Polycythemia & B12

[jwh7699]

My Hematocrit runs High usually around 51. I donate blood every 2 months. I recently have been feeling tired more often so I stopped taking my usual Vitamins for a few days and had some of the more important Vitamin Levels Checked. My B12 Level is High. I read this can happen with Polycythemia (High HCT) due to the increase in RBC's. I was wondering if I should stop taking my B-12 Supplement or reduce the amount I take, Daily 5,000mcg sublingual tablet?

Thanks!!


Vitamin B12 1500 HIGH 232-1245 pg/mL

Folate (Folic Acid),Serum 19.1 >3.0 ng/mL


Zinc, Plasma or Serum 95 56-134 ug/dL


Vitamin A, Serum 51 24-85 ug/dL

Magnesium, RBC 5.0 4.2-6.8 mg/dL

(I've had my Vitamin D level checked before and it was Low, so I take 10,000 iu's a day)

[kelkel]

What is your TRT protocol?
Have you pulled an iron panel recently?
Consider dropping your B12 to EOD.
51 is really not that high for Hct.

[jwh7699]

I inject Test Cyp 62.5mg 2 x a week HCG 500mg 2 x a week Arimidex .25mcg 2 x a week

I'll lower the B12 to EOD

No, I haven't had an Iron panel done since 11/2015. I don't take any Iron supplements.

Iron and TIBC
Iron Bind.Cap.(TIBC) 330 250-450 ug/dL
UIBC 211 150-375 ug/dL
Iron, Serum 119 40-155 ug/dL
Iron Saturation 36 15-55 %

Ferritin, Serum 146 30-400 ng/mL

Reticulocyte Count 1.7 0.6-2.6 %

[GearHeaded]

do you have sleep apnea ?

[TRA]

My Hematocrit runs High usually around 51. I donate blood every 2 months. I recently have been feeling tired more often so I stopped taking my usual Vitamins for a few days and had some of the more important Vitamin Levels Checked. My B12 Level is High. I read this can happen with Polycythemia (High HCT) due to the increase in RBC's. I was wondering if I should stop taking my B-12 Supplement or reduce the amount I take, Daily 5,000mcg sublingual tablet?

Thanks!!


Vitamin B12 1500 HIGH 232-1245 pg/mL

Folate (Folic Acid),Serum 19.1 >3.0 ng/mL


Zinc, Plasma or Serum 95 56-134 ug/dL


Vitamin A, Serum 51 24-85 ug/dL

Magnesium, RBC 5.0 4.2-6.8 mg/dL

(I've had my Vitamin D level checked before and it was Low, so I take 10,000 iu's a day)

Not sure why you’re taking b12 unless you’re vegetarian or? You have elevated B12 so why continue to take it at all?
What are your test levels?
Did you have elevated crit before or just after you started on the test? Why HCG 500 instead of just 250 twice weekly?
What is the rest of your CBC like?
How long have you been on trt and what is your age? Do you cycle at all? Any other ancillaries, orals, etc.?

[Youthful55guy]

Are you asking whether there is concern over the high B12, or whether it is causing your high hematocrit? The latter question is probably not causing the high hematocrit. I googled this and it seems that high B12 is associated with some blood diseases, but not the cause of it. Side-effects of B12 are also pretty minimal, so probably nothing to be concerned about. However, given that your B12 levels are above the upper range of normal, you might want to consider cutting back to half the dose. Here's a quick good read on the side-effects: https://www.healthline.com/health/fo...2-side-effects.

[jwh7699]

Sorry, been a little busy.

Yes, I do have Sleep Apnea. I've had it since about 2011, I've used a CPAP pretty faithfully ever since.

B-12 can give you a boost in energy and it's water soluble, so it's not stored long term. Even with being on TRT I've had some fatigue issues, so trying different things to see what helps.

Since I got the Blood Work back I haven't taken the B-12. My breathing seems to be a little better, but it may be placebo affect at the moment.

Last Testosterone Blood Work was May 2017 (I split my dosing twice a week, Wed & Saturday. I went Wed Morning before my shot)
Total T 1112 ng/dl
Free T 25.5 ng/dl
Estradiol-Sensitive 31.6 pg/ml

My Hematocrit increased after being on TRT. I've been on TRT since 2012. I am 41 years old. I've been on HCG 250mg 2 x weekly for about 4 years. Recently I read it can give libido an extra kick with an increase to 500 2 x a week, so I started it 2 months ago and it helps.

I have not used other Hormones before except for HGH. I used it once 8/2014 to 2/2015, while on TRT. 4 iu's Mon - Friday off on Weekends. I had some strength increases, but mostly it was a dud. I am looking to try another round in a few weeks.

The rest of the CBC Blood Work is fairly Normal. My A1C is a little High, I get it done at the local Veteran's Hospital, and they always ask me to do blood when I haven't fasted and already eaten. I have a fasted one scheduled in a month so that one will be the standard.

Cholesterol is a little High. I stopped taking my Cholesterol medicine awhile ago. One Doctor said to stop the other said I should be on it, so probably go back on it at after the fasted blood work in a month.

I pretty much had the Vitamin Levels Checked because of Fatigue issues. I'm aware the High B12 won't cause the High Hematocrit, rather if I should do something about the High B-12 level. I'm gonna stop the B-12 supplement. I'm going to continue with the B-Complex supplement that covers Folate and the other B Vitamins.

Thanks Guys!!!

[GearHeaded]

if your CPAP is not dialed in or theres nights you don't use it , you have a very good chance of increasing your hematocrit . essentially when your body goes below 90% oxygen saturation and is starving for air it begins to make more red blood cells to help carry more oxygen.

Multiple linear regression analysis revealed that mean oxygen saturation, RDI, and percent of time spent at oxygen saturation <90% were significant predictors of hematocrit level, even after controlling for gender, ethnicity, 24-h urine NE, BMI, and BP (p < 0.05). The severity of OSA is significantly associated with increased hematocrit, even after controlling for possible confounding variables

pub med study

[TRA]

Your A1c does not require fasting. Blood glucose in your CMP depends upon fasting, and it is like a snapshot of your blood sugar at the moment labs are drawn. A1c is like a video of your blood sugar and reflects what it has been over the past month or so and does not require fasting

[jwh7699]

Thanks for the Info GH, I pretty much use it 95% of the time. Occasionally I'll fall asleep quick before I put it on, but when I wake up I put it on.

Thanks TR I wasn't aware of that. Gotta work on those.

[TRA]

if your CPAP is not dialed in or theres nights you don't use it , you have a very good chance of increasing your hematocrit . essentially when your body goes below 90% oxygen saturation and is starving for air it begins to make more red blood cells to help carry more oxygen.

pub med study

Agree. Your cpap should have a computer chip so you can submit a report to the company and they analyze and provide a readout so you know you’re in your zone.

[Youthful55guy]

Sorry, been a little busy.

Last Testosterone Blood Work was May 2017 (I split my dosing twice a week, Wed & Saturday. I went Wed Morning before my shot)
Total T 1112 ng/dl
Free T 25.5 ng/dl
Estradiol-Sensitive 31.6 pg/ml

My Hematocrit increased after being on TRT. I've been on TRT since 2012. I am 41 years old. I've been on HCG 250mg 2 x weekly for about 4 years. Recently I read it can give libido an extra kick with an increase to 500 2 x a week, so I started it 2 months ago and it helps.

Cholesterol is a little High. I stopped taking my Cholesterol medicine awhile ago. One Doctor said to stop the other said I should be on it, so probably go back on it at after the fasted blood work in a month.

A couple of thoughts:
Both your T and your Free T seem a bit high being it's the nadir sampling of your longest (3/4 day) interval. It would be helpful to see the normal ranges of your labs, but generally it's around 1100 ng/dL for TT and 25 pg/mL for free T. That means you are way above the upper end of the ranges for both throughout the rest of the week. I'd consider dialing it back to a 50 mg dose.

E2 is OK but at the upper end of the typical normal range (~35 pg/mL) for guys using the LC/MS/MS (sensitive) methodology. I would not attempt to change the anastrozole dose unless you converted to the Vodka method, as it's simply impossible to cut those tinny tables accurately beyond 0.25 mg (and even that is tough). Lowering your T dose should also bring your E2 down well within the upper end of the range.

Your dose of HCG is fine. I've seen data published that says 1000 IU/week will increase your T levels about 300 ng/dL above what the exogenous T will do. here's the article, but it's not explicitly stated. You have to tease the numbers out of Figure 2: https://www.ncbi.nlm.nih.gov/pubmed/15713727. I'd consider breaking up the dosing schedule of both your T and your HCG into an E3D protocol, which will give you lower peaks and nadirs, and allow you to do labs at any scheduled injection day. Lower peaks, will mean lower conversion of T to E and DHT and a more stable ride.

If your cholesterol is high (which is a common side-effect of high T), I'd consider going on a low dose of a cholesterol lowering med. I resisted for several years and then finally let my doc put me on the lowest possible dose of Lipitor (atorvastatin, 10 mg). There are no side-effects that I can tell and it keeps my cholesterol and lipids nicely within range.

[jwh7699]

I used to go once a year to the VA and they would take out the chip and read it. My readings were always good, they look for compliance more than anything. They changed it too every two years now.

I was on Pravastatin for a couple of years and one of my Doctors was on an improving memory kick. He suggested I stop taking it, because of a small memory problem side effect that medicine can have. I read a book about increasing your Niacin, natural cholesterol lowerer, it actually seemed to keep it normal for about a year. But my last couple of blood tests have shown it increasing. I don't mind going back on the medicine.

About a year ago I tried everyday dosing. I did it for a month. It really helped my HCT. It brought it down from 51 avg to 45. For some reason though I felt weak all the time, not fatigued, just a weak feeling. I didn't like it so I went back to 2 x a week. I did some reading over the weekend and I decided to try EOD injections, same total amounts, one week broken into 4 doses the next week into 3 and repeat. Will see how that goes.

I purchased my Arimidex in liquid form. When I first went on Arimidex I had those triangle shaped pills, pain in the butt to cut, never very accurate, and part of it always turned to dust when you tried cutting it smaller.