From the Guidelines
Your testosterone level is significantly low at 178.6 ng/dL, which is consistent with your report of being off testosterone therapy, and this likely explains any symptoms of fatigue or decreased energy you may be experiencing. However, your hemoglobin of 18.2 g/dL and hematocrit of 52% are both elevated above normal ranges (normal hemoglobin for men is typically 13.5-17.5 g/dL and normal hematocrit is 38.3-48.6%), which is concerning as these high values can increase your risk of blood clots and cardiovascular problems, and may actually be a lingering effect of your previous testosterone therapy which commonly raises these blood values, as noted in a study published in the New England Journal of Medicine 1.
According to the most recent guidelines, if your hematocrit exceeds 54%, intervention such as dose reduction or temporary discontinuation of testosterone therapy is warranted 1. Given your current hematocrit level of 52%, it is essential to closely monitor your blood work and adjust your treatment plan as needed to minimize the risk of erythrocytosis and its associated complications. It is also crucial to weigh the benefits of testosterone therapy against the potential risks, particularly in terms of cardiovascular health, and to consider alternative treatment options or adjustments to your current regimen, as recommended by the American Urological Association 1.
From the FDA Drug Label
Laboratory tests: Hemoglobin and hematocrit levels (to detect polycythemia) should be checked periodically in patients receiving long-term androgen administration. Your blood work results show a testosterone total of 178.6, hemoglobin of 18.2, and hematocrit of 52, indicating that your red blood cell count is elevated, which is a potential side effect of testosterone therapy, as noted in the drug label 2. You should discuss these results with your doctor to determine the best course of action.
From the Research
Blood Work Results
- Your total testosterone level is 178.6, which is being monitored as you are on testosterone replacement therapy and have been out of it for a little while.
- Your hemoglobin and hematocrit levels are 18.2 and 52, respectively, which are important to monitor while on testosterone replacement therapy, as elevated levels can increase the risk of vascular events, as noted in studies 3, 4, 5, 6, 7.
Key Findings
- According to the studies, testosterone replacement therapy can cause an increase in hemoglobin and hematocrit levels, which can lead to polycythemia and increase the risk of vascular events 3, 5.
- The current guidelines recommend monitoring hematocrit levels and discontinuing or reducing testosterone replacement therapy if the hematocrit exceeds 54% 3, 6.
- Your hematocrit level of 52 is below the threshold of 54%, but it is still important to continue monitoring your levels to minimize the risk of vascular events 4, 7.