Increased Red Blood Cells on TRT - 12 Rules to Live by on Testosterone - Doctor's Guide

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This video covers increased red blood cell counts and iron levels on TRT as well as their effects and management. This is part of my 12 Rules to Live by on Testosterone series. Increased RBC and iron is perhaps the most common side effect of TRT, but it’s often misunderstood, treated incorrectly, or over-diagnosed just based on moderately elevated levels. The reference ranges may be too low for correctly diagnosing men on TRT, but on the other hand genetics and family history may require earlier intervention not based just on labs. This is a complex topic, but this videos is an in-depth look at the condition, its risks, and how to manage it. If you’re on TRT and have elevated red blood cells, iron, or are concerned you may have them in the future, this video should give you a practical guide to understanding what’s going on and what you can do.

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TABLE OF CONTENTS:

00:00 - Intro
00:55 - Why red cells go up on androgens
01:37 - A new set point - what's going on with this?
02:51 - EPO and ferritin don't respond as expected to hemoglobin
04:50 - Iron can deposit in your brain, heart, liver, & testes
06:11 - Genetics beyond the mechanism of action
07:07 - Impacts of age and dose of TRT
08:18 - Impact of sleep apnea and elevation
09:07 - Impacts of diet
09:34 - Risks of high RBC - blood clots, DVTs, pulmonary embolism
10:30 - Risks - heart attacks, strokes, high blood pressure
11:50 - Clinically - blurry vision, headache, ruddy look
12:20 - Management - key labs & iron studies
13:22 - Management should be informed by family history
13:53 - Why hemoglobin reference ranges may not be accurate
14:56 - Interpreting labs & when to see a hematologist
15:42 - Clinical symptoms - ruling out other causes
16:40 - Importance of iron studies including ferritin
17:41 - Management - lower the dose, consider other therapies
18:26 - Types of doctors to see
19:00 - Management - treat your sleep apnea, adjust diet








Stay Strong and Healthy,
Dr. O

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As the Anabolic Doc, since 2003, I’ve provided men who are using or have used anabolic steroids a confidential, ethical and professional medical venue to discuss their use. I do NOT in any way support the use of any performance enhancing drugs - PEDs, anabolic steroid or other medicine for muscle building or body transformation. The “off-label” use of PEDs, as such agents is considered illicit and may lead to adverse health outcomes. Please consult an expert health professional regarding any medical agent and do NOT use any medicine without the explicit advice and supervision of an appropriate medical expert.

This video is for education and information only. This is not medical advice. Only take medications as prescribed by your doctor. Do not take illegal substances. Taking steroids can lead to serious health consequences.

#Testosterone #TRT #RedBloodCells #Iron