Please have a read of the information below to learn more about Haematocrit. You will have been shared this as your blood test has returned with a slightly elevated level, and we want to mitigate any further side effects as soon as possible.
What is Haematocrit?
You have recently completed a blood test that has shown your Haematocrit (HCT) levels are raised as a result of your Testosterone Replacement Therapy (TRT) treatment. HCT is a blood test that measures the percentage of red blood cells in your blood. This gives us an idea of your blood viscosity (thickness).
Your HCT was monitored before starting treatment and is continuously monitored whilst you are on TRT to make sure that it stays within a safe range. If your levels begin to increase, we may recommend safety measures such as pauses in your treatment to reduce the impact of an increase in HCT.
The actions that we recommend will mostly depend on your HCT level but other factors will also be taken into consideration, such as your historic trend of HCT. Below is our general guidance.
If your HCT level is:
≥ 0.540 (54%)
You will be advised to pause your testosterone treatment immediately (you may continue Clomid or HCG if prescribed).
Please book a review with your TRT doctor to assess your treatment plan and dosing.
We recommend that you repeat your blood test first, ensuring you:
- Keep well hydrated
- Avoid alcohol and caffeine
- Avoid strenuous exercise prior to testing
If your HCT remains elevated we may recommend:
- Blood donation (via NHS, if eligible) or
- Private venesection (if not eligible to donate)
These may be recommended to reduce your HCT to a safe level for TRT.
Once we have a repeat blood test showing HCT <0.54, your doctor will review your results and advise when it is appropriate to restart TRT.
≤ 0.539 (≤53.9%)
There are no immediate concerns with your HCT level
Keeping well hydrated, reducing your alcohol intake, stopping smoking & carrying out moderate exercise can help.
If you are a regular blood donor, continuing this can also be helpful to prevent a rise in HCT.
If you currently have any of the following symptoms; headaches, visual changes, chest pain or breathing difficulties, we would urge you to visit A&E. These are signs of raised HCT.
If you have already been advised to attend A&E, you must do so as soon as possible.
Why is my Haematocrit raised?
TRT can cause an increase in your HCT as the increased level of Testosterone triggers the process of red blood cell production. This side effect can be common with TRT and this is why we monitor HCT pre-treatment and during and why it is important to stick to the monitoring schedule we recommend.
There are other factors that can also contribute to a raised HCT, such as processes which result in a persistently low blood oxygenation, smoking, dehydration or kidney disease.
The reason we want to make sure we do not increase your HCT, is because the increase in blood thickness can increase your risk of developing blood clots, which can then increase the risk of certain cardiovascular (heart-related) events.
What happens when I stop my treatment?
We understand that it is not ideal that we need to temporarily pause your testosterone, especially if you are seeing great results, however this is in your best interest.
You may notice yourself developing symptoms of low testosterone again when you do stop your testosterone, however this is temporary and once you restart your treatment, your levels will increase and your symptoms will improve once again.
How do I lower my Haematocrit?
The easiest way to lower your HCT whilst you are on TRT is to undertake blood donation under an NHS service. Some customers will be doing this before starting TRT and continue to do so whilst on treatment, whereas others will start as a result of TRT or when advised to do so based on blood test results.
Blood donation services will only accept someone with a Haemoglobin <180 so depending on your blood results our team may not recommend you donate blood (as you would not be accepted).
NHS blood donation is an independent organisation & as long as you fulfill their eligibility criteria then having TRT from a registered medical provider (Manual/VOY) or HCG from our suppliers would not be a barrier in itself.
If you have been advised to temporarily pause TRT, it is important to only restart treatment when your haematocrit levels return to normal. If you have been prescribed HCG or Clomid, you may continue using these.
If you have been advised to book a blood donation, it is important to do so as soon as possible and ideally within the next 2-4 weeks. This is the fastest and safest way to lower your haematocrit.
It is important to stay hydrated when you are completing your monitoring and repeat blood tests. Dehydration can inflate your HCT results.
What if I cannot donate blood?
If you are unable to donate blood, which can be the case for a wide variety of reasons, the alternative procedure that can be undertaken to reduce your HCT is Therapeutic Venesection.
Therapeutic venesection is simply when a trained professional will take your blood, similar to a blood donation, but it will not be used for any further reasons.We also have some other providers that you can use whom we work closely with:
- Eval blood analysis: https://evalbloodanalysis.com/home/
Their private venesections are offered at £50 - their coverage may be limited based on your location. You can book an appointment directly through the website and search if there is a clinic near you.
- Phelbo: https://phlebo.co.uk/
Their private venesections are offered at £90 - they have one clinic based on Bristol. You can book an appointment directly through their website and you can add MANUAL10/VOY10 to receive £10 off your first appointment.
- Kratos: https://kratosmedical.co.uk/
Their private venesections are offered at £89 - they current have clinics based in Cardiff, Nottingham, Manchester. You can book an appointment directly through their website.
- Olive Health + WellZone: https://olivehealthandtravel.co.uk/venesection-therapeutic-phlebotomy / https://wellzoneclinics.co.uk/venesection-therapeutic-phlebotomy/
Their private venesections are offered at £110 through a direct referral from our services to theirs. They have a clinic in Bermondsey and Ilford. If you want to progress with this clinic, please let our team know and we can provide you with a copy of your blood test and referral letter to send to contact@olivehealthandtravel.co.uk
Here is a list of other private providers that can be found online.
This private donation can sometimes be expensive and may not be a feasible option for all but it is important to know that it is available.
If you are unable to donate blood or arrange a therapeutic venesection, your HCT level will naturally fall over several weeks. This is due to the natural life cycle of the red blood cells. It is important to also have an awareness of your iron intake, as an excess iron intake can inflate your HCT.
If the above applies to you, and you have been advised to donate blood, please let us know as soon as possible.
What else can I do?
There are some other general modifications that can contribute to lowering your HCT naturally but these are not as effective as blood donation and may not all be relevant to you:
- Staying well hydrated
- Reducing your alcohol intake
- Avoiding caffeine on the day of your blood test
- Avoiding heavy/intense exercise on the day of your blood test
- Ensuring a moderate level of exercise is incorporated into your weekly routine
- Stopping smoking
We do not recommend any herbal supplements or prescribed medication to lower your HCT. This includes the use of blood thinners such as Warfarin or Aspirin, unless you are prescribed these by a registered prescriber, please do not use these.
For more information please refer to the NHS website
If you have any further questions about HCT in general or specifically related to your plan, please reach out via the support section of your account to direct your queries to the medical team.