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RBC/Hemoglobin/Hematocrit Discussion for the EXPERT PANEL 9/27/2020

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  • #16
    Excellent response. Thank you, Scott.

    Skip

    Originally posted by homonunculus View Post

    For sure! There are probably dozens of research groups furiously working away to get the scoop on that one... LOL

    One thing that might help wrap our heads around this is to consider that we can frame a physiological phenomenon in various and multiple ways:

    Symptom
    Cause
    Adaptive response / Adaptation
    Pathophysiological Change / Pathology

    An above normal / average HCT might be an adaptation that lessens stress at high altitude but could also be stimulated by androgen use in a person where the HCT is run-away b/c of some underlying deterioration / pathology (e.g., age, failure of regulatory systems over time more acutely that is a sign of underlying poor health).

    The higher HCT and BP might not necessarily in a health person increase clotting risk b/c that healthy person's has more tightly controlled systems of hemostasis.

    In the drug-related / pathological system, the increased HCT might be something that does indeed tip the balance towards more clotting, atherogenesis, etc. and greater risk of stroke, embolism, etc.

    So what is for one person represents (the symptom of) a positive adaptive response could be a symptom of a pathological change that could be considered the cause of an adverse cerebro-/cardiovascular event.

    -S


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    • #17
      Originally posted by Ken "Skip" Hill View Post
      Excellent response. Thank you, Scott.

      Skip


      For sure, Ken!

      -S
      The Book Has Arrived!
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      • #18
        Originally posted by Datas4 View Post
        I generally do not use phlebotomy as a means to control hemoglobin/hematocrit/RBCs.

        I definitely notice that in some it makes things worse. This idea was originally brought to me by an MD friend of mine at the time and I started seeing it more and more in lab work.

        This is not the case across the board, it does seem to help some folks.

        If its a chronic issue (especially in PED users), I tend to lean toward a low dose ARB med. These meds are Renin-angiotensin-aldosterone system inhibitors and they will lower both hemoglobin and hematocrit. They are cardioprotective and renal protective as well. Generally they are used for hypertension but they dont require a high dose to help with RBC values some someone with pretty normal BP could still benefit. Effects will increase as dose goes up as well.

        There are several protective benefits of these ARB drugs, even in lower doses. A lot of bodybuilders could benefit from them in the right context.


        This is obviously assuming that values arent skewed because the person is overly dehydrated on the labs or using a lot of AAS.

        Plugging a podcast link in here too as long as Ken is cool with it. This is a recent chat with an MD thats a PED harm reduction specialist and overall very bright guy. We do chat about the topic in here and I know hes not a fan of using phlebotomy for this reason.

        https://player.fm/series/optimal-phy...r-scott-howell
        Austin I had heard of that before using a low dose ARB med, bu never knew of anyone actually taking them for this purpose. Sounds like a good tool to utilize and will definitely look into more. Thanks for the info
        Allen Cress

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        • #19
          I have been meaning to respond to this but kept forgetting.

          What do you mean by "renal protective?" I thought that ARBs would stress the kidneys. Am I wrong or are you saying that the low dose will not impact renal numbers as much as higher dosages?

          Also, I believe hyperkalemia is a concern with ARBs but is it significantly decreased with the lower dosages?

          Skip

          Originally posted by Datas4 View Post
          I generally do not use phlebotomy as a means to control hemoglobin/hematocrit/RBCs.

          I definitely notice that in some it makes things worse. This idea was originally brought to me by an MD friend of mine at the time and I started seeing it more and more in lab work.

          This is not the case across the board, it does seem to help some folks.

          If its a chronic issue (especially in PED users), I tend to lean toward a low dose ARB med. These meds are Renin-angiotensin-aldosterone system inhibitors and they will lower both hemoglobin and hematocrit. They are cardioprotective and renal protective as well. Generally they are used for hypertension but they dont require a high dose to help with RBC values some someone with pretty normal BP could still benefit. Effects will increase as dose goes up as well.

          There are several protective benefits of these ARB drugs, even in lower doses. A lot of bodybuilders could benefit from them in the right context.


          This is obviously assuming that values arent skewed because the person is overly dehydrated on the labs or using a lot of AAS.

          Plugging a podcast link in here too as long as Ken is cool with it. This is a recent chat with an MD thats a PED harm reduction specialist and overall very bright guy. We do chat about the topic in here and I know hes not a fan of using phlebotomy for this reason.

          https://player.fm/series/optimal-phy...r-scott-howell


          Facebook: Skip Hill
          Instagram: @intensemuscle
          YouTube: TEAMSKIP
          TikTok: @intensemuscle


          For Training Inquiries: [email protected]

          Use discount code "SKIP" and get your TEAM SKIP protein here: www.TrueNutrition.com/TEAMSKIPblend

          Comment


          • #20
            Originally posted by Doggcrapp View Post
            Wow this is extremely interesting! I have always wondered this as you have many top coaches like Palumbo talking about not to worry about high RBC's. Of course most doctors do freak out including TRT doctors and endocrinologists.
            I am paranoid about this as I had a near death experience this year which required brain surgery. They said the issue could have been caused by a bloodclott in the brain which formed some improper connections between arteries and veins. They do not know this for sure, but they said it can happen from that. Of course the thought always crosses my mind coudl it have been using gear and indirectly causing this? I will never know.
            BUUUUT... from what I gather in this video, if you do not have a blood disease, and your platelets are fine, don't stress about donating blood?
            I always do make sure to stay hydrated and take a baby aspirin before bed (only when on cycle not when on TRT dose).

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