I want to be fair, so I'll respond. In the future however, please break up longer replies with paragraphs. It makes it much easier to digest and to respond to.
Ok, my post has generated some controversy. Let me explain a little. I would suggest that your doctor doesn't know much of what he is doing.
We are in absolute agreement to this point.
HOWEVER, if you go to any blood donation place, it your hemoglobin is 19 or over, most places will not accept your blood. Also, if bp is too high, they will not accept your blood either.
Hemoglobin requirements are actually at the discretion of the site, but the guidelines established by the FDA (the governing body in the US) is 19.2. Blood pressure is actually not related to hematocrit unless there are other conditions present.
Source (I realize that the study is regarding children, but it presents a good example with clear language. I have another study on my desktop, but I'm on my phone atm) However, yes - a systolic above 190, and diastolic above 100 does defer you for a day.
When it comes to TRT, I was rejected by a blood donation site, because I was on TRT. They kept saying, "Since you take steriods, you have polycythemia, therefore we cannot take blood from you." I tried to explain to them that it was doctor prescribed, but I could tell that they had a bias against what they referred to as "Steriods." I had to turn around and walk out.
If you're going to a private collection site, they can defer you for just about anything they wish. But you're also likely being paid for your time - which makes a tremendous difference. They also cannot make a diagnosis (polycythemia vera is a medical diagnosis) unless it's a medical doctor doing the screening - that's the law.
The Red Cross however is not private, and follows guidelines set forth by the federal government. Some numbers are flexible to an extent, but anything set by the FDA must be adhered to. Ex: Having sexual intercourse with another male is a deferment.
A website might tell you that donating blood will lower your hematocrit. If you are donating a pint of blood, then all you are going to be doing is getting ride of a pint of blood. The number of red blood cells, per volume, in your blood will not be reduced. Testosterone will keep the bone marrow producing a high number of red blood cells.
You do realize that your body replaces the missing pint with WATER, right? This reduces your blood solid concentration (hematocrit) by exactly the volume displaced until new red blood cells are generated. This takes time, and donations are a life long commitment as such. I don't know where you got your information from, but just to drive home this concept
here Is a nice short study even giving quantitative data.
When it comes to TRT, I am not saying that someone is SUPPOSED to go on and off TRT. In the years that I have been doing TRT, I have come to experience that my estradiol level will sky rocket after about 7-8 months, despite taking Anastrazole. I will get bloated, my hematocrit will hit about 52%, blood pressure rises to a dangerous level, to the point that blood donation centers will not accept my blood. They told me that if I gave a pint of blood with the blood pressure that I had at the time, it could cause me to have a heart attack.
You're aware that edema has many causes, right? Hematocrit and water retention are actually inversely proportionate, as hematocrit is a percentage of solids to fluids in the venous system. The more water you're retaining, the lower your HCT will be by the very definition.
I suspect there's something else going on in your case, and whomever at that site is seeing you is
dangerous to say the least. Just as an example, body composition changes can manipulate both estradiol and hematocrit. Dietary changes are the most common however. (which directly can impact the first example)
I just can't comment on the silliness of the statement where taking blood would cause cardiac arrest, unless you're well over 200/140. At that point, donating blood is the least of your worries.
During that time, my blood thickened to the point that I could not walk across a room without having to stop and catch my breath. I was later informed, that at times, it is wise to stop the TRT, use HCG injections 2-3 times a week, along with taking Clomid. It causes your testicles to jump start back up again, to a level much higher than what your body was producing BEFORE TRT. It keeps the equipment working well. You can do that for 2-3 months at at time. This will also help get rid of the water retention in the blood (which causes the blood pressure issues, it gets the good cholesterol producing again, and will lower the estradiol level) But since that won't last long term (Clomid is fairly toxic for the liver), you go back on the TRT again. So, you gotta figure out what works best for your body.
I don't think whomever told you this understands how the HPTA works at ALL. If you could PCT (post cycle therapy; using a SERM to trick the hypothalamus into releasing gnrh by hiding estradiol) back to eugonadal values, you simply wouldn't need TRT! HCG at effective doses is suppressive to the HPTA, so taking it with a SERM (clomiphene citrate - clomid) is pointless. A SERM forces gnrh ->LH ->testosterone, so why would you take an LH analogue anyway?
I would have to delve into your issue to understand more, but there's no such thing as random estradiol issues requiring cessation of TRT. I have heard of something very similar though, and it was how a vitality clinic was able to stay in business; changing patient ID numbers by having them drop treatment for just about any random reason. Not saying this is your case by any means, but I've been participating in the TRT community for the better part of a decade, and have NEVER heard of such issues.
Just remember, there is still a lot of controversy about TRT, in terms of whether it should be continued to be a medical prescribed drug anymore, it has a lot of controversy surrounding it, and there is still a lot of unanswered questions as to how it affects the body. When I was first put on TRT, my doctor prescribed a 100mg injection once every 4 weeks. How crazy. Now, there are tons of HRT clinics everywhere (most are in Florida) and they can prescribe up to 500 mg every week. And I had to learn about the estrogen level, hematocrit, hemoglobin, water retention in the blood, and blood pressure issues the hard way. You gotta experiment, within reason, and figure out what works best for you.
The only controversy is when lawyers get involved in trying to make money. I don't know how you can say not a lot is understood as TRT has been studied for over sixty years. We just didn't hear much about it as the prescribing guidelines (and profit margins) haven't been high enough to get attention until the last 5-10 years or so.
I do agree with you once again in that there is a significant amount of experimentation needed in 'dialing in' an optimal protocol, but as there's no one-size-fits-all solution, that's really the only option.
If you feel that I have not carefully explained a specific topic in great enough detail, or you require additional references - I will be more than happy to provide them tomorrow.
