question from a user
i don’t like needles even though i inject twice a week, i haven’t donated blood in 6 months. How high of a risk is me neglecting reducing high RBC?
AlphaMD's Answer
The reality is that risk associated with high RBC due to TRT has never been directly studied. All the risks believed to be associated with high RBC are extrapolated from studies regarding other conditions that cause erythrocytosis (being overweight, smoking, alcoholism, COPD, polycythemia vera, renal artery stenosis, etc).
For this reason, it would be false to say that elevated RBCs from TRT increases the risk of heart attack or stroke, as that direct association has never been proven.
The logic behind the management of erythrocytosis is that the blood is “thicker”, which increases the risk of blood clots. However, in the absence of other disease (ie high elevation induced erythrocytosis), high RBCs alone do not equal a higher risk of heart attack or stroke. If it did, all people in Tibet would be in real trouble.
Despite this, we still recommend that you try to keep your RBC level within the normal range. Blood donation is not the only way to do this. There are a few limited studies which have shown use of naringen (grapefruit extract) can stabilize RBC levels, and we have had several of our patients achieve good results with this cheap supplement.
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