High hematocrit causes the blood to thicken which puts an extra burden on the heart to try to pump that sludge. This causes the heart to fatigue and also suffer from a lack of oxygenation, very similar to what people feel prior to a heart attack. This burden is not healthy.
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Hematocrit is another way of measuring hemoglobin. Hemoglobin is the component of RBCs that carries oxygen to the cells. This is important to an endurance athlete, like a cyclist and marathon runners. This is why it is on the Wada list, it serves as a PED for endurance athletes-skinny guys that rely on aerobic (not anaerobic) respiration. It isn't on the list just because it is a PED or else sugar would be on the list, it's on there because of the negative effect it has on the health of the heart. Much like the NFL trying to reduce TBIs with better helmets, it isn't good for the sport to have players suffering from TBIs and it isn't good for cycling to have cyclist die early from high H&H (Hemoglobin and Hematocrit).
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High H&H in the presence of AAS and or Growth Hormone leads to cardiomegaly (enlargement of the heart). This sounds good at first but, what really happens is thickening of the walls. Thickening of the walls leads faulty function via two pathways. 1) A disrupted electrical signal through the Purkinje Fibers and 2) the chambers of the heart are unable to pump properly due to inadequate flexibility.
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High platelets, a completely separate issue from H&H, lead to thrombi which causes stroke, DVT, PE, and heart attack.
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I am not a bodybuilding coach nor AAS expert. I am a nurse and a libertarian. It is my duty to provide others with health facts so they can make informed decisions.