recent blood draw and im concerned about HGB and HCT levels

[tall1]

i recently had to have an unexpected blood draw for my hrt(200mg cyp e2w), usually i break it up and shoot 100mg ew but i got kind of lazy the last couple of months. i gave myself a shot about 2 weeks before the test and actually shot more than 200mg as i was finishing out a high dose vial(using up my stash based on exp. date). its been between 6mo and a year since i ran any kind of cycle and all my #'s are in the normal range except:

HGB 19.3 (14.0-18.0)
HCT 57.1 (42.0-48.0)

i havent talked to my actual doc yet but one of the doc's in the office has made quite a big deal about these #'s(my girl works there). i am a smoker(dont plan to be for much longer) and the doc is saying that these levels are high because of problems with my lungs but i dont know if he was aware of my hrt. i know that steroids can raise the red blood cell count so would my hrt explain these high #'s?

[cpeil2]

Your hematocrit is pretty high. Enough so that you probably want to discuss temporarily withdrawing from HRT until you get the Hct to a healthier level.

You should probably also consider donating a unit of blood or a therapeutic phlebotomy to get the hematocrit down.

Definitely do quit smoking. Cigarette smoking not only increase Hct, but fibrinogen and blood viscosity.

This is all stuff that should be done sooner rather than later.

[mranak]

HRT elevates these numbers. Go give a pint of blood prior to your next doctors visit and plan to give blood on a regular basis.

But go ahead and don't smoke another cigarette. That's good for you, too.

[stat1951]

First of all, it looks like your Lab's range for hematocrit is way low. most show a range that goes to 50 or even 52. Some - even like the Cleveland Clinic - use 55 for the cut-off limit.

Obviously your are above those levels, but not as bad as it would seem. Also (and this was a big surprise for me) buit being dehydrated is a significant factor for increasing one's hematocrit levels... Also, doing the HRT by way of the 200mg IM shot every two weeks instead of 100mg weekly probably increases hematocrit levels as you are getting that initial "spike" of higher testosterone. May also want to consider switching over to a transdermal as I have read in a couple places that IM shots are more likely to produce elevated hematocrit than the gels (???)....

I would check with your HRT doc obviously but I don't know that these levels call for suspending your HRT. I'd say donating some blood, making sure you keep hydrated (along with quittting the smokes) and another updated test should give you some indication of a more positive position as relates to your H&H...

[cpeil2]

Originally Posted by stat1951

First of all, it looks like your Lab's range for hematocrit is way low. most show a range that goes to 50 or even 52.

The value needs to be interpreted in the context of the reference range. The reference range is a reflection of that particular lab's equipment, reagents, techniques and patient population.

[tall1]

this is all very confusing and i cant seem to get a solid answer from my doc either way, although he said he would do some checking. i am in the process of quitting smoking(down to just a couple a day) and i am overdue for my shot and waiting to find out whats up.

thanks for your help guys and if you can give me any more info to help make this less confusing then i would really appreciate it.

[cpeil2]

Your doc is right to be concerned. A high hematocrit increases your blood viscosity. Increased blood vicosity puts you at risk for clotting problems - deep vein thrombosis, pulmonary embolism, stroke, heart attack. I'm a little more sensitized to clotting problems than most, having already had 3 dvt's. I have forgotten the value at which he considers it necessary, but SWALE interrupts TRT if hematocrit goes too high. I think it's 55%. Have they repeated the test since you got the abnormal result? It could be lab error, or some sort of outlier.

stat1951 made a good point. Your hydration level can effect your hematocrit. Make sure to drink plenty of water.

[tall1]

i finally got a hard copy of my lab today and there are a couple of other levels that are high.

MCV 95.1 (80.0-94.0)
MCH 32.2 (27.0-31.0)

i dont even know what these are but im about to try and search online to find out. btw, would it help you guys out if i posted my complete results?

[tall1]

i just stopped at the docs office and got a finger stick done and my HGB came out at 16.4 so im going to have a blood draw again tomorrow to double check everything.
i guess i screwed up in my first post, i had:
HCT 57.1 (42.0-48.0)
and after seeing the hardcopy it should have been:
HCT 57.1 (42.0-52.0)
sorry about that, i guess stat1951 was right on the money in his post.

[SWALE]

You have been given all the good advice here you need.

I would hold your TRT given your numbers.

[tall1]

i got a second blood test yesterday, now my HCT is down to 54 but HGB remained the same. my doc says "I just dont think it's a big deal"

i think i need a new doc.

[SWALE]

Dr. Stephen Sinatra, the Cardiologist I follow, told me a lunch a year ago that he considers 18.0/55.0 for H/H an absolute ceiling. If Dr. Sinatra says it, I do it. THAT is how much I trust his professional opinion.

[tall1]

i have discontinued my trt for now. i am going to try to talk to a diff. doc in the office tomorrow to check out my lungs using a spirometer(sp?) but i really have no idea what is causing this. ive never had any breathing problems and would never have classed myself as a heavy smoker, i dont have a smokers cough and never wake up hacking.