Low and High hematocrit increase cardiovascular risk for Testosterone patients -

Hematocrit is the percentage of red blood cells in the blood. High hematocrit levels can increase the risk of cardiovascular disease, while low hematocrit levels can lead to anemia and other health problems. Testosterone replacement therapy (TRT) can affect hematocrit levels in some men. In this blog, we will explore how low and high hematocrit increase cardiovascular risk and how TRT can impact hematocrit levels.

High Hematocrit increase Cardiovascular Risk

High hematocrit levels can increase the risk of cardiovascular disease, particularly in men. The excess red blood cells in the blood can cause the blood to become thicker and more viscous, making it more difficult for the heart to pump blood throughout the body. This can lead to an increased risk of heart attack, stroke, and other cardiovascular problems. Some of the factors that can contribute to high hematocrit levels include:

Dehydration: Dehydration can cause hematocrit levels to increase.
Smoking: Smoking can increase hematocrit levels.
Altitude: Living at high altitudes can cause hematocrit levels to increase as the body tries to adapt to lower oxygen levels.
Genetic conditions: Some genetic conditions, such as polycythemia vera, can cause hematocrit levels to increase.

Low Hematocrit and Anemia

Low hematocrit levels can lead to anemia, a condition where there are not enough red blood cells in the blood. Anemia can cause symptoms such as fatigue, weakness, and shortness of breath. It can also increase the risk of complications during surgery and childbirth. Some of the factors that can contribute to low hematocrit levels include:

Iron deficiency: Iron is essential for the production of red blood cells, and a deficiency can lead to anemia.
Vitamin deficiency: Vitamins such as B12 and folate are also essential for red blood cell production.
Chronic kidney disease: Chronic kidney disease can lead to a decrease in the production of red blood cells.
Chronic diseases: Chronic diseases such as cancer and HIV/AIDS can lead to anemia.

TRT and Hematocrit Levels

TRT can impact hematocrit levels in some men. Testosterone stimulates the production of red blood cells in the bone marrow, which can lead to an increase in hematocrit levels. However, not all men will experience an increase in hematocrit levels with TRT, and some may even experience a decrease. It is important for men receiving TRT to have their hematocrit levels monitored regularly to ensure that they are not at an increased risk for cardiovascular disease. If hematocrit levels become too high, TRT may need to be adjusted or discontinued to reduce the risk of cardiovascular problems.

Lance Armstrong and elite cyclists using EPO to increase Hematocrit

Lance and other elite cyclists allegedly used EPO to increase their hematocrit levels to increase oxygen carried around their body and improve endurance and recovery. These cyclists also have incredibly developed hearts that could operate efficiently at higher Hct levels. Cyclists risks are different than men in their 40s and 50s trying to get back into shape and experiencing TRT related higher HCT and thicker blood.

How TRT patients and clinicians can monitor and manage Hematocrit levels

We generally feel that <51 Hct levels is a green light, 51-54 is a yellow light and 54+ a red light. Not only are the levels important but if the levels are increasing and at what rate. If hematocrit levels are raising or elevated the best ways to manage them are:

Increase hydration and water consumption. We recommend never going into a test hydrated as the tests may result in a false positive and require actions to return to safer levels.
Grapefruit and grapefruit seed extract help lower hematocrit.
Donate blood. Donating a pint of blood can lower Hct 1-3% points. A double red blood cell or ‘Power Red’ donation can lower it further.
Therapeutic phlebotomies are also donating blood. Many advanced blood centers have machines that strap your arm and run blood through it strip out red blood cells to a specific target Hct level around 42-43%. Blood donations can only happen so frequently and the therapeutics phlebotomy can reduce them dramatically.

Conclusion

Hematocrit levels can impact cardiovascular risk and overall health. High hematocrit levels can increase the risk of cardiovascular disease, while low hematocrit levels can lead to anemia and other health problems. TRT can impact hematocrit levels in some men, and it is important for men receiving TRT to have their hematocrit levels monitored regularly to ensure that they are not at an increased risk for negative cardiovascular events. By understanding the relationship between hematocrit and cardiovascular risk, men can make informed decisions about their health and wellbeing and improved conversations with their care team.

Hormone Therapeutics March 21st, 2023

Posted In: Health & Wellness, Hormone Replacement, Uncategorized