Polycythemia and Donating Blood

**OhGeez** · 04-06-2018, 09:43 PM

First: I'm months away from starting my first cycle. This one of several questions (and a possible solution I want to run by y'all) I have after not seeing it directly addressed in the forum.....

Testosterone and other androgens (for our purposes I'll lump them together as test) have a stimulating effect that can cause polycythemia. Polycythemia is the thickening of the blood (an increase in hemoglobin, hematocrit, or red blood cell count). Thicker blood increases the risk of stroke (among other not-so-fun things).

There are higher instances of polycythemia among patients who inject test, and the likelihood of developing polycythemia appears to be connected to the amount of test injected.

A common way to manage this is to donate blood. Donating pint of blood will apparently lower hematocrit by ~3%.

Now a lot of the articles I've read are about developing polycythemia during TRT. I didn't find any scholarly articles about likelihood during an 8 week cycle. All things being equal, I'm ok with my body being a little stressed during the process especially if I'm on top of it.

I'm gay, and can't donate blood without staying celibate for 2 years (not gonna happen), and I doubt very highly my doc will prescribe a therapeutic phlebotomy for blood tests she didn't order.

I have no desire to bloodlet myself at home.

So I'm thinking of adding a baby aspirin (~81mg/day) and 2,000 to 4,000mg of omega-3 fatty acids to my cycle and the first few weeks of PCT to help lower blood viscosity. Has anyone tried this?

Has anyone else on this board had to deal with being unable to give blood and having test-induced polycythemia?

**almostgone** · 04-07-2018, 01:49 AM

If you are deferred from donation, your Dr. won't write you a script for a therapeutic draw,and you aren't capable of self-phelobotomy, your options are limited.
If you decide to cycle, monitor your hematocrit. Stating.hydrated will only help a little, it isn't a substitute for getting rid of excess RBC, nor is aspirin therapy, although aspirin therapy is a good practice.
Probably your best option would be to make friends with a phlebotomist and dispose of the blood in a safe manner. Personally, I throw my blood on a brush pile, light it, and pretend it's a Viking funeral.
FWIW, a whole blood donation (1 pint) gets me ~ a 1-1.5% reduction, a double red gets me closer to a 3% reduction.
I have always had naturally rich blood (pre -TRT and off cycle for years I was around 52%). My Dr. doesn't get overly excited until she starts seeing values in the 54%+ range, and then strongly encourages me to go donate blood. I do donate at every opportunity, but also I pull a total iron panel several times/year to include TIBC, serum iron, and ferritin.

**Lemonada8** · 04-11-2018, 09:33 AM

Drink plenty of water, at least a gallon of water a day.

Take a baby aspirin a day, wont hurt.

I dont know ur other medical issues... adding a omega-3 wont effect ur blood viscosity much... (if anything it would make it thicker i presume... but thats negligble... )

main point is... DRINK Water, and alot of it.

Do u even know what ur baseline CBC is? Is ur Hematocrit even normally an issue? or r u just researching and worrying urself now about it?

**Mr.BB** · 04-11-2018, 04:56 PM

Unless there is an underlying condition, like Lemon mentioned, and take enough break time between cycles, you shouldn't have problems due to the higher hematocrit on cycle.

Of course you should monitor it by doing blood work mid cycle. Not doing blood work during cycles is like driving in the dark with no lights.

Don't know where are you from, but most in most countries you can have private blood work done.

My country also has the stupid rule about gay donations, and some other stupid rules, many of which I lie when I go donate.

**GearHeaded** · 04-11-2018, 07:16 PM

your worrying about a problem that does not yet exist ? correct ? does your blood work indicate high hematocrit levels ?

keep in mind that guys all over the world, from bodybuilders, to cyclist, to swimmers, etc.. take these drugs to purposely increase hematocrit levels. thats part of the performance benefit. I think the whole thing about elevated hematocrit is blown out of proportion.

unless you have a pre existing condition for Polycythemia like untreated sleep apnea, running a cycle of test here and there should be far from your worries ( you should be more worried about getting bunk or dirty gear that will get you infected, or buying legit gear that gets you arrested). lots more to worry about brother

**Quester** · 04-11-2018, 07:30 PM

No offense to the community but protections added by water and aspirin are a harmful myth.
Drinking water is going to add to blood volume, causing a rise in blood pressure and increasing the work rate of the heart. Aspirin is an anti-platelet, it will keep your blood from clumping and slow clotting. Anti-platelets will not "thin the blood," they simply alter its chemistry in a way that keeps it from clotting easily.
Just remove the amount that you'd be donating into a container and dispose of it. There is a thread on here about it. Also, it is very unlikely you will have to worry about this at all on a cycle. However, your foresight and preparation is commendable.

**Quester** · 04-11-2018, 07:33 PM

Also, the range for hematocrit is 37%-52%. Depending age, gender and health, this is a wide range.

**mxgregg** · 04-12-2018, 12:50 PM

So do you think it is better to not drink so much water?

Originally Posted by Quester

No offense to the community but protections added by water and aspirin are a harmful myth.
Drinking water is going to add to blood volume, causing a rise in blood pressure and increasing the work rate of the heart. Aspirin is an anti-platelet, it will keep your blood from clumping and slow clotting. Anti-platelets will not "thin the blood," they simply alter its chemistry in a way that keeps it from clotting easily.
Just remove the amount that you'd be donating into a container and dispose of it. There is a thread on here about it. Also, it is very unlikely you will have to worry about this at all on a cycle. However, your foresight and preparation is commendable.

**GearHeaded** · 04-12-2018, 01:01 PM

Originally Posted by mxgregg

So do you think it is better to not drink so much water?

drinking too much water can flush your body of minerals and electrolytes,, which can exasberate any under lying heart conditions, or cause irregular heart beat, muscle cramping, etc..
simple thing is to just drink according to your thirst, do not force water down your throat when your not thirsty

**Mr.BB** · 04-12-2018, 01:52 PM

Originally Posted by GearHeaded

drinking too much water can flush your body of minerals and electrolytes,, which can exasberate any under lying heart conditions, or cause irregular heart beat, muscle cramping, etc..
simple thing is to just drink according to your thirst, do not force water down your throat when your not thirsty

Agreed. Plus your kidneys can only process about half a liter per hour. IMO anything over 3 liters, in a moderate climate place, is not needed. If its a hot climate things can change drastically.

**ZoomyR6** · 04-12-2018, 04:56 PM

First of all, Testosterone causes a healthy increase in RBC, just like people living at altitude. This is different from polycythemia which is a disease that causes blood to thicken.

Second, if worst comes to worse, why not lie on the questionnaire at the blood center about not being gay? Your blood is getting tested anyway...

**Lemonada8** · 04-12-2018, 05:41 PM

Originally Posted by Quester

No offense to the community but protections added by water and aspirin are a harmful myth.
Drinking water is going to add to blood volume, causing a rise in blood pressure and increasing the work rate of the heart. Aspirin is an anti-platelet, it will keep your blood from clumping and slow clotting. Anti-platelets will not "thin the blood," they simply alter its chemistry in a way that keeps it from clotting easily.
Just remove the amount that you'd be donating into a container and dispose of it. There is a thread on here about it. Also, it is very unlikely you will have to worry about this at all on a cycle. However, your foresight and preparation is commendable.

This discussion is about hematocrit being high. This is due to low plasma volume compared to RBC ratio. Most of the time when hematocrit is high, it is due to low plasma volume and not super elevated hemoglobin. Now in this case, there is a cause for elevated hemoglobin with the AAS. With the general population usually being dehydrated anyways, I would tend to bet that most cases of elevated hematocrit is due to dehydration, and with that I suggested to increase fluid intake. As i suggested a gallon a day.

And a baby aspirin a day is not harmful in any way, esp with a possibility of elevated hematocrit. And you are correct, they dont 'thin' the blood, they help prevent the platelets from clotting which is very helpful when the blood has an increased viscosity due to decreased viscosity.

I disagree with your suggestion to instead 'remove the amount into a container and dispose of it' as an alternative, as that is much more invasive and takes much more knowledge of how to do it safely and sterile and prevent infection, and does take more sterile equipment that can be more difficult to obtain.

**Quester** · 04-12-2018, 06:44 PM

Originally Posted by Lemonada8

This discussion is about hematocrit being high. This is due to low plasma volume compared to RBC ratio. Most of the time when hematocrit is high, it is due to low plasma volume and not super elevated hemoglobin. Now in this case, there is a cause for elevated hemoglobin with the AAS. With the general population usually being dehydrated anyways, I would tend to bet that most cases of elevated hematocrit is due to dehydration, and with that I suggested to increase fluid intake. As i suggested a gallon a day.

And a baby aspirin a day is not harmful in any way, esp with a possibility of elevated hematocrit. And you are correct, they dont 'thin' the blood, they help prevent the platelets from clotting which is very helpful when the blood has an increased viscosity due to decreased viscosity.

I disagree with your suggestion to instead 'remove the amount into a container and dispose of it' as an alternative, as that is much more invasive and takes much more knowledge of how to do it safely and sterile and prevent infection, and does take more sterile equipment that can be more difficult to obtain.

Lemonada,
No attack on your previous post was made by that response, it is just that it is a common misconception to think that we can drink all of the water we want with no pathology resulting. My father would put a half gallon pitcher next to his bed and fill it three times during the night. While he still swims a half mile every day, he also take a bunch of blood pressure and cardiac medication.
Our vasculature is made up of small tubes, bp is a small range. Everything that goes down your throat enters your bloodstream.
Hematocrit is a ratio. If one adjusts that ratio, where does one look to see the tolerances being surpassed?
No, aspirin doesn't help. Thinning the blood is just a bunch of words. Aspirin keeps the blood from coagulating. Thinning the blood does not describe its method of action.
The basis of your disagreement regarding blood -letting. OK, it will not solve the problem of erythrogenisis. Which is the heart of his problem. But it will lower viscosity by lowering volume. Perhaps someone else may know of a way to correct the problem of increased testosterone creating to many RBCs, but until then, lowering volume is a viable solution.
And, as previously stated, on an eight week cycle one has nothing to fear regarding the issue. The whole point of this is to dispel the idea of adding to blood volume, through the mechanism of drinking water, or introducing substrates like aspirin, when our primary concern should be reducing the workload on the heart.
No offense was meant, nor made to you personally.

**Lemonada8** · 04-12-2018, 07:23 PM

^^ No offense was taken, sorry if i sounded defensive. I did not take any offense at all, and definatly not personally

.

Assuming with fully functioning kidneys, drinking a gallon of water a day should not be harmful whatsoever. and with the general population being generally dehydrated and can use some fluids, it wouldnt hurt.

As for the aspirin, with an elevated hematocrit the chances for clot formation are increased due to 'virchows triad" (hypercoagulibility *increased viscosity, hormonal imbalance*, stasis, and endothelial injury *hypertension - increased from the stress of working out even temporary can cause damage; and the everyday shit that normally happens, and cholesterol deposits on the endothelium). I feel that a baby aspirin would help prevent possible complications associated with an elevated hematocrit.

I dont think that bloodletting would help reduce the blood viscosity alone, unless it was also included with included with increased fluid intake to replete the plasma volume to 'tip the scales' in favor of plasma volume compared to hemoglobin.

**Quester** · 04-12-2018, 07:44 PM

Ok,
I half agree with everything your saying but the other half still requires a redress.
1-Yes on the kidneys but no on the heart. The vasculature is just a contained system pumping system, the heart has to pump increased volume which is increased burden. As to the specifics, ...perhaps.
2-Aspirin. The point is still in regard to the heart's burden. Aspirin does not address that, it is like a detergent, it prevents bonding.
3-Half agreed. Not on the point of increased fluid intake, that would upset the osmolality.
The whole point is that water isn't a miracle, it is just another thing that needs to be taken into account. There's good and bad with all things. Also, adding water deplets the cells of water-soluble substances (B & C, among others). This requires further ingestion which further disrupts balance.
It is not as if we, in the world where we have computers and internet, walk around in a half-starved-dehydrated state waiting on the next rain or herd to pass in front of out cave. Our bodies, however, are adapted to those kind of conditions. Meaning, I have never turned on the tv and seen the apes, nor the primitive man, from whom I am descended, chugging pure water like fratboys drinking PBR doing a keg stand.

**Quester** · 04-12-2018, 07:50 PM

In the same vain,
I'm doing this so I'll take more of that... When has that ever worked out? NAC, Fish Oil, Green Tea, Saw palmetto, Water, etc. Yes, do them if your doing this but its not as if they bring things back into balance. The only thing that brings balance is time. Those other things help. But they are not time machines. Our bodies will adapt, given time. Time heals all.

**Lemonada8** · 04-12-2018, 08:35 PM

Aspirin doesnt do anything with the heart, it wasnt meant to. I was refering to helping prevent possible strokes and heart attacks due to the possibility of clots forming as described before.

But thanks for the constructive discussion. I like those, and thanks for not resorting to ad homenium attacks, its refreshing to not have people resort to those.

**Marc6667** · 04-17-2018, 10:10 PM

Not sure if this is helpful but my TRT clinic took my blood due to elevated hema. They destroyed my blood due to an active tattoo I’ve been getting. Also my Psychiatrist has offered to write me a script/note/idk if I ever needed it done some where else. I’m
New here but this was an issue I recently ran into but just with TRT.
Good luck!