Hematocrit 55.3 at Elevation - Donate ASAP?

[powerdiesel]

I'm currently 5 weeks on 75 mg test C EOD (~265 mg per week) for a mini cycle to assess how many body handles progressing beyond TRT. I just got partial lab results back and my hematocrit was 55.3 and hemoglobin 17.7. All other blood markers were normal (RBC was 5.81, platelets on low end of normal at 179). I live at around 5200'. My blood pressure is very good, I average 105/60.

These labs were done fasted in the AM, but I chugged ~30oz of water ~45 mins before. Over the last 6 months my hematocrit has been 54.5 (AM), 46.1 (PM), 52.4 (AM), 47.4 (PM). So it seems like there is a trend that when I pull labs in the AM I am still dehydrated even after chugging water.

I haven't donated blood in ~15 years, and it would be complicated right now because I just started accutane. But given all this, whats the collective wisdom on phlebotomy vs just drink tons of water and dial up more cardio?

Thanks!

 

[Tbaz192]

How much fluids did you have prior to donating? Like total. Not just the 30 oz. If it wasn’t much.
That’ll be why your HCT was high. It’s pretty influenced by hydration as well.
I’ll chug minimum half a gallon before labs. And it’ll come back 2-3 points lower than non hydrated.

If you don’t have iron issues and you’re pretty keen on donating. Just do a normal donation.

I don’t believe in donating. Iron issues aren’t fun to fix. But your levels aren’t insane. I’d say your RBC was highly elevated, HBG, and HCT. Then that would be more concerning.

 

[RockyP]

I'm currently 5 weeks on 75 mg test C EOD (~265 mg per week) for a mini cycle to assess how many body handles progressing beyond TRT. I just got partial lab results back and my hematocrit was 55.3 and hemoglobin 17.7. All other blood markers were normal (RBC was 5.81, platelets on low end of normal at 179). I live at around 5200'. My blood pressure is very good, I average 105/60.

These labs were done fasted in the AM, but I chugged ~30oz of water ~45 mins before. Over the last 6 months my hematocrit has been 54.5 (AM), 46.1 (PM), 52.4 (AM), 47.4 (PM). So it seems like there is a trend that when I pull labs in the AM I am still dehydrated even after chugging water.

I haven't donated blood in ~15 years, and it would be complicated right now because I just started accutane. But given all this, whats the collective wisdom on phlebotomy vs just drink tons of water and dial up more cardio?

Thanks!

There does seem to be an element of hemoconcentration here. Before doing anything else, repeat the CBC but try to get as close to a gallon of water in as you can. People will say it's silly, but your body does not naturally have a HCT level that fluctuates as much as you have indicated from AM to PM. What's likely changing from those two points is your hydration status.

Also, when repeating the CBC, be sure to check your ferritin. You'll need to know what that is if you want to donate. If it's low, you don't want to donate blood.

Separate of all of this, what is your body habitus like? Are you lean / in shape? How much cardio do you do? Have you ever been evaluated for sleep apnea? All of these can contributed to elevated HCT. From what I've seen, this high of a H/H level, assuming we exclude dehydration for a moment, is due to guys being out of shape and / or having undiagnosed / untreated OSA. Once in a while some guys are just super sensitive to Test's impact on their H/H, but overwhelmingly addressing any OSA with CPAP and getting into better cardio shape should help manage this.

 

[powerdiesel]

Thanks, appreciate the insights! I was diagnosed with mild sleep apnea last summer and religiously use my CPAP. And I'm not a cardio bunny, but I'd consider myself above average cardio fitness. I'm ~11% BF, backcounyry ski and mountain bike pretty regularly, average ~13k steps per day, and do HIIT cardio 1-3x per week.

It seems like the wisest thing for me to do is focus on hydration + electrolytes and repeat the CBC in a few days. I think I drink a lot of water with LMNT, but maybe I'm just chronically dehydrated. I live in a high elevation dry climate and do daily sauna.

 

[RockyP]

Thanks, appreciate the insights! I was diagnosed with mild sleep apnea last summer and religiously use my CPAP. And I'm not a cardio bunny, but I'd consider myself above average cardio fitness. I'm ~11% BF, backcounyry ski and mountain bike pretty regularly, average ~13k steps per day, and do HIIT cardio 1-3x per week.

It seems like the wisest thing for me to do is focus on hydration + electrolytes and repeat the CBC in a few days. I think I drink a lot of water with LMNT, but maybe I'm just chronically dehydrated. I live in a high elevation dry climate and do daily sauna.

Sounds like a plan. I try to get a gallon of water with an LMNT packet in it prior to a blood draw. I drink about 7 liters per day in all, so it takes me several hours in the morning to get un-dry