Hematocrit and RBC were over the reference range before ever taking anything.
Starting
RBC 5.89
Hematocrit of 50.4%
I am awaiting the results of a sleep study, took the test on Tuesday night. Wouldn’t surprise me if I did have sleep apnea. I had serious sinus problems as a kid. I also was fighting competitively for 6 years prior to taking it easy. I haven’t had problems with sinus infections or anything like that how I used to.
Gut health historically not so good, I had 5 sinus surgeries as a young adult, leading up to them I had been on prednisone and other steroids for years on end. Doctors told me it would ruin my gut bacteria but they had no choice. I had ulcers at 24.
The last 9-12 months I have been taking gut health more seriously. Last 6 months I take a pro and prebiotic. For the past year I focused on eating mostly whole foods, not much processed. Gut feels better then it ever has. I still have my Friday bad meal with processed foods and some sweets but 90% of my food intake is whole foods. Meat, fish, veggies and fruit. Bloating has subsided. I am a bit on the chunkier side since I have been raising my calories over the last year and a half. I was eating about 2,650 calories daily but starting to slim back down.
FWIW I do believe I hadn’t been hydrating as much as I should. Could also explain elevated hematocrit. I started drinking at least a gallon of fluids a day. Half a gallon is a mix of water and electrolytes daily. Been doing that for 6 weeks, I’ll see if it has any impact.
What markers for immune system do you recommend checking? I might have had them checked at my physical.
Mild "dehydration" wouldn't affect your hematocrit that much.
You might have sleep apnea yes, or you might have some sort of hematopathology (which I'm leaning more towards). You should look into this further, especially now that you've gone the trt route (and 160mg's sounds like a lot for actual trt, which should fall more in to 75 - 125 mg range), which has a chance of, or should I say "will" amplify such issues. I'd also keep an eye on TSAT. 38% right after 3 donations (or was it just one) means it was most probably over 45% before the donations, which means some sort of iron overload issues (doing genetics might be smart idea). Reticulated hemoglobin is a good marker for your actual iron status, however, high TSAT will push your shbg up no matter. The higher the TSAT the higher the shbg. Iron overload could (probably is) also be tied to high hematocrit and rbc's. Checking your EPO would be a good idea as your RBC's are high and your reticulocyte number too.
Immune system, basic tests are: protein electrophoresis, immunoglobulins (M, D, G, ...), IGG1 through 4, and then more in depth; a cytokine panel, and immunotyping your B and T leukocyte subsets. I doubt you have any autoimmune issues, your crp is low, but you can check ANA and Anti-dsdna.
I wont delve in to gut issues, but know that it can tax your liver, for instance due to high endotoxin burden, which can elevate shbg up. Iron overload can also tax your liver, even if ferritin is low, if tsat is high, that probably means a high labile iron load, which means - oxidative stress. There was research done on patient's livers who also had gut issues. Liver biopsies revealed problems, while basic liver tests were normal.
I'm going to back off now, as this is getting to exhaustive, more like a consultation or something. I hope this helps and furthers your research!
