy bro and best wishes on your surgery in the future.

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helloBrooklyn's picture

I love informative posts like these! Big ++

This notwithstanding, a great precaution to help keep crit under control more naturally is by doing regular aerobic exercise. Which we’re all already doing anyways… riiiight? ;)

Armwrestlingfiend's picture

Thanks bro I appreciate it. I didn’t know regular aerobic exercise could help keep it under control? Learn something new every second here haha.

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helloBrooklyn's picture

In fact, endurance athletes have to be concerned with crit getting too low. But that’s on the extreme end of prolonged aerobic activity. Hence Lance Armstrong, blood doping scandal, blatant media scapegoat… oops, that escalated quickly

Armwrestlingfiend's picture

Ahh that makes sense now! Aerobic exercise decreases h/h so they take drugs to increase it. Haha I feel dumb I didn’t know that. But let’s be honest 90% of those bikers were probably on stuff. I think I heard somewhere one of his teammates threw him under the bus? I could be wrong I thought that’s what I heard though.

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helloBrooklyn's picture

Oh god, at the Tour de France level? Man, that one individual had to have been the exception, not the rule. While I don’t agree with Lance trying to blackmail the person by involving his family and all, I can’t blame him for being pissed off. Like, “if you’re not willing to do what it takes to win at the highest level, get the fuck off of my team. You have no place here if you want to be Mr Morality.”

But, things got ugly. All it takes is one rat to undo it all.

Bryarb1312's picture

Wow that’s interesting nice write up!

Armwrestlingfiend's picture

Thank you!

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