Risks of Excessive Phlebotomy on Testosterone & Steroids – Case Study

Phlebotomy, or drawing blood, is frequently used by men on testosterone and steroids who have a high red blood cell count. However, excessive phlebotomy comes with its own risks. In this video I discuss those risks in the context of a case study, as well as explain why the red blood cells are elevated in the first place: androgen induced erythrocytosis leading to polycythemia. Not all men on androgens experience this, but there are several risk factors to watch out for and steps you can take to monitor yourself and manage the condition if it does occur. If you’re on androgens or are a healthcare provider treating men who may be on androgens, please watch this video!

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01:24 – CASE HISTORY: 39 y.o. man with history of steroid use, now on TRT
03:10 – Symptoms: “heavy” heart beat, anxiety
04:02 – Began self phlebotomy (without consulting doc)
05:51 – Notable low iron status on blood tests
– Can lead to polycythemia – increased red blood cells
09:35 – 4 risk factors for androgen induced erythrocytosis
– Blood clots / hypercoagulable states
13:56 – Veins: DVTs, pulmonary embolism
14:29 – Arteries: heart attack & stroke
– Full history & physical, monitor with blood tests
16:51 – Manage TRT dosage, potentially stop
17:13 – Sleep apnea & why it increases red blood cells
17:46 – Careful phlebotomy

Stay Strong and Healthy,
Dr. O


As the Anabolic Doc, since 2003, I’ve provided men who are using or have used anabolic steroids a confidential, ethical and professional medical venue to discuss their use. I do NOT in any way support the use of any performance enhancing drugs – PEDs, anabolic steroid or other medicine for muscle building or body transformation. The “off-label” use of PEDs, as such agents is considered elicit and may lead to adverse health outcomes. Please consult an expert health professional regarding any medical agent and do NOT use any medicine without the explicit advice and supervision of an appropriate medical expert.

This video is for education and information only. This is not medical advice. Only take medications as prescribed by your doctor. Do not take illegal substances. Taking steroids can lead to serious health consequences.

#testosterone #steroids #polycythemia

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