Finally getting a Phlebotomy

[lovbyts]

For the past several years my hemoglobin & Hematocrit have been slowly getting higher and sometimes peaking past where they should be. Well the last year its been mostly above where it should be and I have been asking my doctor the last few years for an RX to get a Phlebotomy but she has always denied it.My doctor is great in most things but this one she just doesn't want to do for some reason.Thankfully she decided to send me to a Oncologist.. Guess what he wants me to do. Besides drinking more water and exercising more he wants me to do a Phlebotomy. lolI cant donate blood because I had Hep B in 1991 so this is my only option. Thank god someone finally understands. Yeah I had to sit and listen to him explain how it all works and how TRT can cause the red blood cells to increase but Im not stopping TRT. lol

[almostgone]

For the past several years my hemoglobin & Hematocrit have been slowly getting higher and sometimes peaking past where they should be. Well the last year its been mostly above where it should be and I have been asking my doctor the last few years for an RX to get a Phlebotomy but she has always denied it.My doctor is great in most things but this one she just doesn't want to do for some reason.Thankfully she decided to send me to a Oncologist.. Guess what he wants me to do. Besides drinking more water and exercising more he wants me to do a Phlebotomy. lolI cant donate blood because I had Hep B in 1991 so this is my only option. Thank god someone finally understands. Yeah I had to sit and listen to him explain how it all works and how TRT can cause the red blood cells to increase but Im not stopping TRT. lol

Welcome to the club. Make sure (an oncologist/hematologist definitely should) to stay on top of your iron panel, TIBC, ferritin, serum iron, and transferrin.

I think older guys are affected more by the phlebotomies, and can get depleted quicker.

There's several of us older guys that are playing that game now. Like you said whatever it takes to keep my current T dosage!

[lovbyts]

Any tips for a quicker recovery so us older guys who might be affected more by the phlebotomies, and can get depleted quicker?

[lovbyts]

Welcome to the club. Make sure (an oncologist definitely should) to stay on top of your iron panel, TIBC, ferritin, serum iron, and transferrin.I think older guys are affected more by the phlebotomies, and can get depleted quicker.There's several of us older guys that are playing that game now. Like you said whatever it takes to keep my current T dosage!

Any tips for a quicker recovery so us older guys who might be affected more by the phlebotomies, and can get depleted quicker?

[almostgone]

Any tips for a quicker recovery so us older guys who might be affected more by the phlebotomies, and can get depleted quicker?

Monitor your iron and ferritin periodically/ a week or two post phlebotomy and pull a complete iron panel...make sure ferritin is checked as well. If you see it drifting towards the bottom of the range grab some elemental iron. I like Vitron-C
(available on Amazon) . Eat iron rich foods as well.

After taking elemental iron 2-3 times per week for a month, my ferritin and iron saturation went from being in the basement to almost the low end of the normal range.

It usually takes a few phlebotomies and then the cumulative effect kicks in. When/ if it happens, you'll likely be very fatigued as well.

Iron can lock your guts down, so I wouldn't preemptively jump on it without lab work.

[lovbyts]

Monitor your iron and ferritin periodically/ a week or two post phlebotomy and pull a complete iron panel...make sure ferritin is checked as well. If you see it drifting towards the bottom of the range grab some elemental iron. I like Vitron-C (available on Amazon) . Eat iron rich foods as well.After taking elemental iron 2-3 times per week for a month, my ferritin and iron saturation went from being in the basement to almost the low end of the normal range.It usually takes a few phlebotomies and then the cumulative effect kicks in. When/ if it happens, you'll likely be very fatigued as well. Iron can lock your guts down, so I wouldn't preemptively jump on it without lab work.

Thank you for the great advice. I will follow up with my results.

[lovbyts]

Little update, had my Phlebotomy done last week. Only took 3 ml but I guess thats normal. My Ferritin levels were good, right in the middle at 141 ng/ml and also in April it was about the same, 148 ng/ml.

[almostgone]

Little update, had my Phlebotomy done last week. Only took 3 ml but I guess thats normal. My Ferritin levels were good, right in the middle at 141 ng/ml and also in April it was about the same, 148 ng/ml.

Just 3ml? A whole blood donation is about 500ml/1 pint. Maybe they were doing preliminary labs or something?

[Cuz]

Little update, had my Phlebotomy done last week. Only took 3 ml but I guess thats normal. My Ferritin levels were good, right in the middle at 141 ng/ml and also in April it was about the same, 148 ng/ml.

My ferratin levels were 4. Thats pretty awesome.

[lovbyts]

My bad. LoL. 300

[lovbyts]

Another update, going in soon for my 2nd Phlebotomy. And had my testosterone done. Total doesn't matter all that much but was a little high, 240 - 940 range, 1010 My Bioavailable range was 40 - 168?? It was 732. A bit high?

[lovbyts]

2nd phlebotomy done and now I know what they mean by Thick blood. Looked like sticky paint. They had to stop 1/2 way through because it stopped coming out. Flushed the line 3x, no change. Tried to pull it out with a Big syringe and it wouldn't come out. Moved the needle a little, no change. Finally it sucked in the clot or whatever was blocking and they were able to take out another 150 ml of so of blood.Hopefully its a little thinner next time.Feritin dropped a bit but still within normal range.

[Bio-Active]

How high was your crit? Mine was high snd I went through that. First phlebotomy was a nightmare had to flush the line over and over but it dropped my crit by 8 points. Second one was way better and put my crit to about 55 but only dropped my crit a point or two. By the next week without a phlebotomy my crit was 54.4 and dr said that was acceptable, after that my crit dropped on its own down to 47.6 over the course of another month

[lovbyts]

How high was your crit? Mine was high snd I went through that. First phlebotomy was a nightmare had to flush the line over and over but it dropped my crit by 8 points. Second one was way better and put my crit to about 55 but only dropped my crit a point or two. By the next week without a phlebotomy my crit was 54.4 and dr said that was acceptable, after that my crit dropped on its own down to 47.6 over the course of another month

My last test my Hematocrit was, Normal range: 39.0 - 50.0 % = 56.7My test 2 weeks before Normal range: 39.0 - 50.0 % = 57.7The one before that was Normal range: 39.0 - 50.0 % = 60.7and one more in June was Normal range: 39.0 - 50.0 % = 61.9Its coming down slowly but I have at least 2 more phlebotomy to go.

[Bio-Active]

How many phlebotomy’s have you done? I only had to go 2 to get me to 54. I started at 62.6 after the first phlebotomy I dropped to 55.6 and then after the second one I dropped to 54.6 or close to, my hematologist said bring on trt and hematocrit at 54 is okay but my last lab was 50.4. Once I got it back in range it has stayed right on track for the last 8 months. I’m only doing 100 mg of test every 5 days now and it doesn’t go up. Hang in there you will get there

[lovbyts]

I just did my 3rd one today. Before the draw it was down to at 54.2 from a high of 61.9 My ferritin has dropped down from 142 when I started down to 70.9

[almostgone]

I just did my 3rd one today. Before the draw it was down to at 54.2 from a high of 61.9 My ferritin has dropped down from 142 when I started down to 70.9

Your ferritin is doing good, just stay on top of it. At one point mine got down to 19. Kind of takes the wind out out of your sails.

[almostgone]

My ferritin was back in range and I haven't donated or had a phlebotomy since then. Just got my ferritin panel a little while ago. It is 13 ng/ml. Range is 38-380 ng/ml.

Back on the Vitron C and eat lots of collards, spinach, steelhead, beef.

Still waiting on total iron, TIBC, and % saturation. They should come through today.

[Bio-Active]

I just did my 3rd one today. Before the draw it was down to at 54.2 from a high of 61.9 My ferritin has dropped down from 142 when I started down to 70.9

Ferritin is weird. On my last lab mine was 305 but my hematocrit was 50.4 and hemoglobin was 16.4. My hematologist never measured it back when I was doing my phlebotomies. My hematologist says as long as my hematocrit stays 54 or lower it’s okay. I like to keep it at or below 52. My trt dose is 100 mg every 4 days and I been staying right around 50. It’s been as low as 47 and the highest is 50.5 but I’m not cycling anymore. I am sticking strictly to just trt moving forward

[lovbyts]

Ferritin is weird. On my last lab mine was 305 but my hematocrit was 50.4 and hemoglobin was 16.4. My hematologist never measured it back when I was doing my phlebotomies. My hematologist says as long as my hematocrit stays 54 or lower it’s okay. I like to keep it at or below 52. My trt dose is 100 mg every 4 days and I been staying right around 50. It’s been as low as 47 and the highest is 50.5 but I’m not cycling anymore. I am sticking strictly to just trt moving forward

Are you using any estrogen blockers or anything along with your TRT

[Bio-Active]

Are you using any estrogen blockers or anything along with your TRT

No my dose is only 100 mg every 5 to 7 days. Do not need one. My last lab came back with my estro less then 15 which is to low

[lovbyts]

4th Phlebotomy done and the test right before showed its still dropping, almost to the normal limits. Hemoglobin range 13.2 - 17 is at 17.1 Hematocrit range 39 - 50 is down to 49.7 now. Started out at 61.9. Ferritin is still in the good range, 11 - 450 is at 36.2. Started out at 141.2 but still in range.So far so good. Hoping to get a bit more energy back but on a plus my blood doesn't look like Goo now and actually flows. lol

[Bio-Active]

That’s great usually crit is hemoglobin x 3. Are you making sure to drink lots of water before pulling labs. My hematologist said anyone on trt at 54 or lower crit is okay but I wanted my lower too. Mine was 62.6 like I stated earlier and I’m keeping it at about 49-50 now. They like me to run labs first thing in the am which makes my crit a little higher cause I don’t have the fluid snd food intake all day long

[almostgone]

4th Phlebotomy done and the test right before showed its still dropping, almost to the normal limits. Hemoglobin range 13.2 - 17 is at 17.1 Hematocrit range 39 - 50 is down to 49.7 now. Started out at 61.9. Ferritin is still in the good range, 11 - 450 is at 36.2. Started out at 141.2 but still in range.So far so good. Hoping to get a bit more energy back but on a plus my blood doesn't look like Goo now and actually flows. lol

You're doing pretty darn good.

My labs this week:

Ferritin @ 11. Range is 38-370. (Really makes me fatigued).
Iron is at 40. Range is
50-180mcg/dL

On the plus side my Hgb is back in range @ 16.7g/dL. Range is 13.2-17.1.
Finally my Hct has drifted back down almost into range @51.8% . Reference range is 38.5-50. As an added bonus, my MCV and MCH are in range. RDW, and RBC are just a tad over the high, but I'll get that in control soon.

Now it's just a matter of managing iron in vs Hct increase.