All steroid users read this..important for your safety and health

[Shol'va]

Ok fellow steroid users of both sexes. I'm bringing forth a subject that hasn't been brought up since at least 2009. It pertains to our health and safety when using steroids. There is a little discussed issue that happens to a lot of us when we take steroids either for our health management or just for vanity sake. Anyhow the term of our health issue is called...are you ready for this? Ok here goes. I'm sure most of you are not even privy to this word. I know I was in the dark on it till my doctor slapped me with it. Ok enough beating around the bush. The term of our illness when using steroids is called POLYCYTHEMIA. Yep what a word indeed. For those of you which have no idea what the hell the word is or what it means I'll beak it down for ya. Polycythemia is when your blood thickens so much so that it starts to slow your blood flow through your veins and actually will start clotting in your veins if not caught soon enough. and well then you have a stroke or heart attack. This is just one more MAJOR reason why everyone who uses must get your blood work done before during and after a cycle. It' just makes sense guys and girls. Unfortunately I am one of the unlucky ones who has developed this disorder. Fortunately there is a way to combat it. I take a regular aspirin daily to help keep my blood thinned out plus I also have a phlebotomy every two months at the blood bank. I donate one pint of my blood. Well actually they just toss it, but that's ok with me. Since I'm one of the high risk boys I don't take any chances with the blood system even though I'm very safe sex wise. So anyways this is a wake up call for all you users who think you don't need any blood work while doing cycles. If you want to be a walking time bomb and drop over dead without notice don't do blood work. I'm just sharing my troubles and what I'm doing to stay on top of this issue to make my cycles safe and happy and productive ones. I don't want us to lose any members over something that they were not made aware of that could save them from themselves by being cautious as they continue down the steroid course like me. Have a healthy,happy, safer cycle and stay informed.
Shol'va

PS: Monitors if you wish to move this over to the steroid Q & A go ahead. It probably should be there anyways or at least a copy of this should be there. Thanks

[ac guy]

Good to know. I imagine a CBC will check this?

[tdoe11]

Another Vital reason for regular blood tests. They are so cheap and in most states you can do it anonymously with no prescription. Think you very much for sharing this, good to hear you are managing yours. If anyone needs a link to get their blood work done PM me.

[jimmyinkedup]

I take an 82mg enteric aspirin daily foir this very reason. The aspirin reduces platelet aggregation, helping to reduce the dangers of this. also those of us in the 40+,possibly even 35+, age group should dicuss daily low dose aspirin therapy with you doc anyway.
Excellent post Shov.

[kelkel]

I take an 82mg enteric aspirin daily foir this very reason. The aspirin reduces platelet aggregation, helping to reduce the dangers of this. also those of us in the 40+,possibly even 35+, age group should dicuss daily low dose aspirin therapy with you doc anyway.
Excellent post Shov.

X2. Plus I give blood every couple months. They love veins there. It's one place I actually feel wanted....

[Shol'va]

X2. Plus I give blood every couple months. They love veins there. It's one place I actually feel wanted....

Same here now but I don't like their needles. At my place they use 16 gauge cannons. I tried to get them to go with a smaller needle to save my veins but they claim they have none smaller and they are in a hurry to get the job done as well. Seems like about 30 minutes per pint with their 16 gaugers. All i know is they are painful ok at least to me..lol But hey I'll admit I'm a wuss...

[kelkel]

I agree. It's not a pleasant moment with that gauge needle. They definitely want you out quickly!

[DexterMorgan]

Donating blood for us is a win/win concept.
We're helping, while getting help.
Hopefully those who receive won't grow a beard with our blood , but i'm sure it's the last thing they worry about.

[Times Roman]

i donate blood bimonthly and take a baby aspirin every day.

one way to help manage this condition

[Shol'va]

i donate blood bimonthly and take a baby aspirin every day.

one way to help manage this condition

What you take a baby aspirin? You? Why I figured you for an adult aspirin.

[ppwc1985]

I don't plan on cycling again I'm where I want to be muscle wise, but I just started trt. Is there something besides aspirin for this problem?

[DexterMorgan]

I don't plan on cycling again I'm where I want to be muscle wise, but I just started trt. Is there something besides aspirin for this problem?

On TRT I would make blood donations a part of my life. Donate every few months to keep your blood from getting thick.

[austinite]

oil change is a good thing. and agree with Jimmy, aspirin daily is a great thing.

[AD]

this is probably the first serious post i see from sholva. i keep looking and waiting for the punchline, but there isnt any!??!

well, excellent post sholv. timely reminder.

[Igifuno]

I've fallen off the wagon with daily aspirin.. Picking some up tonight. Great post sholv - thx.

[bigt405]

I've fallen off the wagon with daily aspirin.. Picking some up tonight. Great post sholv - thx.

Same here and is time to give blood again too!

[marcus300]

I was admitted to hospital for Polycythemia, it was at a dangerous level what needed immediate attention

[Trevtrev]

I take an 82mg enteric aspirin daily foir this very reason. The aspirin reduces platelet aggregation, helping to reduce the dangers of this. also those of us in the 40+,possibly even 35+, age group should dicuss daily low dose aspirin therapy with you doc anyway.
Excellent post Shov.

I've been taking 81mg aspirin daily for years and my level last Friday was 49.7. Not even on a cycle. I'm a regular blood donor too.

Preventative measures are a good idea but yes the only way to know is by getting BW. Planning to donate again this week. Thin my blood and save some lives.....maybe even my own.

[boz]

Dually noted thanks for taking the time shol to give us this informative post.

[Hazard]

X2. Plus I give blood every couple months. They love veins there. It's one place I actually feel wanted....

Lmfao the lady at the collection center near me said "ohhhhh we can take 2 pints from you I bet" lololol

[Shol'va]

Lmfao the lady at the collection center near me said "ohhhhh we can take 2 pints from you I bet" lololol

DSM has been saying that for years about you but it isn't blood he is talking about..

[Hazard]

DSM has been saying that for years about you but it isn't blood he is talking about..

You can't spit two pints..... Swallowing's a must

[ghettoboyd]

great post shovla...can anyone tell me what the symptoms of this condition are? id appreciate it...

[drake4243]

great post shovla...can anyone tell me what the symptoms of this condition are? id appreciate it...

I would also like to know this? Is taking aspirin only relative to age 35+ or is it beneficial for everyone?

[Hazard]

Symptoms
By Mayo Clinic staff
In its early stages, polycythemia vera usually doesn't cause any signs or symptoms. However, as the disease progresses, you may experience:

Headache
Dizziness
Itchiness, especially following a warm bath or shower
Redness of your skin
Shortness of breath
Breathing difficulty when you lie down
Numbness, tingling, burning or weakness in your hands, feet, arms or legs
A feeling of fullness or bloating in your left upper abdomen due to an enlarged spleen
Fatigue
When to see a doctor
Make an appointment with your doctor for an evaluation if you have any of the signs or symptoms of polycythemia vera.

Because polycythemia vera causes your blood to thicken and slows blood flow, it increases your risk of developing blood clots. If a blood clot occurs in your head, it can cause a stroke. Seek emergency medical care if you have any of the following signs or symptoms of a stroke:

Sudden numbness, weakness, or paralysis of your face, arm or leg -- usually on one side of your body
Sudden difficulty speaking or understanding speech (aphasia)
Sudden blurred, double or decreased vision
Sudden dizziness, loss of balance or loss of coordination
A sudden, severe headache or an unusual headache, which may be accompanied by a stiff neck, facial pain, pain between your eyes, vomiting or altered consciousness
Confusion, or problems with memory, spatial orientation or perception


http://www.mayoclinic.com/health/pol...CTION=symptoms

[ghettoboyd]

thanks hazard I was being lazy I appreciate this...time to see the doc its been a while...

[Hazard]

thanks hazard I was being lazy I appreciate this...time to see the doc its been a while...

Lmfao no prob - I'm only watching tv at the moment relaxing haha - its quite nice!

[Shol'va]

To be quite open here guys I'm not liking what I've been reading on this disease. Well see for yourselves by reading this article.

Polycythemia may not cause any symptoms. It's often discovered only if a hemoglobin test or a red blood cell count is done. Some people do experience symptoms that appear gradually. These may include itching following bathing, dizziness, and a flushing of the face and hands. Weakness, headaches, visual disturbances, and a sense of "fullness" in the head and in the left upper abdomen may also be associated with the condition. Some people may have high blood pressure.

An infant who has polycythemia may be feeding poorly and have low blood sugar and difficulty breathing. It's very important to note that the problem isn't a cause for major concern in babies. It often doesn't require treatment, and it often resolves within a few days. However, these symptoms do warrant a visit to the doctor. Only very rarely does polycythemia cause serious problems in babies, such as seizures due to poor circulation to the brain.

Anyone who has polycythemia vera must receive treatment. Without treatment, the symptoms will become much worse and the risk of death from stroke, blood clots, or heart attack will increase. With proper treatment, the average survival of people with polycythemia vera is 7 to 15 years. People will probably feel quite normal and their risk of stroke or heart attack will be much less than if they didn't seek treatment. Although there's no cure, most people live for more than 10 years with the disease. Blood clots are the most common cause of death, followed by complications of myeloid metaplasia (a progressive disease of the bone marrow), hemorrhage, and development of acute leukemia.

[Shol'va]

Average survival rate of 7 to 15 years??? Well there goes my social security retirement...As if it would have been there anyhow. lol I'm still trying to catch up on all this as there is more than one type of this.

[Spartans09]

Great you brought this up. I've been sounding the alarm on this for several months now too. I had a scary run in where they told me I had polycythemia. There are two forms-primary and secondary. Primary is a form of leukemia. Let me tell you, that was a stressful couple of weeks until they ran all the tests and finally determined it was the non-cancerous form.
BE AWARE, 1 blood draw every few months will not even remotely resolve the issue if your hematocrit is in the mid 50's. It will take multiple draws in a short period of time-which requires a prescription.

How to Manage Polycythemia Caused by Testosterone Replacement Therapy
Testosterone Replacement Therapy and Polycythemia

By Nelson Vergel, B.S.Ch.E., M.B.A.

Source: Testosterone Replacement Therapy and Polycythemia in HIV-Infected Patients - TheBodyPRO.com

November 16, 2011




A research letter recently published in the journal AIDS by Vorkas et al determined that testosterone use was associated with polycythemia, and intramuscular administration demonstrated a stronger association than topical (testosterone patch) use. No adverse cardiovascular or thrombotic events were observed. HIV-infected patients taking testosterone should undergo routine hematologic monitoring with adjustment of therapy when appropriate.

Polycythemia is an excessive production of red blood cells. With polycythemia the blood becomes very viscous or "sticky," making it harder for the heart to pump. High blood pressure, strokes and heart attacks can occur.

The association between testosterone replacement therapy and polycythemia has been reported for the past few years as this therapy has become more mainstream. In addition to increasing muscle and sex drive, testosterone can increase the body's production of red blood cells. This hematopoietic (blood-building) effect could be a good thing for those with mild anemia.

Although all testosterone replacement products can increase the amount of red blood cells, the study showed a higher incidence of polycythemia in those using intramuscular testosterone than topical administration (testosterone patch was the main option used -- no gels). Smoking has also been associated with polycythemia and may contribute to the effects of other risk factors.

In the above mentioned study, twenty-five patients met the criteria for polycythemia (21 male; four female). Using the number of unique patients with five clinic visits during the time frame of the study as the denominator, the estimated prevalence of polycythemia was 0.42% (95% CI 0.27-0.61). Mean hemoglobin at the time of diagnosis of polycythemia was 18.9+/-0.42 g/dl in men and 17.0+/-0.83 g/dl in women. Among the four female cases, one was diagnosed with chronic obstructive pulmonary disease (COPD) and severe pulmonary hypertension, while the other three did not have a documented explanation for elevated hemoglobin. Because of the relatively small number of female cases and the fact that the primary hypothesis is related to testosterone use, this case-control study focused on the 21 male patients.

Five of the 21 cases (24%) did not use testosterone, but had other explanations for their polycythemia: pulmonary hypertension, COPD and plasma volume contraction. In two of the 21 cases (10%) there was no documented reason for elevated hemoglobin. No cases met the criteria for polycythemia vera, and no adverse cardiovascular or thrombotic events were noted among the cases or controls.

The letter recommends that all HIV-infected patients taking testosterone should undergo routine hematologic monitoring and adjustment of testosterone dose or cessation of testosterone therapy as appropriate based on hemoglobin values. Unfortunately, no mention is made of therapeutic phlebotomy as a management strategy for this problem. Considering that stopping testosterone replacement would affect patients' quality of life and leave their hypothalamic-pituitary-gonadal axis in a dysfunctional state for weeks, months or permanently, other ways to manage polycythemia besides treatment cessation need to be discussed.

Below is an excerpt from my book, Testosterone: A Man's Guide, further detailing the prevention and management of polycythemia.


Preventing and Managing Polycythemia
It's important to check patients' hemoglobin and hematocrit blood levels while on testosterone replacement therapy. As we all know, hemoglobin is the substance that makes blood red and helps transport oxygen in the blood. Hematocrit reflects the proportion of red cells to total blood volume. A hematocrit of over 52 percent should be evaluated. Decreasing testosterone dose or stopping it are options that may not be the best for assuring patients' best quality of life, however. Switching from injectable to transdermal testosterone may decrease hematocrit, but in many cases not to the degree needed.

The following table shows the different guideline groups that recommend monitoring for testosterone replacement therapy. They all agree about measuring hematocrit at month 3, and then annually, with some also recommending measurements at month 6 after starting testosterone (it is good to remember that there is a ban on gay blood donors in the United States).

Many patients on testosterone replacement who experience polycythemia do not want to stop the therapy due to fears of re-experiencing the depression, fatigue and low sex-drive they had before starting treatment. For those patients, therapeutic phlebotomy may be the answer. Therapeutic phlebotomy is very similar to what happens when donating blood, but this procedure is prescribed by physicians as a way to bring down blood hematocrit and viscosity.

A phlebotomy of one pint of blood will generally lower hematocrit by about 3 percent. I have seen phlebotomy given weekly for several weeks bring hematocrit from 56 percent to a healthy 46 percent. I know physicians who prescribe phlebotomy once every 8-12 weeks because of an unusual response to testosterone replacement therapy. This simple procedure is done in a hospital blood draw or a blood bank facility and can reduce hematocrit, hemoglobin, and blood iron easily and in less than one hour.

Unfortunately, therapeutic phlebotomy can be a difficult option to get reimbursed or covered by insurance companies. The reimbursement codes for therapeutic phlebotomy are CPT 39107, icd9 code 289.0.
Unless a local blood bank is willing to help, some physicians may need to write a letter of medical necessity for phlebotomy if requested by insurance companies. If the patient is healthy and without HIV, hepatitis B, C, or other infections, they could donate blood at a blood bank.

The approximate amount of blood volume that needs to be withdrawn to restore normal values can be calculated by the following formula, courtesy of Dr. Michael Scally, an expert on testosterone side effect management. The use of the formula includes the assumption that whole blood is withdrawn. The duration over which the blood volume is withdrawn is affected by whether concurrent fluid replacement occurs.

Volume of Withdrawn Blood (cc)=
Weight (kg) × ABV×[Hgbi - Hgbf]/[(Hgbi +Hgbf)/2]
Where:
ABV = Average Blood Volume (default = 70)
Hgbi (Hcti) = Hemoglobin initial
Hgbf (Hctf) = Hemoglobin final (desired);
So, for a 70 kg (154 lbs) man (multiply lbs x 0.45359237 to get kilogram) with an initial high hemoglobin of 20 mg/mL who needs to have it brought down to a normal hemoglobin of 14 mg/mL, the calculation would be:
CC of blood volume to be withdrawn = 75 x 70 x [20 - l4]/[(20 + l4)/2] = 75 x 70 x (6/17) = approximately 1850 cc;
One unit of whole blood is around 350 to 450 cc; approximately 4 units of blood need to be withdrawn to decrease this man's hemoglobin from 20 mg/mL to 14 mg/mL.

The frequency of the phlebotomy depends on individual factors, but most men can do one every two to three months to manage their hemoglobin this way. Sometimes red blood cell production normalizes without any specific reason. It is impossible to predict exactly who is more prone to developing polycythemia, but men who use higher doses, men with higher fat percentage, and older men may have a higher incidence.

Some doctors recommend the use of a baby aspirin (81 mg) a day and 2,000 to 4,000 mg a day of omega-3 fatty acids (fish oil capsules) to help lower blood viscosity and prevent heart attacks. These can be an important part of most people's health regimen but they are not alternatives for therapeutic phlebotomy if the patient has polycythemia and does not want to stop testosterone therapy. It is concerning that many people assume that they are completely free of stroke/heart attack risks by taking aspirin and omega-3 supplements when they have a high hematocrit.

Although some people may have more headaches induced by high blood pressure or get extremely red when they exercise, most do not feel any different when they have polycythemia. This does not make it any less dangerous.

[ppwc1985]

oil change is a good thing. and agree with Jimmy, aspirin daily is a great thing.

I can't take aspirin, I have a blood disorder. So I can give blood every month, but is there something else besides aspirin. I know my dad takes prescription blood thinners, why not for ppl on trt if it is a problem?

[TBrah]

They only let you give once every 2 months around here. It's not enough to keep H&H normal. Especially if you cycle.

[ppwc1985]

Ok, I'm not going to cycle anymore. Just trt, at least that's my thoughts now.

[OnTheSauce]

So are we talking high rbc and hematocrit? Do either ever lower by themselves? My last bloodwork showed hematocrit had crept up to 51. I was feeling head full and could feel my heartbeat laying down. I went to give blood but they wouldn't let me since I had left the country, and I'm not eligible until July 2014. I feel fine now though. My question, is it possible it lowered back down? I get bloods every 3 months and this is the first time it's been high

[AD]

The average lifespan of a rbc is about 3 months. So if you go off aas and remove the stimulus to overproduce rbc, things might get better in the next few months.

[OnTheSauce]

The average lifespan of a rbc is about 3 months. So if you go off aas and remove the stimulus to overproduce rbc, things might get better in the next few months.

Well my rbc has always been a tad high, but hematocrit was always 46-47 until last bloodwork at 51.

[ali.jones]

Another Vital reason for regular blood tests. They are so cheap and in most states you can do it anonymously with no prescription. Think you very much for sharing this, good to hear you are managing yours. If anyone needs a link to get their blood work done PM me.

Ahhhhhh I wish I were in USA, in Australia no lab takes you without doctors prescription and they send results directly to doctor without even telling you anything. It's expensive too, couple of visits to doctor and full panel test will end up much more than we say CHEAP. also you HAVE TOO give your doctor a solid reason for blood test. You can't convenes doctor than forget about it.

<Sad Jones>

[AD]

Well my rbc has always been a tad high, but hematocrit was always 46-47 until last bloodwork at 51.

The counts can change depending on what and how much gear you're using. Other factors may include hydration level, blood volume, excess water retention...

Or it could be random lab error
Check it again to confirm.

[OnTheSauce]

The counts can change depending on what and how much gear you're using. Other factors may include hydration level, blood volume, excess water retention...

Or it could be random lab error
Check it again to confirm.

I'm due for next set of bloods in about 6 weeks. And I feel fine now. No more head pressure and feeling my heartbeat when laying down

[AD]

I'm due for next set of bloods in about 6 weeks. And I feel fine now. No more head pressure and feeling my heartbeat when laying down

Sounds good. No rush then.