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Testosterone replacement therapy can be a great way to improve your health and vitality, but certain risks areassociated with it. One of the most important things you need to monitor when taking testosterone is your hematocrit levels. High hematocrit is one potential side effect of testosterone treatment that should not be ignored or overlooked, as it can lead to serious health complications if left untreated. In this blog post, we'll go over what high hematocrit is, how testosterone replacement therapy raises hematocrit levels, and how to reduce high hematocrit due to testosterone treatment so that you can benefit from all the advantages of hormone optimization safely and effectively. Table of Contents: What is Hematocrit? Definition of Hematocrit: How Does Testosterone Replacement Therapy Increase Hematocrit? a. Effects of Testosterone on Red Blood Cells: How to Lower High Hematocrit Caused by Testosterone Treatment? Monitoring and Managing High Hematocrit Levels with Testosterone Replacement Therapy Regular Blood Tests to Monitor Hematocrit Levels: Conclusion FAQs in Relation to High Hematocrit Should I worry if my hematocrit is high? What can cause high hematocrit? What are symptoms of high hematocrit? How do you treat high hematocrit levels? Conclusion What is Hematocrit? Hematocrit measures the percentage of red blood cells in your body. It’s an important indicator of overall health and can help diagnose various conditions, such as anemia or dehydration. Definition of Hematocrit: Hematocrit is a measure that reflects the ratio between the volume of red blood cells (RBC) and the total volume of whole blood in your body. The hematocrit value is expressed as a percentage, with normal values ranging from 40 to 54 percent for men and 36 to 48 percent for women. How is Hematocrit Measured? A hematocrit test measures how much space red blood cells take up in your bloodstream by spinning down a blood sample in a centrifuge machine. This separates different components within the sample, including RBCs, white blood cells (WBCs), platelets, and plasma. The amount of packed RBCs compared to other components gives you your hematocrit value. Normal ranges vary slightly depending on age and gender but generally range from 40–54% for men and 36-48% for women. Low levels could be a sign of anemia or bleeding disorders, whereas high levels might be the result of dehydration or specific cancer treatments like chemotherapy or radiation therapy. Hematocrit is an important measure of health and can be increased through testosterone replacement therapy. However, it is important to understand the potential risks associated with high hematocrit levels before beginning treatment. How Does Testosterone Replacement Therapy Increase Hematocrit? TRT has been found to have numerous health benefits, including improved energy levels, increased muscle mass and strength, and improved sexual function. One of the most important effects of TRT is an increase in hematocrit, which is the percentage of red blood cells in your bloodstream. a. Effects of Testosterone on Red Blood Cells: Testosterone helps stimulate the production of red blood cells by increasing the number of stem cells that produce them. It also increases their lifespan so they can circulate longer throughout your body before being broken down and replaced by new ones. This leads to an overall increase in hematocrit levels as more red blood cells are present in your bloodstream at any time. An increased hematocrit level can provide many benefits, such as better oxygen delivery throughout the body, improved stamina during physical activity, and reduced risk for certain diseases like heart disease or stroke due to higher amounts of oxygen-carrying red blood cells circulating through your system at all times. Additionally, some studies suggest that higher hematocrit may even improve cognitive performance since it provides more oxygen to the brain for mental processes like memory formation or problem-solving skills Testosterone replacement therapy can increase hematocrit levels, but it is important to know the potential risks associated with high hematocrit. We'll talk about lowering a high hematocrit that results from testosterone therapy in the following section. In a study done by Dr. Ramasamy and his team at the University of Miami Medical School, a total of 5,842 men who received TRT and developed polycythemia were matched and compared to 5,842 men who did not develop polycythemia. Heart problems or venous thromboembolism - VTE were more likely to happen to men with polycythemia (301 cases, or 5.15% of all cases) while they were on TRT than to men with a normal hematocrit (226 cases, or 3.87%) (OR 1.35, 95% CI 1.13–1.61, p <0.001). The same team later found out that greater changes in hematocrit predicted greater cardiovascular risks in men on testosterone therapy.   Key Takeaway: Testosterone replacement therapy (TRT) increases hematocrit levels, providing numerous benefits such as improved oxygen delivery throughout the body, increased stamina during physical activity, and better cognitive performance. How to Lower High Hematocrit Caused by Testosterone Treatment? High hematocrit levels caused by testosterone treatment can be a serious health concern. It is important to understand the causes and treatments available for this condition. Some physicians and TRT guidelines believe that stopping TRT is the best way to lower hematocrit.  But stopping TRT can have negative consequences for the quality of life, as men who do so tend to stay hypogonadal for months, and most do not return to “normal levels.”  Fortunately, there are several ways to decrease high hematocrit and potentially prevent it. How Can High Hematocrit Be Reduced Due to Testosterone Therapy? A severe health hazard might result from high hematocrit levels brought on by testosterone therapy. Understanding the underlying causes and available therapies for this illness is crucial. TRT guidelines and several doctors concur that the best strategy to reduce hematocrit is to cease TRT. However, discontinuing TRT can harm a man's quality of life because most men who discontinue TRT do not revert to "normal levels" and instead tend to stay hypogonadal for months. Fortunately, there are a number of strategies to lower high hematocrit and avoid it. Donate blood. Men on testosterone therapy can lower their hemoglobin levels with this tried-and-true method. And while you're doing it, you're helping someone else! Every donated unit of blood can reduce hematocrit by three points. Be careful not to donate more frequently than every 2.5 months, as the Red Cross advises, to prevent losing too much iron and ferritin, which can cause fatigue in men taking testosterone therapy. This iron blood test allows you to determine your iron and ferritin levels. It is advised that you donate when your hematocrit is between 51 and 52 percent. If you want to donate blood, you should avoid having a hematocrit above 53% because some organizations (like the Red Cross) would reject blood at that level. Men whose high hematocrit disqualifies them from blood donations may still donate blood if their doctors request therapeutic phlebotomy at the nearby blood center. Reduce the TRT dose. Your doctor could tell you to lower your dose if you have high hemoglobin or hematocrit levels as a result of testosterone therapy. This is not always a negative thing because some men take more testosterone than they need, which can have both long-term and short-term side effects. Make sure you drink water. It's critical to keep in mind that hematocrit is highly dependent on the amount of water you drink. This might have made things worse if you were already dehydrated when you had your blood drawn. Talk to your doctor about a repeat test if you believe you were dehydrated. Address thyroid problems. Your RBC counts can decrease with hypothyroidism (low thyroid function) and increase with hyperthyroidism (high thyroid function). Doing this could be a good idea if you have yet to examine your thyroid function. And if you can afford it, have a complete thyroid panel, including thyroid antibodies. [10] Think about testosterone applied topically to the skin. According to a research summary, intramuscular testosterone injections are the only form of testosterone that significantly raises hematocrit above normal levels. Topical testosterone creams or gels often do not have this effect. However, it does so strongly, changing up to 6% from the starting point. The testosterone gel comes in second place, with a 2.5% average increase over baseline levels. [7]. Therefore, switching to topicals may help if you are receiving intramuscular injections and experiencing high hematocrit or hemoglobin. Discuss this with your doctor. COMPOUND TESTOSTERONE CREAM AND GEL IS A CHEAP ALTERNATIVE Change from intramuscular to lower dose testosterone subcutaneous injections. 236 men participated in a study that the University of California conducted. All men's baseline values in each of the four measurement locations were noted, as well as those between 6 and 12 weeks after therapy. According to the findings, males who received subcutaneous testosterone injections (SubQ) exhibited an increase in total testosterone levels that was 14% greater than that of patients who had intramuscular testosterone injections (IM). Additionally, post-therapy, hematocrit was 41% lower in SubQ patients than in IM patients, and estradiol levels were 26.5% lower. No PSA readings were abnormally high in any group of men.  Steer clear of or consume less red meat. It's fascinating because one of the arguments used by meat eaters against vegetarians is that plant meals include a lot of "anti-nutrients" that might inhibit the absorption of or bind to minerals like iron. For instance, groups like Weston Price criticize vegetarians for consuming phytic acid. Plant foods contain phytic acid, which binds to calcium, magnesium, phosphorus, and iron. Mineral deficits may result from overuse. Dr. Bernard notes that because certain minerals, like zinc and iron, are neurotoxic at even very modest levels of tissue accumulation, they are often likely to be highly health protective for most people. Additionally, studies have demonstrated a connection between colon cancer, too much iron, and heart problems. If no other preventive measures are taken, avoiding red meats, which are heavy in iron, stands a decent chance of decreasing your hemoglobin levels and preserving your long-term health (such as by giving blood). The validity of this claim requires dietary research. Females had significantly lower hemoglobin levels, according to a study that compared vegetarians and non-vegetarians. Although it could not have been statistically significant, males had lower amounts. It was found in a more solid study that vegetarians had much lower levels of white blood cells, neutrophils, serum ferritin, and serum vitamin B12 compared to control patients. Vegetarians also had much lower levels of hematocrit and mean corpuscular hemoglobin. By the way, ferritin is a crucial indicator since it shows that tissue iron levels are lower, which suggests that there will likely be less long-term harm. It should be emphasized that this study did reveal that some vegans were iron deficient. Correct sleep apnea. Depleted oxygen saturation levels brought on by sleep apnea may encourage the body to create more red blood cells and hemoglobin in an effort to make up for the low oxygen levels in the blood during sleep. Indeed, there is research that backs this up as well.  Consider having a sleep apnea test done if your hematocrit, hemoglobin, or RBC levels are high. "One possible explanation is that repeated episodes of nocturnal hypoxia (low oxygen status) lead to a hypercoagulable state that predisposes individuals to thrombotic (blood clotting) events," a recent study stated. Research backs up a number of changes in the blood that affect hemostasis. These include higher hematocrit, blood viscosity, platelet activation, clotting factors, and lower fibrinolytic activity. Minimize inflammationInflammation can further reduce hepcidin, the hormone that controls iron absorption. It could be helpful to check for infections, CRP levels, etc., before treating the underlying reason. [13] Think about Curcumin (Turmeric).More research is being done on turmeric, or curcumin, as an anti-inflammatory and anti-cancer substance. It produces iron shortage in mice by binding to ferric iron in the stomach. According to a case study, a person consuming turmeric may have had iron deficiency anemia. Stop smoking. Smoking lowers the blood's oxygen saturation, which causes the body to create more red blood cells and hemoglobin to make up for it. [14] Talk to your doctor about Losartan, which is used to treat high blood pressure. You should think about taking Losartan if you have high blood pressure. [15] In patients with COPD and erythrocytosis, losartan can be administered safely and efficiently to normalize hematocrit, which may eliminate the requirement for therapeutic phlebotomy. Eat grapefruit. Grapefruit extract (narigin) may lower the hematocrit [16]. Although there was no discernible difference between eating half or a whole grapefruit each day, the effect of grapefruit consumption on hematocrit was statistically significant at the p 0.01 level. However, bring up with your doctor the possibility that grapefruit may elevate drug levels in the blood. Monitoring and Managing High Hematocrit Levels with Testosterone Replacement Therapy It is essential to monitor hematocrit levels while on testosterone replacement therapy (TRT). TRT can have an impact on hematocrit, which measures the quantity of red blood cells in the body. Regular blood tests should ensure that hematocrit levels remain within normal range. If high hematocrit levels are detected, some steps canbe taken to manage them. Regular Blood Tests to Monitor Hematocrit Level: It is recommended that men on TRT have their hematocrit tested every 3–6 months or more frequently if needed. This will help identify any potential issues with high hematocrit early on so they can be addressed quickly and effectively. High hematocrit may indicate an underlying medical condition such as polycythemia vera, which requires further evaluation and treatment from a healthcare provider. Adjusting Dosage or Frequency of Testosterone Injections as Needed: If high hematocrit levels are found during regular testing, adjusting the dosage or frequency of testosterone injections may help lower them back into the normal range. For example, reducing the dose or spacing out injections over longer periods of time could reduce the risk for complications associated with elevated hemoglobin and/or red cell counts due to TRT use. Additionally, lifestyle changes such as increasing physical activity level and making dietary modifications may also help lower high hematocritevels caused by TRT use. By closely monitoring hematocrit levels and adjusting testosterone dosage or frequency as needed, men can successfully manage high hematocrit levels while undergoing testosterone replacement therapy. Next, we'll discuss the key points to remember when managing this condition.   Key Takeaway: Regular blood tests should be done to monitor hematocrit levels while on TRT. If high hematocrit is detected, adjusting the dosage or frequency of testosterone injections and making lifestyle changes may help lower them back into normal range.   FAQs in Relation to High Hematocrit Should I worry if my hematocrit is high? Yes, you should be concerned if your hematocrit is high. Hematocrit is a measure of the number of red blood cells in your body and can indicate an underlying health issue. High levels may mean that there are too many red blood cells in circulation, which can lead to thickening of the blood and other serious complications such as stroke or heart attack. It's important to speak with your doctor about any concerns regarding your hematocrit level so they can determine the best course of action for managing it. What can cause high hematocrit? Dehydration, testosterone therapy, smoking, polycythemia vera (an overproduction of red blood cells), and specific medications are just a few of the things that can cause high hematocrit levels. Dehydration occurs when the body does not have enough fluids to function properly. Smoking increases the production of red blood cells in the bone marrow. Polycythemia vera is an uncommon disorder that causes too many red blood cells to be produced in the bone marrow. Certain medications, such as erythropoietin or testosterone, may also cause high hematocrit levels due to the increased production of red blood cells in response to these drugs. What are the symptoms of high hematocrit? High hematocrit is a condition where the percentage of red blood cells in the bloodstream is higher than normal. Symptoms can include fatigue, shortness of breath, dizziness, headaches, and pale skin. In more severe cases, it can lead to chest pain or heart palpitations due to an increased risk of clotting. It is important to seek medical attention if any symptoms are present, as high hematocrit levels can be indicative of underlying health conditions such as anemia or dehydration. How do you treat high hematocrit levels? High hematocrit levels can be treated by making lifestyle changes, such as reducing alcohol consumption and increasing physical activity. Additionally, medications may be prescribed to reduce the production of red blood cells or increase their breakdown. Other treatments include phlebotomy (the removal of excess red blood cells) and iron chelation therapy (the removal of excess iron). It is important to speak with a doctor about the best treatment plan for high hematocrit levels, as it will depend on the individual's medical history and current health status. Conclusion In conclusion, high hematocrit is a common side effect of testosterone replacement therapy and should be monitored closely. It's crucial to comprehend what hematocrit is, how testosterone replacement therapy raises it, and how to lower a high hematocrit that results from testosterone treatment. With proper monitoring and management of your levels with the help of your doctor or healthcare provider, you can reduce the risk of any health complications associated with elevated levels of hematocrit due to testosterone replacement therapy. Are you suffering from high hematocrit? ExcelMale is here to help. Our online men's health forum provides a wealth of knowledge and resources on testosterone replacement therapy, general health, and sexual dysfunction. Join our community today to get the support you need for managing your condition and improving your overall wellbeing. Register for this TRT forum .   REFERENCES   Secondary Polycythemia in Men Receiving Testosterone Therapy Increases Risk of Major Adverse Cardiovascular Events and Venous Thromboembolism in the First Year of Therapy GREATER CHANGES IN HEMATOCRIT PREDICT MORE FREQUENT MAJOR ADVERSE CARDIAC EVENTS IN MEN INITIATED ON TESTOSTERONE THERAPY - A LARGE CLAIMS DATABASE ANALYSIS The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 10, 1 October 2010, Pages 4743–4747 TRANSFUSION 2008; 48: 2197-2204

The glucose tolerance test is one of the best ways to find out if your body is metabolizing blood sugar well. Everything you eat and drink, except water, is eventually transformed into glucose in the body. Glucose is also known as blood sugar level, and it acts as a fuel for the brain. However, having more glucose in the body isn’t necessarily a good thing. The body requires energy to carry out multiple processes and functions. It uses glucose but only needs it in moderate amounts, not too much at once. Problems with blood sugar level appear when there is too much glucose in the bloodstream which facilitates inflammation, infection and the development of diabetes type 2 which is a life-threatening disease. Glucose is processed in the body using insulin which is a hormone secreted by the pancreas. Table of Contents What is insulin? What is insulin resistance? Factors that contribute to insulin resistance Types of diabetes Symptoms of diabetes type 1 and 2 Risk factors for having impaired glucose tolerance or a predisposition to diabetes Glycemic index How is glucose tested? What is a Glucose Tolerance Test (GTT)? How is glucose tested in the lab? What to do after getting the results? How to stabilize and reduce blood sugar levels Tip #1 – Get more fiber into your diet Tip #2 – Take a multivitamin supplement Tip #3 – Eliminate foods which promote inflammation Tip #4 – Find time to relax Tip #5 – Work out more often What to do next? What is insulin? Insulin is a hormone secreted by the pancreas. Its job is to normalize blood sugar levels and reduce the amount of sugar present in the bloodstream. When too much sugar is detected in the blood, the brain sends a signal to the pancreatic cells to start secreting insulin. The insulin hormone “opens up” cells and tissues to absorb glucose (the fuel). This effect makes them function normally and ensure that the blod sugar level is stabilized.   What is insulin resistance? Insulin resistance develops when cells and tissues no longer “open up” to absorb blood sugar. This dysfunction makes people feel relatively lethargic and fatigued. Additionally, since the sugar in the blood is not absorbed, it will simply stay in the bloodstream which is a bad thing. Having too much sugar in the blood can lead to chronic inflammation, fatigue, poor sugar level control and the likelihood of developing type 2 diabetes. Insulin resistance develops over time. This happens as a result of a sedentary lifestyle and unhealthy diet, among other factors.   Factors that contribute to insulin resistance It might take years to develop insulin resistance since this is a gradual process. It is very important to monitor blood sugar levels and prevent insulin resistance which can lead to diabetes type 2 and a poor-quality life. Here are some factors which contribute to insulin resistance: · Not exercising, at least a few times a week – exercise is hands-down one of the best ways to decrease insulin resistance and promote insulin sensitivity which makes cells absorb sugar from the blood · Eating plenty of refined sugars – cookies, candies, chocolate, ice cream are all delicious, but if they are eaten frequently, they significantly increase insulin resistance. Body cells become used to sugar and less susceptible to absorb it from the bloodstream · Being overweight or obese – having too much fat content (particularly in the abdominal area) leads to insulin resistance and a decreased ability to process sugar properly · Acute stress – being under a lot of pressure and having to deal with lots of stress on a daily basis can also lead to the development of insulin resistance. People of an elderly age are more predisposed to develop insulin resistance. However, the quality of the diet and the exercise regimen are primary factors which contribute to insulin resistance. Once cells and tissues become more resistant to insulin, diabetes type 2 can appear. This disease develops slowly over time and requires major lifestyle adjustments to manage it properly.   Types of diabetes There are several types of diabetes, and it is a good idea to learn something about each of them. Diabetes type 1 is also known as juvenile-onset diabetes or insulin-dependent diabetes. People who have this disease produce little to no insulin for reasons not completely understood by science today. Insulin is vital to process sugar into the bloodstream, and if the body doesn’t make it, it has to be injected. This illness can be encountered at all stages of life, but it usually affects children. Patients with type 1 diabetes need to rely on periodic doses of insulin to stay healthy. If insulin is not administered at certain moments, these patients can develop health complications which might result in death. Diabetes type 2 is one of the most common types of diabetes. It is caused particularly by insulin resistance which makes cells “harder” and less predisposed to absorb sugar from the bloodstream. Approximately 90% of all diabetic patients have diabetes type 2. It can appear at any age, and it is usually detected and diagnosed using blood glucose tests. People can live with diabetes, but they need to follow strict dietary guidelines and eat foods with a low glycemic index. Diabetes type 2 can be reversed, but only in rare cases and using special diets for a low period such as the ketogenic diet. At some point in time, if diabetes type 2 condition progresses, patients require oral drugs and additional doses of insulin to survive. This disease can also be managed through a steady fitness regimen and by reducing stress levels.   Symptoms of diabetes type 1 and 2 These medical conditions are not without symptoms, and by paying attention to certain signs the body offers, one can discover the illness earlier on and possibly stop its progress. Here are a few common signs of diabetes type 1 and 2: · Excessive thirst and a dry mouth – the body uses water to dilute excessive sugar in the blood · Excessive fatigue for no real reason – since the sugar doesn’t get into cells and tissues anymore because of insulin resistance, people who have diabetes frequently feel tired and fatigued · Frequent urination – the body tries hard to eliminate excess sugar through urine · Wounds which heal slowly – this happens because diabetes damages nerve endings, making it harder for blood to reach surface wounds and heal them · Blurred vision – similarly, too much sugar can affect nerve endings in the retina which can lead to blurred vision and other eyesight problems People must know that these symptoms should be consistent over time. If one has the symptoms above, he or she should take the glucose test as soon as possible to properly diagnose the health problem.   Risk factors for having impaired glucose tolerance or a predisposition to diabetes There are certain groups of people who are more likely to handle glucose in the bloodstream improperly and develop diabetes type 2 in the future. Here are some of them: · People who have a history of diabetes in the family · People who are older than 50 years are more likely to have impaired glucose tolerance · People who have abnormal cholesterol levels · People who have a lot of fat in the abdominal area as well as visceral fat (fat packed between organs and tissues)   Glycemic index The glycemic index is used to measure how much insulin the body needs to produce to process different types of foods. For example, pure glucose has 100 as a glycemic index (GI) which means that it will generate the highest insulin spike. Broccoli, on the other hand, is a complex carbohydrate with a GI of 15 which is considered to be pretty low. Bananas are somewhere in the middle with a GI of 54. Specialists recommend eating a lot of foods with a low GI because these generate a smaller insulin spike and don’t lead to insulin sensitivity. For example, foods you should eat include: 1. Most types of vegetables and legumes since they have a low GI 2. Brown rice (not white rice since it has a higher GI) 3. Yogurt and whole milk 4. Peanuts, beans, and lentils You should avoid foods like: · Pasta and bread · Baked potatoes · Bagels · Taco shells · Most cookies and candies Monitoring your diet and including more foods with a low glycemic index can reduce the risk of developing insulin resistance.   How is glucose tested? Glucose can be tested very simply using a glucose meter which uses a single drop of blood to determine the amount of sugar in the body. The most common glucose test is performed after a fasting period of 9 to 12 hours by taking a blood sample and running a CMP blood test. The patient refrains from eating food or drinking anything else than water for up to 12 hours . A normal fasting glucose level is less than 100 mg/dL. A glucose level between 100 and 125 mg/dL is considered to be prediabetes. In this case, the patient needs to carefully monitor his or her blood glucose level and try to prevent it from rising. Glucose levels can decrease with diet and exercise. If the glucose level is higher than 125 mg/dL, then the patient has diabetes. This should be confirmed in two separate tests to avoid false diagnosis. The presence of pre-diabetes can also be tested using a special test called a Glucose Tolerance Test for 2 Hours.   What is a Glucose Tolerance Test (GTT)? This test is more thorough, and it can easily discover glucose intolerance, metabolic syndrome, insulin resistance, impaired pancreatic cell function or different other health complications. Its primary role is to determine how the body handles glucose at certain time intervals. Patients begin by eating a balanced meal which includes at least 150 grams of carbohydrate per day for three days before the test. They are not allowed to drink anything but water for these three days, and they should discontinue nonessential medication which might interfere with the test results. Patients shouldn’t eat anything for at least 8 to 14 hours before the test, and they are allowed to drink water only. Similarly, patients shouldn’t do high-intensity physical exercise for at least 12 hours before the test. They are not allowed to smoke or drink coffee either. If water is consumed, it should be plain water, not flavored water.   How is glucose tested in the lab? When the patient arrives at the doctor’s clinic, a simple fasting blood glucose test is performed. This measurement requires taking a small blood sample using a glucose device and find out the blood sugar levels. The glucose meter gently penetrates the skin of a finger to let a drop of blood pop out. The device immediately measures the glucose level in the blood. Many people are scared that they will feel pain when the glucose meter reaches for a blood sample, but they shouldn’t be worried. The process is painless, and it is over in less than one second. The second test involves drinking a sugary beverage which contains 50 or 75 grams of sugar. This quickly increases blood sugar levels and determines an insulin spike. The way the body handles this test is an important indicator of sugar levels in the bloodstream and how the body reacts. It is a more thorough and accurate test which offers better results. The glucose drink should be consumed quickly, and the patient needs to wait for approximately 2 hours before taking the test again. During this time, the patient is allowed to talk, read or listen to music. These are relaxing activities which let the body process sugar optimally. After 2 hours, a blood glucose test is performed again. This time, the sugar levels will be higher which is normal. However, if they are excessively high, this might indicate a predisposition to diabetes or a confirmed diagnosis of diabetes. After drinking the glucose beverage and waiting for 2 hours, normal glucose blood levels should be below 140 mg/dL. Levels between 140 mg/dL and 200 mg/dL indicate impaired glucose tolerance. Levels above 200 mg/dL indicate diabetes.   What to do after getting the results? Changes in lifestyle should be performed according to the test results. For example, if the fasting glucose levels as well as the ones after drinking a sugary beverage fall in the normal category then it means that the patient has a healthy lifestyle and he or she should continue it. If the glucose levels fall in the “impaired glucose tolerance” then the patient needs to make certain lifestyle changes to prevent getting diabetes at some point in the future. Some of these changes include: · Exercising more often · Giving up on sugary foods and drinks or at least reducing their intake – this includes candies, sweets, sodas and alcohol · Reducing stress levels – the patient might want to try yoga, meditation, breathing exercises, taking a vacation, etc If the tested glucose levels indicate diabetes, then the patient needs to work with his or her healthcare provider to find out appropriate treatment options. Certain diets might be prescribed which include foods that have a low glycemic index, so the blood sugar levels don’t rise too often. Certain foods and drinks should be eliminated from diets altogether such as sodas, chocolate, candies, ice cream, and white rice. It is possible to live with diabetes and even reverse it using special diets, but patients need to be disciplined and follow the advice given by the healthcare provider.   How to stabilize and reduce blood sugar levels Getting more exercise and eating healthier foods is a great way to normalize sugar in the bloodstream, but many people are still confused about what does this mean. It's important to take a closer look at the actual habits one can develop to prevent diabetes altogether and normalize sugar levels. Here are some important tips to remember:   Tip #1 – Get more fiber into your diet Fiber is seriously underrated. It basically consists of chunks of food which are not processed by the body, so they are eliminated as a whole. The good thing is that fiber gathers up plenty of toxins and unwanted substances from the gut and takes them out during the excretion process. People who have relatively solid stools (which is a good thing) eat a lot of fiber and enjoy healthier guts and a better lifestyle. Fiber also gives a great sensation of satiety, so one is less likely to overeat if he or she consumes a lot of fiber. Back in the days, humans relied mostly on foods taken from the ground or trees, so their fiber intake would amount to approximately 100 grams per day. Unfortunately, nowadays most people get around 15 grams of fiber per day or less. This is a bad thing because if the body doesn’t have enough fiber, stools become loose and hunger pangs appear throughout the day. Fiber also plays a vital role in metabolizing sugar, and it can be as effective as diabetes medication for certain people. Increasing the fiber intake might make patients give up on diabetes medication altogether. Fiber can be easily found in fruit, vegetables, seeds, whole grains, and complex carbs.   Tip #2 – Take a multivitamin supplement It is nearly impossible to take all the required vitamins and minerals from food only, and that’s why it is highly recommended for anyone to get a multivitamin supplement. Certain nutrient deficiencies such as a lack of vitamin D or a lack of chromium and magnesium can make the sugar levels imbalanced in the bloodstream. These vitamins and minerals are essential for key metabolic processes, and without them, one can become more predisposed to insulin resistance which can lead to diabetes type 2 in the future. Each health conscious person should make a habit of taking more vitamins such as getting a vitamin D supplement. Alpha-linoleic acid, a type of acid similar to omega-3 fatty acids, is also required to maintain normal blood sugar levels and it can be taken as a supplement.   Tip #3 – Eliminate foods which promote inflammation There are certain types of foods which can do more harm than good to the human body. Some of these foods include refined sugars and processed vegetable oils. The bad thing about these foods is that they promote inflammation by activating inflammatory genes. This activation can lead to chronic inflammation in the body which affects cells, tissues and organs. Chronic inflammation also leads to poor insulin sensitivity which translates to insulin resistance and diabetes type 2 at some point in the future. One should try to limit processed oils and refined sugars as much as possible to minimize the chances of having high sugar levels in the bloodstream.   Tip #4 – Find time to relax Stress is an important factor when it comes to insulin resistance. Most people live stressful lives when they have to juggle numerous responsibilities daily, meet deadlines or work under pressure. The human body is not ready to cope with high amounts of stress which basically consists of the hormone cortisol secreted by the adrenal glands in huge quantities. The key to manage stress is to make a habit to relax and take breaks from work every day. For example, one can do breathing exercises, go for a walk in the park, watch a movie, play a game, do yoga and even take a vacation. By reducing stress levels, one doesn't only live a happy and more productive life, but he or she also has fewer chances of developing insulin resistance.   Tip #5 – Work out more often A sedentary lifestyle is one of the worst habits one can have. Lack of exercise drastically increases the likelihood of developing insulin resistance at some point in the future. The human body performs at its best when it engages in physical exercises on a regular basis. This doesn’t mean that one should immediately go to the gym today, but make a conscious effort to move more often throughout the day. For example, taking a 20-minute stroll once in a while can have major positive benefits for health, improving the cardiovascular system and insulin sensitivity. Going for a run is also highly beneficial as well as practicing yoga or engaging in HIIT (high-intensity interval training). The point is to move the body a few minutes each day and slowly build up to a healthy habit of being more fitness-conscious. This can lead to a healthier lifestyle and a healthier mind.   What to do next? The next step is to order the 2H glucose tolerance test today and take action. This test is inexpensive and provides the perfect way to know more about your health with a minimal financial investment.   Buy a GTT test  

Introduction Testosterone Replacement Therapy (TRT) is a commonly administered treatment for men grappling with hypogonadism or low testosterone levels. TRT has been shown to help ease the symptoms of low testosterone, but it also has a noticeable side effect: it raises hematocrit levels, which can cause a medical condition called erythrocytosis or polycythemia. Elevated hematocrit levels cause the blood to thicken, bringing about potential cardiovascular risks like strokes, heart attacks, and clotting events. This comprehensive guide seeks to elucidate various strategies to manage high hematocrit levels induced by TRT, fostering a well-rounded understanding for both patients and healthcare providers. Table of Contents Introduction Understanding Hematocrit and Its Normal Ranges Factors Contributing to High Hematocrit Levels in TRT When to Act on Rising Hematocrit Levels Testosterone Treatment and Blood Cell Production Managing High Hematocrit Levels Monitoring Adjusting TRT Dosage Lifestyle Modifications Sleep Apnea Management Medication and Supplements Comparative Effects of Different Testosterone Therapy Forms Therapeutic Phlebotomy Treating High Red Blood Cell Counts with Phlebotomy No Set Guidelines for Phlebotomy in Testosterone Therapy Yet Phlebotomy: A Temporary Solution? Conclusion References Footnotes Understanding Hematocrit and Its Normal Ranges Hematocrit gauges the volume of red blood cells in the blood, expressed as a percentage, illustrating the proportion of blood comprised of red blood cells. Normal hematocrit levels for men range from 41% to 50%, and for women, they range from 36% to 48%. Factors Contributing to High Hematocrit Levels in TRT Testosterone Replacement Therapy can trigger erythrocytosis, where an overproduction of red blood cells occurs. It is known that testosterone lowers hepcidin levels. Hepcidin is a hormone that is made in the liver and is closely connected to iron absorption pathways. This lowers hepcidin levels leads to erythrocytosis and raises hemoglobin and hematocrit levels. When to Act on Rising Hematocrit Levels If you're using testosterone therapy (TT) and your hematocrit—the percentage of red blood cells in your blood—reaches 54% or more, experts from the European Association of Urology (EAU) and the American Urological Association (AUA) recommend taking action. The EAU advises checking for other possible causes that might be increasing your hematocrit, which could include factors mentioned in their risk section [8]. Testosterone Treatment and Blood Cell Production Typically, the body produces more red blood cells in the first six months of testosterone treatment before this process levels off. If you stop TT, your hematocrit and hemoglobin (the protein in red blood cells that carries oxygen) usually return to normal within 3 to 12 months. Adjusting your TT dose or how it's administered might help prevent high red blood cell counts by mimicking the body's natural hormone levels more closely. Managing High Hematocrit Levels Monitoring Regular monitoring of hemoglobin and hematocrit levels is pivotal for patients undergoing TRT. It is recommended to get baseline hematocrit values before starting treatment and then to do regular measurements at 3, 6, and 12 months after starting treatment. Adjusting TRT Dosage In instances where hematocrit levels soar beyond 54%, healthcare providers might consider decreasing the TRT dosage or temporarily halting the therapy until hematocrit levels normalize. Additionally, switching to subcutaneous injections could also be contemplated as a strategy to modulate hematocrit levels. Lifestyle Modifications Adopting certain lifestyle alterations can significantly impact hematocrit levels. Hydration: Ensuring ample fluid intake to maintain high blood volume. Exercise: Engaging in regular physical activity to reduce blood thickness. Smoking Cessation: Avoiding smoking can decrease hematocrit levels Sleep Apnea Management TRT has the potential to make sleep apnea, a condition marked by intermittent breathing interruptions while sleeping, worse. Continuous Positive Airway Pressure (CPAP) devices or other medically approved treatments that help people with sleep apnea can also help people with high hematocrit levels improve their health. Medication and Supplements Medications like Losartan and supplements like Naringin have shown promise in helping manage high hematocrit levels. However, it's crucial to consult with a healthcare provider before embarking on any new medication or supplement regimen. Comparative Effects of Different Testosterone Therapy Forms While all forms of testosterone therapy, such as gels, pills, patches, and injections, are linked to increased hematocrit levels, injectable forms were once thought to have the most significant impact. Recent studies have shown that although injections like testosterone enanthate can significantly raise hematocrit compared to patches, usually no form of therapy increases hematocrit by more than 4.3%. This suggests that careful patient selection and monitoring could mitigate the risk of excessive red blood cell production. The risk does not seem to correlate with the duration of testosterone therapy but is more pronounced during the initial phase due to the abrupt hormonal shift. Typically, hemoglobin and hematocrit levels rise within the first six months of therapy and tend to normalize within a year of discontinuation. However, dosage is a critical factor, and selecting an appropriate dose requires considering individual patient factors. Therapeutic Phlebotomy Therapeutic Phlebotomy (TP) is a widely adopted procedure to manage testosterone-induced polycythemia, involving the removal of a pint of blood to diminish hematocrit levels. The frequency of  blood donations should not exceed once every 12 weeks to prevent iron loss due to frequent donations, contingent on individual responses to TRT. Treating High Red Blood Cell Counts with Phlebotomy Phlebotomy—the process of drawing blood—is a common treatment for polycythemia vera (PV) and high hematocrit caused by testosterone therapy, a condition with too many red blood cells, and there's no reason it can't be used for people with high red blood cell counts from TT [13]. A study by Marchioli and colleagues found that keeping hematocrit levels below 45% significantly reduced blood clots and other serious issues compared to allowing levels to be between 45 and 50%. While phlebotomy has been helpful in PV, its effectiveness for TT-related high red blood cell counts needs more high-quality research. An observational study by Hazegh et al. showed that men on testosterone who donated blood saw their average hemoglobin levels decrease over a year. The frequency of their donations varied widely, indicating that blood donation could be a useful strategy. There are No Set Guidelines for Plebotomy in Testosterone Therapy Yet Currently, there are no specific guidelines on how often or how much blood should be drawn if you're on TT and experiencing high red blood cell counts. Phlebotomy: A Temporary Solution? While phlebotomy can lower hematocrit levels, it may not be a permanent fix. Chin-Yee et al. evaluated patients who donated blood and found that many had high hematocrit levels even after donating. This suggests that while phlebotomy can help, it might not completely control red blood cell counts related to TT. In summary, phlebotomy can safely reduce hematocrit levels temporarily, but it should be used alongside other methods, like adjusting TT doses, to manage red blood cell counts effectively. More research is needed to define the role of phlebotomy in managing TT-related high red blood cell counts. Conclusion The meticulous management of high hematocrit levels in patients on TRT is pivotal to averting potential cardiovascular risks. A multifaceted approach can be used to effectively manage hematocrit levels. This includes monitoring, changing TRT dosages, making changes to the patient's lifestyle, managing sleep apnea, therapeutic phlebotomy, and medication or supplementation. It's incumbent upon healthcare providers and patients to collaborate and ascertain the most conducive management strategy, ensuring the efficacy of TRT while safeguarding the patient's health. References Footnotes Excel Male TRT Forum. (n.d.). How to Manage High Hematocrit Caused by Testosterone Replacement Therapy. Retrieved from Excel Male TRT Forum ↩ ↩2 Discounted Labs. (n.d.). High Hematocrit Caused by TRT: How to Lower and Manage it. Retrieved from Discounted Labs ↩ ↩2 ↩3 PubMed Central (PMC). (n.d.). Testosterone use causing erythrocytosis. Retrieved from PMC ↩ PubMed. (n.d.). Management of Erythrocytosis in Men Receiving Testosterone Therapy. Retrieved from PubMed ↩ Iron Mountain Men's Health. (n.d.). How to Lower Hematocrit While on TRT. Retrieved from Iron Mountain Men's Health ↩ American Journal of Clinical Pathology, Oxford Academic. (n.d.). Therapeutic Phlebotomy for Testosterone-Induced Polycythemia. Retrieved from Oxford Academic ↩ American Journal of Clinical Pathology, Oxford Academic. (n.d.). Therapeutic Phlebotomy for Testosterone-Induced Polycythemia. Retrieved from Oxford Academic ↩

Table of Contents What is Anemia? How is Anemia Diagnosed? What Test Are Included in the Discounted Labs Anemia Panel? How is Anemia Treated? Sources What is Anemia? Anemia is a condition characterized by an individual’s blood not containing enough healthy red blood cells. This blood disorder often goes hand in hand with insufficient levels of hemoglobin, a protein in red blood cells that helps circulate oxygen throughout the body. There are many distinct types of anemia, the symptoms of which can range from non-existent to very severe. Some of the most common symptoms include headaches, shortness of breath, and fatigue. Anemia can be caused by many potential factors but is usually related to an inability to generate enough healthy red blood cells or a loss of blood. How is Anemia Diagnosed? To diagnose anemia, a healthcare professional will most likely run an Anemia Panel and ask about your family history. An anemia panel is a series of tests designed to quickly and accurately determine the cause and type of anemia a patient is experiencing. There are many different kinds of anemia so thorough testing is necessary to determine an appropriate course of action for treatment. Anemia can be tested by measuring the concentration of hemoglobin in red blood cells. In men, a concentration of less than 13 to 14 grams per deciliter (g/dL) can indicate anemia. The same goes for women who fall under the 12 to 13 g/dL range.  An anemia panel includes many different tests to pinpoint exactly what is occurring within the patient’s blood. What Test Are Included in the Discounted Labs Anemia Panel? Some factors measured in an Anemia Panel are: Complete Blood Count (CBC): Inventory of different components that make up blood: red blood cells, white blood cells, and platelets. Red Blood Cell Count (RBC): Anemia is most strongly characterized by a lack of normally functioning red blood cells. Since red blood cells are used to carry oxygen from the lungs to every cell in the body, anemia can leave a person feeling fatigued or short of breath. This test measures the total number of red blood cells found within a patient’s plasma, the liquid part of their blood. Red Blood Cell Distribution Width: Measures the size and homogeneity of red blood cells. Hemoglobin: Hemoglobin is a protein found in red blood cells that assist in carrying oxygen to the body’s tissues and carbon dioxide back to the lungs. White Blood Cell Count: Total quantity of white blood cells in a blood sample. As white blood cells are responsible for fighting off sickness and pathogens, an increased concentration can indicate an individual is fending off an infection. A healthy adult typically has between 4,000 and 11,000 white blood cells per cubic millimeter of blood (cells/mm3). Neutrophils: Normally making up 50-70% of white blood cells, neutrophils fight off bacterial infections. If a person’s neutrophil count falls below normal levels (500-750 cells/mm3) their risk of bacterial infection rises significantly. Platelets: Imperative in the process of blood clotting, a normal platelet count is between 130,000 and 440,000 cells/mm3. A low platelet count can lead to easy bruising and excessive bleeding and could be caused by certain drugs, deterioration of the spleen, or autoimmune reactions. Folic Acid/Vitamin B-12: Measuring these essential nutrients can help doctors diagnose anemia, nervous system disorders, or malabsorption syndromes. Lack of B-12 can directly result in pernicious anemia, as the vitamin is responsible for helping the body produce red blood cells. Iron: The body uses iron to create hemoglobin, therefore, a lack of which can impact the health of your red blood cells. This condition is called iron deficiency anemia. How is Anemia Treated? Anemia treatment is dependent on what caused it in the first place. As you can see, there are a plethora of potential causes, all of which occur on a microscopic level within our blood. Be it an iron or vitamin deficiency, chronic disease, or immune system suppressing drugs, anemia is not a “one size fits all” disease. Treatment is directly related to identifying the cause, which is what makes an Anemia Panel so critical for individuals who think they are experiencing anemia symptoms. Sometimes treatment is as simple as making dietary or lifestyle changes. However, in many cases, more severe treatments, such as medication or blood transfusions are required to remedy the problem. The crux of the issue always boils down to the number of healthy red blood cells the body is capable of producing. Whether or not the body can be stimulated into making more is contingent upon identifying the root cause of anemia, as cases can vary widely in severity and treatability. For some, the solution is as simple as introducing a supplement into their daily regimen. For others, the only options can be bone marrow transplantation or chemotherapy. Due to the wide range of causes and treatments, if you are experiencing symptoms that resemble anemia it is strongly recommended to screen for it using an Anemia Panel. At first glance, the number of tests included may seem excessive, but they are imperative in identifying what cellular components are missing from your bloodstream. Doing so is a critical first step toward treating anemia and managing health on a molecular level.       Sources Bunn, H. F. (2014). Vitamin B12 and pernicious anemia—the dawn of molecular medicine. New England Journal of Medicine, 370(8), 773-776.   DeLoughery, T. G. (2014). Microcytic anemia. New England Journal of Medicine, 371(14), 1324-1331.   George-Gay, B., & Parker, K. (2003). Understanding the complete blood count with differential. Journal of PeriAnesthesia Nursing, 18(2), 96-117.   Shine, J. W. (1997). Microcytic anemia. American Family Physician, 55(7), 2455-2462.   Walters, M. C., & Abelson, H. T. (1996). Interpretation of the complete blood count. Pediatric Clinics, 43(3), 599-622.     Wang, M. (2016). Iron deficiency and other types of anemia in infants

Table of Contents Check Out the Most Important Blood Tests for Seniors Lipids Panel Comprehensive Metabolic Panel Complete Blood Count Thyroid Test Panel A1c Test PSA Test Find Out More About Your Health Today! References: Check Out the Most Important Blood Tests for Seniors   You might be happy to find out that direct-to-consumer blood tests have become so affordable and accessible these days that it's a pity not to take advantage of them. This is particularly important for seniors because they are exposed to more health issues in comparison with younger generations. Fortunately, this article gives you a shortlist of some of the most important blood tests most physicians order for senior patients in follow up visits. These tests give you a great overview when it comes to your general health and based on the test results, you will know exactly what to do next. Let's find out more about these tests. Lipids Panel The lipid panel is a battery of tests that looks at how well your body metabolizes fat and whether you're at risk for coronary artery disease. As you already know, cholesterol is a waxy substance made by your liver. It lines the insides of your blood vessels, making them more elastic and adding protection. Unfortunately, too much cholesterol can cause blockages and blood clots. This is where the lipid panel can help. It shows you an accurate snapshot when it comes to the levels of cholesterol in your blood. Also, the lipid panel looks at your triglycerides, HDL, and LDL cholesterol as well as other important lipids.  Certain foods can raise your cholesterol levels and having a sedentary lifestyle can also increase the chances of having unhealthy cholesterol levels. Some people may also have a genetic predisposition to high lipids due to family history. A lipids panel test can let you know exactly where you stand when it comes to cholesterol and triglycerides. Comprehensive Metabolic Panel You might be happy to find out that the Comprehensive Metabolic Panel is an inexpensive collection of 14 tests that check your protein levels, electrolyte, and fluid balance and more. It also looks at some important liver and kidney enzymes, so you will know right away if these important organs work correctly. For example, some of the substances tested by the CMP are calcium, potassium, albumin, aspartate transaminase, creatinine, and others. Based on the results, your doctor might suggest minor lifestyle and diet changes or further investigations to prevent more complicated health problems. Complete Blood Count The CBC panel looks at the numerous components of the blood such as red blood cells, white blood cells, platelets and more. It's important to have accurate information about these components because they might reveal if you're struggling with known health problems such as anemia, autoimmune diseases and so on. The CBC panel is paramount for older adults as part of the annual health checkup. Best of all, it doesn't cost a lot of money and you can do it in conjunction with other test panels such as lipid or metabolic panels. The results are emailed to you in just a few business days and your primary healthcare provider can help you interpret them. Thyroid Test Panel Unbelievably, the thyroid gland situated at the base of your neck is the source of your daily energy levels. Its hormones impact most of the organs and bodily processes, so if something goes wrong, you will feel fatigued and your body temperature might get low. As part of the thyroid blood test, the panel looks at some of the most important thyroid hormones such as T3 and T4. If your thyroid hormones are not balanced properly, you might feel certain symptoms such as sensitivity to heat, nervousness, chronic fatigue, and others. If you have these symptoms, you should test your thyroid hormones and see what treatment options are appropriate for you. Some thyroid ailments can easily be mitigated with proper medications, but you need to know your thyroid's hormonal profile before starting a thyroid treatment. A1c Test This test is not as popular as the others, but equally important. The A1c is also known as glycated hemoglobin. The levels of A1c go up in the body when glucose starts to combine with the red blood cells. This usually happens when the blood sugar levels are very high for a couple of months in a row. As you know already, having high blood sugar levels predisposes you to one of the most dangerous chronic diseases - type 2 diabetes. A simple blood glucose test can tell if you're pre-diabetic or your blood sugar levels are within normal ranges. However, A1c can stay in the blood for up to 3 months and this tells you that your blood sugar levels have been high for a long time. It's a more accurate test for some people and it lets you know if you should immediately do something to lower your blood sugar levels to prevent diabetes. PSA Test On top of the aforementioned tests, seniors should also consider doing a PSA test. This stands for prostate-specific antigen and it's a biomarker of prostate inflammation. The prostate can get inflamed for assorted reasons and people of an elderly age are more vulnerable to various prostate diseases. For example, benign prostate hyperplasia, bacterial prostatitis and even prostate cancer are among the numerous illnesses related to the male prostate. A simple PSA test can reveal if your PSA levels are within normal ranges or not. If these levels are high and you also have some specific symptoms, you should consider doing further investigations to find out more about your prostate's health. Painful urination as well as urinating with interruption are among the most common symptoms of prostate inflammation. Find Out More About Your Health Today! As the saying goes, "An ounce of prevention is worth a pound of cure". This is especially true when it comes to your health. Therefore, do your best to order these blood tests annually to keep your health in check. These tests are not only highly recommended to only adults, but to younger generations as well. At the same time, you can have most of them in a simple package from reputable vendors. For example, go to DiscountedLabs.com and order the Annual Physical Lab Test Panel. This panel contains everything you need to get a comprehensive snapshot of your health!   ====================== References: Top 10 Blood Tests for Older Adults: What to Know A1c- Hemoglobin (Hgb) Comprehensive Metabolic Panel (CMP) - Medical Tests