There have been some studies demonstrating the association of testosterone replacement therapy with adverse cardiovascular events in men with hypogonadism . Studies in mice models have shown that testosterone supplementation normalized older mice’s iron status and stimulated splenic erythropoietic activity . Although there are no randomized clinical trials (RCTs) that analyze the direct effect of testosterone supplementation in treating anemia, there is evidence for the potential therapeutic benefits of testosterone replacement therapy. Among the 209 randomized men, 166 men, who completed the 6-month intervention, were evaluated at baseline, after 1, 3, and 6 months of intervention and 3 months after discontinuation of study intervention (Figure 1). Testosterone levels were measured by a radioimmunoassay that has been validated against liquid chromatography tandem mass spectrometry (13) and has a sensitivity of 10ng/dL. We anticipated that trajectories with time would be nonlinear; therefore treatment effects were allowed to vary by visit. They may order follow-up tests or start a treatment plan. Many health conditions can cause high or low blood counts. After a blood draw for a CBC test, you’ll have some gauze and a bandage on your arm, secured with tape. Your provider sends the blood to a lab for testing. It is one of the main numbers they watch during TRT because testosterone can increase the body’s production of hemoglobin. Hemoglobin and hematocrit are two of the most important markers your doctor checks when you are on testosterone replacement therapy (TRT). Because of all these reasons, hemoglobin is one of the most important markers to watch when using testosterone therapy. Even without symptoms, elevated hemoglobin can raise health risks. Understanding these changes is important because many people do not feel symptoms when their hemoglobin gets high. When hemoglobin or hematocrit go above the recommended range, the blood becomes thicker. Testosterone has a strong effect on how many red blood cells your body makes. Hematocrit is the percentage of your blood made up of red blood cells. Over time, the risk tends to grow if testosterone levels stay high or if the dose is not adjusted. This makes high hemoglobin one of the most frequent lab changes seen with testosterone therapy. High hemoglobin is one of the most common side effects of testosterone replacement therapy (TRT). Understanding these mechanisms explains why doctors monitor hemoglobin and hematocrit during TRT. This is another reason why TRT can increase hemoglobin more than natural testosterone does. Lowering the testosterone dose, changing how often you take it, or switching from injections to a gel or patch can help bring levels down. Another key point is understanding that high hemoglobin on TRT does not mean therapy must be stopped forever. But for some, it can climb higher than it should, which can increase the risk of health problems if not managed.
