Unexpected Problem With HRT

[coinflipper_21 (imported)]

Since I am an unintentional eunuch, I have been using Androgel, for HRT, for about 14 years. I had some blood work done a month ago, prior to a procedure, and the results alarmed my doctor. It seems that my hemoglobin was elevated beyond normal. Having too many red blood cells can clog the smaller arteries causing a stroke. This, he says, is very common with the use of a testosterone supplement. He has reduced my dosage, put me on a low dose aspirin regimen, and will re-check my hemoglobin levels in a couple of weeks. Has anyone else on HRT run into this?

[Woggler58 (imported)]

"

Has anyone else on HRT run into this?

"

Yes, closely enough to be responsive. I'm your age and on T replacement beginning in Jan 2010 via daily rub-on creme as prescribed and monitored by a HRT specialist with the BodyLogicMD group. That doctor told me early on that raised red blood cell, hemoglobin, and hematocrit test results are normal, that excessive levels could occur, and that giving blood periodically is a way to mitigate that effect, and is preferrable to lowering T below our target of 75th to 90th percentile.

I have kept a self-made spread sheet of my comprehensive blood test results over the last 7 years (one in 2006; two each in 2007, 08, and 09; four in 2010, three in 2011, and two to date in 2012.) My TRT began in 2010 following two full years of low T (210) following radiation for prostate cancer in late 2007. My ambient T before all that ran 366 to 402, about 25th percentile where 540 is the 50th %-ile mean.

My red blood cell-related test results do indeed correspond to my blood T level test results, hemoglobin in the high 14s pre-radiation, low 13s during the 2 years of depressed T, and now runs in the high 15s to low & mid 16s while on TRT that my MD approves of. None of my hemoglobin results fell outside the Lab's ref range of 12.5 to 17.0, although my red blood cell count was below its ref range a little when my T was at its lowest.

I did however acquire a blood clot, not arterial in a small artery but a deep vein clot (thrombus, a"DVT") in a big thigh vein, early in 2011, first diagnosed in June of that year after its outward effects of ankle and calf edema (swelling with non-blood fluid) were already clearing and I went onto Coumadin (warfarin) and off Vit K-containing foods and supplements for the rest of 2011 while continuing with frequient, speed-oriented bicycling. The clot was gone per ultrasound testing and I went off Coumadin and onto low-dose Vit K2 and low-dose aspirin effective Jan 2012 to date, with no DVT recurrence. Clotting is a complicated subject and worth some self-study online.

I recommend frequent lab testing as a way of monitoring one's internal conditions. I order my own testing and update my spread sheet with the results. That's how my low T and low thyroid conditions were discovered by me, not by any doctor, and how the MD-prescribed remedies are tracked. I order tests my doctors want plus what I'm interested in, paying myself with no heed to what Medicare approves or would cover. I fwd the lab results to my doctors, pre-appointment, and include my updated spread sheet. Lab tests may be ordered by members of Life Extension Fdn; they contract with LabCorp to do the pre-paid blood draw and tests, then fwd me the results they get from the lab. Many tests are bundled into "panels" and I regard them as plenty affordable. Usually I order panels (plus a few individual tests) that include what all my doctors want, and schedule seeing all of them within a month of when fresh results are at hand, hand-carrying in copies of what I'd forwarded to cover the frequent lapses of handling within their offices.

Hope this helps.

[Uncle Flo (imported)]

I encountered the same situation when preparing for surgery. I was asked to stop HRT at once. I did stop but it took two months to get my blood test levels down to an acceptable level. This was no surprise to my medical advisors who seemed to expect it. --FLO--

[nonuts (imported)]

This is a vital and important warning to post here. Thanks coinflipper_21! I've often wondered how bodybuilders avoid this issue. Or, perhaps they don't. Or maybe, since they "cycle" it's not as much of an issue. I'm on a therapeutic does of T as well, and my Hemocrit, Hemoglobin, Red blood cell counts have all increased. The only way to control this is to go off for periods of time, or reduce the dose to where you are at nearly eunuch levels. OR donate blood, or have blood let out if you do not qualify to donate. To me, threads like this are what the archive should be mostly about. THANKS!

[Sweetpickle (imported)]

Go donate blood. Or better yet platlets. That reduces your red cell count, and does something good.

[nonuts (imported)]

Go donate blood. Or better yet platlets. That reduces your red cell count, and does something good.

Just remember in the United States at least if you are gay, you can't donate blood. Other places I don't know what those policies are.