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admin | Office Exercises | 09.01.2014
A research letter recently published in the journal AIDS by Vorkas et al determined that testosterone use was associated with polycythemia, and intramuscular administration demonstrated a stronger association than topical (testosterone patch) use. The association between testosterone replacement therapy and polycythemia has been reported for the past few years as this therapy has become more mainstream.
Although all testosterone replacement products can increase the amount of red blood cells, the study showed a higher incidence of polycythemia in those using intramuscular testosterone than topical administration (testosterone patch was the main option used -- no gels). Five of the 21 cases (24%) did not use testosterone, but had other explanations for their polycythemia: pulmonary hypertension, COPD and plasma volume contraction. The letter recommends that all HIV-infected patients taking testosterone should undergo routine hematologic monitoring and adjustment of testosterone dose or cessation of testosterone therapy as appropriate based on hemoglobin values. Below is an excerpt from my book, Testosterone: A Man's Guide, further detailing the prevention and management of polycythemia.
It's important to check patients' hemoglobin and hematocrit blood levels while on testosterone replacement therapy.
The following table shows the different guideline groups that recommend monitoring for testosterone replacement therapy. Many patients on testosterone replacement who experience polycythemia do not want to stop the therapy due to fears of re-experiencing the depression, fatigue and low sex-drive they had before starting treatment.
Unless a local blood bank is willing to help, some physicians may need to write a letter of medical necessity for phlebotomy if requested by insurance companies. The approximate amount of blood volume that needs to be withdrawn to restore normal values can be calculated by the following formula, courtesy of Dr. The frequency of the phlebotomy depends on individual factors, but most men can do one every two to three months to manage their hemoglobin this way.
Some doctors recommend the use of a baby aspirin (81 mg) a day and 2,000 to 4,000 mg a day of omega-3 fatty acids (fish oil capsules) to help lower blood viscosity and prevent heart attacks.
Although some people may have more headaches induced by high blood pressure or get extremely red when they exercise, most do not feel any different when they have polycythemia.
We will have a brief description of Testosterone Replacement Therapy and alternatives to the common erectile dysfunction pills. Event details may change at any time, always check with the event organizer when planning to attend this event or purchase tickets. Testosterone is the main male hormone that maintains muscle mass and strength, fat distribution, bone mass, sperm production, sex drive, and potency. High levels of testosterone appear to promote good health in men, for example, lowering the risks of high blood pressure and heart attack.
Testosterone therapy may be given to treat medical conditions, including female (but not male) breast cancer hypogonadism (low gonadal function) in the male, cryptorchism (nondescent of the testis into the scrotum), and menorrhagia (irregular periods).
Testosterone is the primary androgenic hormone and is responsible for normal growth and development of male sex organs and maintenance of secondary sex characteristics.
Evaluation of potential candidates for testosterone replacement therapy should include a complete medical history and hormonal screening. Testosterone is a male hormone produced by the testes and responsible for producing and maintaining male sex characteristics.

It is one of those “chicken and egg” kind of questions… which came first, low testosterone in men leading to lower desire, or is it less romantic activities that leads to decreased testosterone? Well-known celebrity, Suzanne Somers, has been very candid about her choice to use Hormone Replacement Therapy (HRT). Hormones are responsible for the stimulation or regulation of just about every bodily process you can think of, from growth, to health, to sexual wellness, and your overall well-being, which is why hormone replacement is so important. Whether size matters or not, the truth is, a lot of men wonder if they are truly satisfying their partners. HealthGAINS can only provide prescriptions or therapy services to patients who have a clinical need.
Any claims or opinions stated within our HealthGains website should not be constructed as medical advice or as a diagnostic. With polycythemia the blood becomes very viscous or "sticky," making it harder for the heart to pump.
Smoking has also been associated with polycythemia and may contribute to the effects of other risk factors. I have seen phlebotomy given weekly for several weeks bring hematocrit from 56 percent to a healthy 46 percent.
These can be an important part of most people's health regimen but they are not alternatives for therapeutic phlebotomy if the patient has polycythemia and does not want to stop testosterone therapy. High testosterone levels also correlate with risky behavior, however, including increased aggressiveness and smoking, which may cancel out these health benefits. Pre-pubertal hypogonadism is generally characterized by infantile genitalia and lack of virilization, while the development of hypogonadism after puberty frequently results in complaints such as diminished libido, erectile dysfunction, infertility, gynecomastia, impaired masculinization, changes in body composition, reductions in body and facial hair, and osteoporosis.
You may have read some articles that allege low testosterone (Low T) is not a “real disease”.
New research out of Australia seems to indicate that decreased intimate activity, can lead to reductions in testosterone levels. In fact, this HealthGains member saw first hand the benefits of hormone replacement therapy, just listen to the benefits he personally received from hormone therapy. To determine a clinical need, patients must complete any required lab work, physician consultations, examinations and a medical history review. HIV-infected patients taking testosterone should undergo routine hematologic monitoring with adjustment of therapy when appropriate. No cases met the criteria for polycythemia vera, and no adverse cardiovascular or thrombotic events were noted among the cases or controls. Therapeutic phlebotomy is very similar to what happens when donating blood, but this procedure is prescribed by physicians as a way to bring down blood hematocrit and viscosity. I know physicians who prescribe phlebotomy once every 8-12 weeks because of an unusual response to testosterone replacement therapy. It is impossible to predict exactly who is more prone to developing polycythemia, but men who use higher doses, men with higher fat percentage, and older men may have a higher incidence.
Hypogonadal men also report levels of anger, confusion, depression, and fatigue that are significantly higher than those reported in eugonadal men (high testosterone men).

When the serum testosterone level is low and LH is elevated, testosterone replacement therapy is warranted. Testosterone is the major androgenic hormone made by the testes in response to luteinizing hormones from the pituitary gland. It has even been said that low testosterone is something “made-up” by the drug companies to sell more product. Just like men, as women get older, their production of testosterone decreases, and also like men, this reduction can negatively impact health and quality of life. She is representing the 60-something crowd on the latest installment of Dancing With The Stars (DWTS), and has just announced a brand new on-going show in Las Vegas. Please note that even if you complete these steps, a clinical necessity for our prescriptions or hormone therapy may not be found. Please be advised that the statements on this informational website have not been evaluated by the Food and Drug Administration.
Among the four female cases, one was diagnosed with chronic obstructive pulmonary disease (COPD) and severe pulmonary hypertension, while the other three did not have a documented explanation for elevated hemoglobin. This simple procedure is done in a hospital blood draw or a blood bank facility and can reduce hematocrit, hemoglobin, and blood iron easily and in less than one hour. The duration over which the blood volume is withdrawn is affected by whether concurrent fluid replacement occurs.
Patients with low serum LH and testosterone levels need an imaging study of their pituitary and may need endocrinologic consultation. Testosterone hormones promote the development of adult male characteristics including deep voice, strong muscle and bone mass, and sperm. I admit I have not always been a big fan of the pharmaceutical industry, but here is one instance where they are correct. Low T in women can effect mood, sexual wellness, and a recent study indicates that it can also increase a woman’s risk of cardiovascular disease. Suzanne credits much of her “Energizer Bunny,” ability to just keep going, and going, and going… to HRT.
Because of the relatively small number of female cases and the fact that the primary hypothesis is related to testosterone use, this case-control study focused on the 21 male patients.
Unfortunately, therapeutic phlebotomy can be a difficult option to get reimbursed or covered by insurance companies. High levels of testosterone promote good health in men and lower the risk of high blood pressure and heart attack.

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