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Elevated Hematocrit and Testosterone Injections
Feb 6, 2013


I'm one of the unfortunate people that experiences elevated RBC and hematocrit when on testosterone injection treatment, long term. I've been down this road before, where at one point I had to do a couple phlebotomy treatments.

My new endocrinologist wants me to stay off all testosterone for a month, then see how my levels are.

I protested this because when my levels plummet, I get really sickly and experience mental confusion. (I'm 44, btw).

So, I contacted him through our medical center online portal asking to be placed at least on Androgel to get me through, or reducing my injection from 1CC to 1/2CC.

I have felt so much better doing 1CC of cypionate, so this is very upsetting.

No endocrine doc in the past has asked me to stay off testosterone for a month, after being on replacement therapy for years -- intuitively, it sounds bad.

I am tempted to go for a second opinion in a different clinic.

In the mean time, I wonder what you've seen and/or experienced with this -- I posted a question to a bodybuilding forum, some men seem accustomed to donating blood periodically (the equivalent of a phlebotomy) -- which seems okay, and it doesn't bother me, but I wonder of the long term consequences (if any) of having your body produce more than you need.

What else is there that you know people are doing to deal with this?


Response from Mr. Vergel

If you are HIV+, you cannot donate blood. So your doctor has to write an order for you to get blood drained. Usually 2-4 units decrease hematocrit from 54 down to 49. HIV negative men who are not gay can donate. But I have heard that some healthy men with high hematocrit have been turned away from donation centers. You can read more about hematocrit reduction here: How to Prevent Heart Attacks if You are Using Testosterone

Any physician can order a phlebotomy. Your primary care doctor can do that.

Taking a month break will decrease your hematocrit. That is a no brainer. But what you know is also a no brainer is your decreased quality of life.

If you do not have a primary care doctor who knows about side effect management of TRT, you can search for some here:

How to find a doctor that knows how to manage testosterone replacement therapy

If you have no insurance, email me at the email shown on

Good luck. It sucks to know your information better than a doctor.


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