Donating Blood While on TRT

 By George Touliatos, MD

Q: When should I donate blood – I’ve been on TRT for few months and my hematocrit reached 51%.

A: Testosterone fights anemia by stimulating erythropoiesis from red bone marrow; therefore, prolonged use and abuse will lead to erythrocytosis. But what matters in a CBC is the hemoglobin value, the protein carrier of oxygen in tissues. It’s an accurate number that is not affected by hydration. On the other hand, dehydration will pseudo elevate hematocrit, the percentage of erythrocytes (RBCs) into the blood. This falsely gives the impression of erythrocytosis, but it’s not – because the plasma becomes concentrated and the percent of RBCs elevates.

We should differentiate the term erythrocytosis from the term polycythemia. The former distinguishes in the number of thrombocytes, or platelets. Under such a condition, the risk of clotting and thrombotic phenomena is less likely to occur. On the other hand, under polycythemia we also have elevated platelets (>450,000) and under such a condition we must either donate blood or undergo a therapeutic phlebotomy. The healthy range of H/H is 54/18 and hemoglobin is 1/3 of hematocritunder normal conditions. So under dehydration, a hemoglobin of 17ng/ml might reflect to a hematocrit of 53%, even though it should be 51%. On the contrary, under proper hydration we may dilute plasma and hematocritcan lower falsely. What matters is the solid number of hemoglobin. Now when your hemoglobin is <18, then you are able to go for a blood donation. In case it’s elevated at 18.5, then your blood is too concentrated and thick to be transfused to a patient. This is when you undergo a phlebotomy. In order to lower your erythrocytosis, follow the following rules:

- Lower your protein intake (hemoglobin is a protein).

- Take salicylic acid precautiously (film-coated aspirin 100) with meal.

- Use pentoxifylline 400mg for better blood flow to avoid DVT/PE.

- Take fish oil 500mg with each meal; that thins the blood.

- Avoid smoking; that kicks EPO through CO.

- In case you snore and suffer from OSA, use a CPAP mask; otherwise, sleep on your left side and try to lose weight.

George Touliatos, MD is an author, lecturer, champion competitive bodybuilder and expert in medical prevention regarding PED use in sports. Dr. Touliatos specializes in medical biopathology and is the medical associate of Orthobiotiki.gr and Medihall.gr, Age Management and Preventive Clinics in Athens, Greece. Heis the author of four Greek books on bodybuilding, has extensively developed articles for www.anabolic.org and is the medical associate for the book Anabolics, 11th Edition (2017). Dr. Touliatos has been a columnist for the Greek editions of MuscleMag and Muscular Development magazines, and has participated in several seminars across Greece and Cyprus, making numerous TV and radio appearances, doing interviews in print and online. His personal website is https://gtoul.com/

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Watch E 144 of "Ask Dr. Testosterone: Can CREATINE Destroy Your Kidneys?"