Ah yes, the ole altitude hand wave.
From this thread: WARNING: Do not believe Internet "gurus" proclaiming no need to manage hematocrit on TRT - Excel Male TRT Forum Underlying Physiological Mechanisms Testosterone Replacement Therapy (TRT) and Erythrocytosis: Exogenous testosterone stimulates red blood cell (RBC)...
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Hi ExcelMale folks, I wanted to start off by expressing my gratitude for this site, all of the amazing work that has been put in to make this place such a great source of information. I would expect no less from a chemical engineer :). I've been following this "debate" about how...
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Easier to just say it's fine. No worries.
Very interesting thread. Thank you for sharing that information (I feel like I say that a lot to you!).
Small quibble: I don’t find the altitude argument a complete hand wave. It presents a positive, credible argument. That article may refute its applicability. Hard to say given just a few short summaries of studies I haven’t read and as a lazy SOB likely won’t.
Nelson Vergel (the forum founder) explains in the thread that men on TRT experience a unique combination of
increased hematocrit and increased blood volume, often alongside higher blood pressure – a scenario that
does raise cardiovascular risk. By contrast, high-altitude natives have
high hematocrit in a context of normal or reduced blood volume and
hypoxia-driven vasodilation, which helps maintain circulation and avoid blood pressure spikes.
I don’t think anybody’s arguing that high HCT with high blood pressure, or HBP at all, is acceptable. If those correlations with various negative health outcomes quoted in the article
also correlate with HBP, then the argument isn’t quite so clear.
It’s also interesting that the article makes the argument that the TRT user’s
increased blood volume is one major disqualifying difference in comparisons to high altitude adaptations. I’ve seen it recommended that people donate Power Red. Sounds like they might be better off donating whole blood’.
I haven’t formally declared my HCT ceiling yet as my last attempt to have the high HCT experience (800mg EQ/week) was followed by a 6 point reduction somehow, but it’s probably a bit closer to 60 than it is to 54. Obviously, having HCT-associated symptoms would trigger instant remedial action, as would HBP that I can’t manage down without extraordinary measures.
But whatever the chosen max HCT number, the practice of regular phlebotomy is a terrible solution to what may or may not be a problem and is likely to cause another problem. I’ve had to get ferritin infusions after a period of regular donations made for altruistic reasons, and I suffered a long string of tired, gray, lifeless months before diagnosis and remedy. No good deed, no matter how small, goes unrewarded.
