Your elevated hematocrit/hemoglobin might well be directly related to your TRT. If so, there are ways to address that. However, your TRT might only be partly to blame as there are other conditions that can either contribute to high hematocrit/hemoglobin or even give false readings.

Depending on your situation, here are several ways to address high levels of hematocrit/hemoglobin:

This is the most obvious solution to elevated hematocrit, but it's probably also the least popular. Hardly any man wants to use less testosterone and give up any of the increased energy, sexuality, and muscularity that the hormone has gifted him. But truth be told, a lot of men are probably taking more than they need. The standard TRT clinic dosage is 200 mg. a week, which is, frankly, equivalent to a mild steroid cycle.

A study conducted by the Department of Urology at University of California found that subcutaneous (subQ) injections (under the skin rather than into the muscle) led to higher levels of free T, along with evidence of subQ being physiologically superior to IM shots in several other important ways.

Men who received subQ injections of testosterone exhibited the following:

The second result is the kicker. Since subQ injections led to a 41% reduction in hematocrit levels, you could theoretically use the same dosage you use for intramuscular injections. Of course, given that subQ injections led to a 14% increase in total T, you might just use a lesser dosage anyhow and further reduce hematocrit while retaining all the positive effects of your TRT.

Studies have shown that testosterone creams and gels raise hematocrit less than intramuscular testosterone injections.

This is the standard go-to treatment for high hematocrit. Every pint donated has been shown to decrease hematocrit by about 3 points. Unfortunately, you'd likely have to continue to periodically donate blood if you hadn't adopted any other hematocrit-lowering strategies.

That being said, there's some evidence that hematocrit levels stabilize after donating blood five times. Whether that's universally true is unlikely.

You can donate blood to places like the Red Cross or have your doctor perform what's known as a "therapeutic blood draw." Be careful not to donate too often, though. Giving a pint of blood more than every two and a half months or so may lead to long stints of fatigue.

High hematocrit readings sometimes occur because the patient was simply dehydrated, making it appear that the concentration of red blood cells was higher than it really was.

Of course, one simple way to determine whether your high hematocrit was caused by dehydration is to do a little simple math: hematocrit must always be three times the value of hemoglobin. If it's lower (Hct<3 x Hb), you're over-hydrated. If it's higher (Hct>3 x Hb), you're dehydrated. Either way, you're getting a false value because of your hydration status.

Red meats are high in heme iron (the type of iron found only in animal tissues), which is more efficiently absorbed than non-heme iron (the type found in whole grains, nuts, seeds, legumes, and leafy greens), and ingesting it can raise hemoglobin and, subsequently, hematocrit.

Sleep apnea is a medical condition where patients suffer from fragmented sleep. They literally stop breathing from 10 to 50 seconds multiple times throughout the night.

As a result of this interrupted breathing/sleep, patients experience poor oxygen saturation, which forces the body to produce more red blood cells and more hemoglobin.

Evidence suggests that curcumin binds to ferric acid in the digestive system, thus reducing hemoglobin levels. Be sure to use micellar curcumin which is 95 times more bioavailable than regular curcumin with piperine.

If you've got high hematocrit/hemoglobin AND have high blood pressure, ask your doctor to consider switching your high blood pressure medicine to Losartan. It's been used by physicians since the early 2000s to bring down hematocrit in kidney transplant patients and patients with chronic obstructive pulmonary disease (COPD).

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TRT Side Effects: The Big One to Avoid - T NATION

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