Bloodwork concerned??

[Beef54]

I'm currently on TRT and just received my labs. I'd like your recommendations on next steps.

Key markers:

• Total Testosterone: 919 ng/dL
• Free Testosterone: 256 pg/mL (high)
• Estradiol (E2): 49 pg/mL (high)
• SHBG: 22 nmol/L
• LH: 0.2 mIU/mL
• FSH: 0.7 mIU/mL
• PSA: 0.56 ng/mL

CBC:

• Hematocrit: 56.7% (high)
• Hemoglobin: 17.2 g/dL (high)
• RBC: 6.02 million/uL (high)

Other markers:

• Vitamin D: 31 ng/mL (low)
• DHEA-S: 344 ug/dL (slightly low)
• TSH: 2.38 uIU/mL
• Glucose: 89 mg/dL
• A1C: 5.0%
• Creatinine: 1.07 mg/dL
• eGFR: 97 mL/min/1.73m²
• AST: 21 IU/L
• ALT: 17 IU/L
• Bilirubin: 1.5 mg/dL

I use nicotine regularly and am wondering if that may be contributing to the elevated hematocrit.

Given these results:
1. Do you recommend donating blood or therapeutic phlebotomy?
2. Should my TRT dose be adjusted?
3. Is my estradiol level high enough to warrant treatment, or should it simply be monitored?
5. Is there any concern regarding the elevated hematocrit, hemoglobin, and RBC count beyond TRT and nicotine use?

Thank you.

 

[Conmike41]

I'm currently on TRT and just received my labs. I'd like your recommendations on next steps.

Key markers:

• Total Testosterone: 919 ng/dL
• Free Testosterone: 256 pg/mL (high)
• Estradiol (E2): 49 pg/mL (high)
• SHBG: 22 nmol/L
• LH: 0.2 mIU/mL
• FSH: 0.7 mIU/mL
• PSA: 0.56 ng/mL

CBC:

• Hematocrit: 56.7% (high)
• Hemoglobin: 17.2 g/dL (high)
• RBC: 6.02 million/uL (high)

Other markers:

• Vitamin D: 31 ng/mL (low)
• DHEA-S: 344 ug/dL (slightly low)
• TSH: 2.38 uIU/mL
• Glucose: 89 mg/dL
• A1C: 5.0%
• Creatinine: 1.07 mg/dL
• eGFR: 97 mL/min/1.73m²
• AST: 21 IU/L
• ALT: 17 IU/L
• Bilirubin: 1.5 mg/dL

I use nicotine regularly and am wondering if that may be contributing to the elevated hematocrit.

Given these results:
1. Do you recommend donating blood or therapeutic phlebotomy?
2. Should my TRT dose be adjusted?
3. Is my estradiol level high enough to warrant treatment, or should it simply be monitored?
5. Is there any concern regarding the elevated hematocrit, hemoglobin, and RBC count beyond TRT and nicotine use?

Thank you

1. I wouldn’t donate . Get checked for sleep apnea as OSA can cause elevated HCT. Make sure to hydrate before blood draws . Look into supplementing w Naringin and tumeric. It’s helped keep my H&H in range

2. What’s your TRT dose ? Were these labs taken immediately after injecting or at the trough, before your next injection. Number look good to me

3. If you’re not having symptoms of high E2, I think it’s fine . Estradiol has benefits too

4. Smoking causes increased HCT because it causes hypoxia which drives HCT up. I’m not aware of any studies that show nicotine in the form of Zyn or Gums causes elevated HCT

What was your HCT before starting TRT?

It’s very common for Hgb/HCT to increase a few points when you get on test, it drives EPO production and H/H tend to rise slightly in most guys

Overall, I wouldn’t lose sleep over it

Hope this helps

 

[Beef54]

Hey thank you for the reply!

25mg daily. I was fasted and I might have been slightly dehydrated. But I pinned the morning prior the blood test and after.

Last E2 was at 70. Feel a lot better in this range for sure no symptoms now.

Looking at natty bloods and I guess I only did hemoglobin 14.4 g/dl