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Androgen-induced polycythemia a "myth"?

Discussion in 'Male Health & HRT' started by Katzenjammer, Dec 28, 2016.

  1. Katzenjammer

    Katzenjammer Active Member

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    Dr. Neal Rouzier is arguing that erythrocytosis is NOT polycythemia.

    He recently presented at this Conference: http://worldlinkmedical.com/wp-cont...-Century-Welness-Medicine-Course-Brochure.pdf

    And in a preview comment he said:

    Dr. Rouzier discusses here at minute 46:00 forward the distinction between erythrocytosis & polycythemia. Actually, the whole lecture is kind of interesting.



    If Dr. Rouzier is correct, then there are three question in my mind:

    1. does erythrocytosis need to be present at every moment for the upregulation of nitric oxide? Suppose, for example, one goes off androgens. Now, the hormone and activity of erythropoietin will be decreased, presumably? But your red blood count would still be elevated, presumably for some time. Is this a valid concern?

    2. Will the Red Cross and other centers will not allow TRT patients to donate blood with elevated hemocrit?

    3. Will pcps/doctors/hospitals continue to see androgen->erythrocytosin-mediated elevated hemo as a dangerous “condition”?
     
  2. Katzenjammer

    Katzenjammer Active Member

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    I'm trying to get a 90 minute lecture Dr. Rouzier gave, chock full of references/studies:

     
  3. Katzenjammer

    Katzenjammer Active Member

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    This is what he gives his patients....

    ERYTHROCYTOSIS VS PCV (Polycythemia Vera)

     
  4. Bulldog

    Bulldog Administrator Staff Member Administrator

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    My Hemoglobin (HGB) and Hematocrit (HCT) have both been slightly above range for a couple years now due to testosterone injections. I occasionally donate blood but it doesn't really make any difference. I have also seen my platelets drop during this same time period and they have been just below range for over a year now. The last two times I have donated blood I had to have a wrap put on my arm because I bled like a stuck pig when they removed the needle, even though my HGB and HCT were high. I do not yet know if my platelet count is dropping to compensate for the increased HGB & HCT or if it is due to some other reason. I'm going to explore that this winter. All that said, I'm not concerned with the high HGB & HCT at this time due to the lower platelet count, but the low platelet count is somewhat concerning since I don't know why it has dropped.
     
  5. Katzenjammer

    Katzenjammer Active Member

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    Hi Bulldog - Merry Christmas and Happy New year! :)

    Interesting - yes, apparently watching platelets is the key. If this is true, in my opinion it's a huge advance in TRT, not to mention a relief, lol.

    The lower platelet count thing - I wonder if it's a matter of % in comparison to RBC?

    For me to keep my HCT down I have had to donate fairly often; and, at one point it drove down my iron levels. People who are donating should REALLY be careful about this; it wasn't something I frankly thought about until I started experiencing symptoms.

    Hope all is well.

    ~katz
     
  6. ManOnMission

    ManOnMission Member

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    I'm a little confused on the 45 minute presentation from Dr. Rouzier.... is he saying to not reduce Estrogen levels? I thought he was saying that reducing estrogen levels elevated body fat? Ive always heard the 20-30 levels for Estradiol and high levels cause increase in body fat?

    It also sounds like people on TRT should not worry about hemaglobin levels anymore if the elevated levels are due to TRT. Maybe just watch platelets to make sure they are in range. People on TRT have erythrocytosis (process of making more blood cells) also associated with people living at altitude not polycythemia (blood disease that can kill you) typically. TRT causes an increase in EPO (hormone your kidneys make) and you make more blood cells but also produces more nitrous oxide which relaxes your blood vessels. People at altitude dont have heart attacks and strokes. people with poly dont have the extra EPO production which is why they are at risk.
     
  7. Dr. John Crisler

    Dr. John Crisler Lord of the Forum Staff Member Super Moderator

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    Yes, my old friend Dr. Rouzier has taken the position taking an AI is "taking a little poison".

    After my talk at AMMG Las Vegas 11/16, the day after his talk, I pointed out all the studies he used were based upon the invalid immunoassay E2 test, not the correct LC/MS.

    That negated his whole talk, other than a good presentation of what happens when you lower E too far: it's always bad for you.
     
  8. Katzenjammer

    Katzenjammer Active Member

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    For those interested, here is where Dr. Crisler was on the AI issue as of early 2017.
     
  9. KYinchampaign

    KYinchampaign Member

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    I reckon the good ole Dr. Rouzier hasn't heard of acute mountain sickness. Yet he references the same physiological reaction as the same. Not quite there Dr. Quackenstein.

    Personally I don't subscribe to his opinions.
     
  10. Katzenjammer

    Katzenjammer Active Member

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    Well, thank God you came along because no one has ever thought of that objection before.*** :)

    Distinctions need to be made between Polycythemia and Erythrocytosis; and between Acute and Chronic altitude sickness. And what is the actual etiology of each case, which is complex.

    But to focus on the immediate issue: TRT-induced Erythrocytosis (NOT Polycythemia). The increase in RBC does NOT pose a risk because it does not increase the viscosity or clotting the blood; it is platelet count that is the issue and needs to be watched, as it's the increase in platelets that are the cause of clotting. Polycythemia induces an increase in plateletes -> increasing viscosity/clotting factors, etc.



    _________
    ***s.a.r.c.a.s.m.
     
    Last edited: Jan 27, 2019

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