Austinite
Moderator
Introduction
Unfortunately, something that is often dismissed is also one of the most important things to observe during and after cycles: blood counts. Frankly, this is far more important than your precious testosterone levels. I'll even go as far as saying that it's more important than estrogen levels. Gynecomastia won't kill you. Ignoring blood counts forever can certainly be fatal. I'm not discounting the importance of other blood tests, but I want to emphasize the vitalness here. This article should serve as your information base for your most important blood count. This article should serve Testosterone-Replacement-Therapy patients just as well.
In order to understand the effects of steroids, it's entirely important to understand the process in which blood is affected. I'm going to do my best not to bore you so I'll try and be brief with the descriptions.
What are Red Blood Cells?
Red Blood Cells (RBC): Oxygen (O[SUB]2[/SUB]) is a nutrient that is vital for our survival. You knew that, right? This nutrient gets around your body via RBC's. When you breath, your lungs fill with O[SUB]2[/SUB]. So RBC's make a quick stop in the lungs and grab a whole bunch of O[SUB]2[/SUB] that sits inside Hemoglobin; a protein that's inside the red cell. They swim through your veins and start dumping O[SUB]2 [/SUB]all over your body. When they're done with that round, they swim over to the lungs for another pickup. The oxygen carries iron with it as well. So red cells transport oxygen and iron. This is a never ending cycle and that's the main purpose of RBC's.
The amount of RBC's that you have matters. If you have too little, you're in trouble. This is called Anemia. If you have too many RBC's, you're also in trouble, and that's called Polycythemia. So obviously we want to have a balanced number of red cells in our system.
How Steroids Affect Red Blood Cell Counts
There's a 2 major parts where steroids affect your blood counts and cause a chain reaction. Put your seatbelts on and come along for this awesome ride...
Hepcidin Suppression:Hepcidin is a peptide that your liver produces. It exists to regulate iron metabolism. We're gonna come right back to hepcidin in a second...
You see, there's this protein called Ferroportin. It's job is to find cells that are holding/storing iron, and it dives inside and pulls the iron out of that cell. Now that iron is free and ready to be metabolized.
Hepcidin is released whenever your Ferroportin pulls too much iron from the cells. Hepcidin is the boss here. It's the 'master iron regulator' and wants to manage the iron so that you have a balance. So Hepcidin swims over to Ferroportin and puts handcuffs on it. Now Ferroportin is in jail and can't free anymore iron.
So what would happen if Hepcidin wasn't around to police Ferroportin? Well, Ferroportin would go nuts and start yanking all the iron out of every cell it can find. And you would end up with a whole bunch of iron in your body that's ready to be metabolized, even though it's supposed to be stored for emergencies. But wait... How is all this iron supposed to get around? It can't swim on it's own. They needs a vehicles. Are you thinking what I'm thinking? You wish you had a life? Oh... sorry. I mean... Oxygen!
Check this out, Hemoglobin is the protein that lives inside of the red blood cells. It holds the oxygen that RBC's are transporting. That oxygen is like a magnet for iron. So when the red cells come around... iron hops inside the cell and binds to oxygen. Now we have oxygen, iron and hemoglobin all nice and cozy inside papa red cell.
There's a problem with this scenario, though. If Ferroportin is out of control and releasing a ton of iron, what happens when there's too much iron and not enough red cells (vehicles)? A phone call is made. "Hello? Houston! We have a problem!" (Houston is the red bone marrow that produces red cells). So this phone call is causing red bone marrow to produce a whole bunch of red cells so we can have enough vehicles to carry all this iron around. Non stop production. Millions by the second I tell ya, millions!
Sweet! now we have a ton of red cells. But hold on a minute... I know that my body didn't generate more veins to make room for all these cells. So what's going on? There must be a RIDICULOUS traffic jam in my blood. That's exactly what happened. Tons of red cells are swimming in the blood, only a lot slower than they should because of traffic. Man! My blood is jammed up and moving very slowly. Not cool!
Hmm. I remember that red cells also carry oxygen, does that mean my body is not getting oxygen fast enough? Yup! And I'm also going to have trouble breathing, causing even more problems.
Oxygen Deprivation:What happens when your body is deprived of O[SUB]2[/SUB]? Well, your liver recognizes that you have low levels and releases Erythropoietin (EPO). This is a hormone that is sent over to your bone marrow, and stimulates red cell production. Basically your system starts pumping out even more red cells to capture as much oxygen as possible when it's deprived. Millions I tell ya! The more EPO is released, the more red cells are produced. This entire process from the release to production is called Erythropoiesis.
Your blood just got super thick and super slow.
How Do I Know If My Blood is Too Thick?
Best thing to do is to get a quick blood test called Complete Blood Count (CBC) panel. This panel has a lot of useful info that can help diagnose any issues. But we're looking for Hematocrit (HCT). Hematocrit is a measure of how thick your blood is. The more RBC's you have, the higher this number will be.
Quest Diagnostics uses a reference range for hematocrit for ages 19 and up: 38.5-50.0 % for men; and 35.0-45.0 % for females.
Your goal is to stay within that range. If your HCT level goes over a little bit, it's not the end of the world, but certainly should not be ignored. So gentlemen, if your level reaches 52%, don't panic. The danger zone is 55% or higher. At this stage you've got some serious issues to attend to. And let me be the first to tell you, it can get up there pretty darn quickly!
What else contributes to high Hematocrit levels?
- Sleep Apnea (Causes oxygen deprivation)
- High Altitude Locations (Causes oxygen deprivation)
- Smoking (Causes oxygen deprivation)
- Dehydration (Less viscous blood)
So as you see, hydration is very important and so is oxygen, obviously. So if have any of the issues listed above, coupled with steroids, your risks are much higher than normal steroid users.
What are the risks of high Hematocrit?
. High blood pressure
. Thrombosis (blood clot)
. Headaches
. Fainting or lightheadedness
. Shortness of Breath (especially listed for Bonaparte)
. Fatigue and Achiness
. Headaches
. Pressure behind eyes
Some of the above obviously can be used to diagnose high blood counts, which should immediately trigger something in your head to get a CBC panel.
Questions and Answers
What can I do to fix or prevent the problem?
To minimize risk (not resolve), first thing is to make sure that you're always hydrated very well. Stop smoking and use mouthpieces for sleep apnea.
To resolve the problem, you have to get rid of some blood. Removing blood from your body is actually healthy and will rid your body from some of the excess. You do this by donating blood.
Can I just take an aspirin?
I recommend that everyone take a baby aspirin daily. It has great benefit, however, it will not resolve the issue.
How do I donate blood?
Locate a blood donation center. Click here. Call them and make an appointment.
How do I prepare for a blood donation?
Be sure to be very hydrated. Take an aspirin. Eat a decent meal and take a snack for after the donation.
Is it ethical to donate blood as a steroid user?
That's really a call that only you can make. Rest assured, however, all blood is tested. Any blood that could cause harm to a patient is destroyed. They're not just going to take your word for it.
How much blood to they take, and is it enough?
They will draw about 1 pint of blood. They will not take anymore. Generally, 1 pint will take you down about 2 to 4 percent. So if you're at 52%, you'll go home at around ~ 48%.
How will I feel after the donation?
I personally don't feel anything. But many people feel pretty light headed, especially if HCT was in the lower range to begin with. Most places will have some snacks for you to help a little. You can also sit in the waiting room until you feel better. Do not attempt to drive or do anything tasking immediately after if you're light headed or feel any ill effects.
Since you may have suffered some of the symptoms mentioned earlier, you should feel almost immediate relief.
What should I do after the donation?
You should avoid any strenuous activities, including cardio, lifting, etc. You should rest for at least 4 hours. Personally, I don't even go to the gym that day. I just wait till the next day. But generally, 4 to 6 hours is plenty of rest time.
How often should I donate?
I recommend that you donate as often as a donation center will allow you. Depending on the center, the time between donation is 2 to 3 months.
I need more than 1 pint gone, can I wait a few days and go to another donation center?
No. Donations are all registered and logged into a national database. They will know that you donated and will reject you.
Can I be rejected for a donation?
You will be rejected if you answer 'yes' to any of the million questions.
You will be rejected if your HCT is too high or too low. They prick your finger and measure on the spot.
What can I do if I am rejected?
You'll need to contact a doctor that will write you a prescription for a therapeutic phlebotomy. The doctor will likely order a CBC panel to verify the necessity. Once you have your prescription, you'll need to locate a blood center that performs therapeutic phlebotomies. Not all of them do. Click here to locate a center. Note that therapeutic phlebotomies are not donated, so they're not free. You need to contact them and be prepared to pay. The center will ask that your doctor fills out paperwork. They will communicate with your doctor directly for this.
What if I can't get a prescription for a phlebotomy?
Well, at this stage you're going to have to drain yourself. This isn't as complicated as it sounds. Google videos on self bloodletting. For your first time, I recommend that you have someone in the same room with you just in case you faint. Don't worry, fainting sucks but you're alive. Be sure you're seated so that you don't fall and slam split your head open. Let your buddy know that if you faint, you might make some odd noises and snoring but you should soon wake up. They do not need to shake you or perform CPR. You should be notably breathing. The needle may have fallen out, if not, it needs to be removed and pressure applied to clot the spot. You should soon wake up. You can dump the blood down the toilet.
And that's how the cookie crumbled.
Have a powerful day,
~ Austinite
Unfortunately, something that is often dismissed is also one of the most important things to observe during and after cycles: blood counts. Frankly, this is far more important than your precious testosterone levels. I'll even go as far as saying that it's more important than estrogen levels. Gynecomastia won't kill you. Ignoring blood counts forever can certainly be fatal. I'm not discounting the importance of other blood tests, but I want to emphasize the vitalness here. This article should serve as your information base for your most important blood count. This article should serve Testosterone-Replacement-Therapy patients just as well.
In order to understand the effects of steroids, it's entirely important to understand the process in which blood is affected. I'm going to do my best not to bore you so I'll try and be brief with the descriptions.
What are Red Blood Cells?
Red Blood Cells (RBC): Oxygen (O[SUB]2[/SUB]) is a nutrient that is vital for our survival. You knew that, right? This nutrient gets around your body via RBC's. When you breath, your lungs fill with O[SUB]2[/SUB]. So RBC's make a quick stop in the lungs and grab a whole bunch of O[SUB]2[/SUB] that sits inside Hemoglobin; a protein that's inside the red cell. They swim through your veins and start dumping O[SUB]2 [/SUB]all over your body. When they're done with that round, they swim over to the lungs for another pickup. The oxygen carries iron with it as well. So red cells transport oxygen and iron. This is a never ending cycle and that's the main purpose of RBC's.
The amount of RBC's that you have matters. If you have too little, you're in trouble. This is called Anemia. If you have too many RBC's, you're also in trouble, and that's called Polycythemia. So obviously we want to have a balanced number of red cells in our system.
How Steroids Affect Red Blood Cell Counts
There's a 2 major parts where steroids affect your blood counts and cause a chain reaction. Put your seatbelts on and come along for this awesome ride...
Hepcidin Suppression:Hepcidin is a peptide that your liver produces. It exists to regulate iron metabolism. We're gonna come right back to hepcidin in a second...
You see, there's this protein called Ferroportin. It's job is to find cells that are holding/storing iron, and it dives inside and pulls the iron out of that cell. Now that iron is free and ready to be metabolized.
Hepcidin is released whenever your Ferroportin pulls too much iron from the cells. Hepcidin is the boss here. It's the 'master iron regulator' and wants to manage the iron so that you have a balance. So Hepcidin swims over to Ferroportin and puts handcuffs on it. Now Ferroportin is in jail and can't free anymore iron.
So what would happen if Hepcidin wasn't around to police Ferroportin? Well, Ferroportin would go nuts and start yanking all the iron out of every cell it can find. And you would end up with a whole bunch of iron in your body that's ready to be metabolized, even though it's supposed to be stored for emergencies. But wait... How is all this iron supposed to get around? It can't swim on it's own. They needs a vehicles. Are you thinking what I'm thinking? You wish you had a life? Oh... sorry. I mean... Oxygen!
Check this out, Hemoglobin is the protein that lives inside of the red blood cells. It holds the oxygen that RBC's are transporting. That oxygen is like a magnet for iron. So when the red cells come around... iron hops inside the cell and binds to oxygen. Now we have oxygen, iron and hemoglobin all nice and cozy inside papa red cell.
There's a problem with this scenario, though. If Ferroportin is out of control and releasing a ton of iron, what happens when there's too much iron and not enough red cells (vehicles)? A phone call is made. "Hello? Houston! We have a problem!" (Houston is the red bone marrow that produces red cells). So this phone call is causing red bone marrow to produce a whole bunch of red cells so we can have enough vehicles to carry all this iron around. Non stop production. Millions by the second I tell ya, millions!
Sweet! now we have a ton of red cells. But hold on a minute... I know that my body didn't generate more veins to make room for all these cells. So what's going on? There must be a RIDICULOUS traffic jam in my blood. That's exactly what happened. Tons of red cells are swimming in the blood, only a lot slower than they should because of traffic. Man! My blood is jammed up and moving very slowly. Not cool!
Hmm. I remember that red cells also carry oxygen, does that mean my body is not getting oxygen fast enough? Yup! And I'm also going to have trouble breathing, causing even more problems.
Oxygen Deprivation:What happens when your body is deprived of O[SUB]2[/SUB]? Well, your liver recognizes that you have low levels and releases Erythropoietin (EPO). This is a hormone that is sent over to your bone marrow, and stimulates red cell production. Basically your system starts pumping out even more red cells to capture as much oxygen as possible when it's deprived. Millions I tell ya! The more EPO is released, the more red cells are produced. This entire process from the release to production is called Erythropoiesis.
Your blood just got super thick and super slow.
How Do I Know If My Blood is Too Thick?
Best thing to do is to get a quick blood test called Complete Blood Count (CBC) panel. This panel has a lot of useful info that can help diagnose any issues. But we're looking for Hematocrit (HCT). Hematocrit is a measure of how thick your blood is. The more RBC's you have, the higher this number will be.
Quest Diagnostics uses a reference range for hematocrit for ages 19 and up: 38.5-50.0 % for men; and 35.0-45.0 % for females.
Your goal is to stay within that range. If your HCT level goes over a little bit, it's not the end of the world, but certainly should not be ignored. So gentlemen, if your level reaches 52%, don't panic. The danger zone is 55% or higher. At this stage you've got some serious issues to attend to. And let me be the first to tell you, it can get up there pretty darn quickly!
What else contributes to high Hematocrit levels?
- Sleep Apnea (Causes oxygen deprivation)
- High Altitude Locations (Causes oxygen deprivation)
- Smoking (Causes oxygen deprivation)
- Dehydration (Less viscous blood)
So as you see, hydration is very important and so is oxygen, obviously. So if have any of the issues listed above, coupled with steroids, your risks are much higher than normal steroid users.
What are the risks of high Hematocrit?
. High blood pressure
. Thrombosis (blood clot)
. Headaches
. Fainting or lightheadedness
. Shortness of Breath (especially listed for Bonaparte)
. Fatigue and Achiness
. Headaches
. Pressure behind eyes
Some of the above obviously can be used to diagnose high blood counts, which should immediately trigger something in your head to get a CBC panel.
Questions and Answers
What can I do to fix or prevent the problem?
To minimize risk (not resolve), first thing is to make sure that you're always hydrated very well. Stop smoking and use mouthpieces for sleep apnea.
To resolve the problem, you have to get rid of some blood. Removing blood from your body is actually healthy and will rid your body from some of the excess. You do this by donating blood.
Can I just take an aspirin?
I recommend that everyone take a baby aspirin daily. It has great benefit, however, it will not resolve the issue.
How do I donate blood?
Locate a blood donation center. Click here. Call them and make an appointment.
How do I prepare for a blood donation?
Be sure to be very hydrated. Take an aspirin. Eat a decent meal and take a snack for after the donation.
Is it ethical to donate blood as a steroid user?
That's really a call that only you can make. Rest assured, however, all blood is tested. Any blood that could cause harm to a patient is destroyed. They're not just going to take your word for it.
How much blood to they take, and is it enough?
They will draw about 1 pint of blood. They will not take anymore. Generally, 1 pint will take you down about 2 to 4 percent. So if you're at 52%, you'll go home at around ~ 48%.
How will I feel after the donation?
I personally don't feel anything. But many people feel pretty light headed, especially if HCT was in the lower range to begin with. Most places will have some snacks for you to help a little. You can also sit in the waiting room until you feel better. Do not attempt to drive or do anything tasking immediately after if you're light headed or feel any ill effects.
Since you may have suffered some of the symptoms mentioned earlier, you should feel almost immediate relief.
What should I do after the donation?
You should avoid any strenuous activities, including cardio, lifting, etc. You should rest for at least 4 hours. Personally, I don't even go to the gym that day. I just wait till the next day. But generally, 4 to 6 hours is plenty of rest time.
How often should I donate?
I recommend that you donate as often as a donation center will allow you. Depending on the center, the time between donation is 2 to 3 months.
I need more than 1 pint gone, can I wait a few days and go to another donation center?
No. Donations are all registered and logged into a national database. They will know that you donated and will reject you.
Can I be rejected for a donation?
You will be rejected if you answer 'yes' to any of the million questions.
You will be rejected if your HCT is too high or too low. They prick your finger and measure on the spot.
What can I do if I am rejected?
You'll need to contact a doctor that will write you a prescription for a therapeutic phlebotomy. The doctor will likely order a CBC panel to verify the necessity. Once you have your prescription, you'll need to locate a blood center that performs therapeutic phlebotomies. Not all of them do. Click here to locate a center. Note that therapeutic phlebotomies are not donated, so they're not free. You need to contact them and be prepared to pay. The center will ask that your doctor fills out paperwork. They will communicate with your doctor directly for this.
What if I can't get a prescription for a phlebotomy?
Well, at this stage you're going to have to drain yourself. This isn't as complicated as it sounds. Google videos on self bloodletting. For your first time, I recommend that you have someone in the same room with you just in case you faint. Don't worry, fainting sucks but you're alive. Be sure you're seated so that you don't fall and slam split your head open. Let your buddy know that if you faint, you might make some odd noises and snoring but you should soon wake up. They do not need to shake you or perform CPR. You should be notably breathing. The needle may have fallen out, if not, it needs to be removed and pressure applied to clot the spot. You should soon wake up. You can dump the blood down the toilet.
And that's how the cookie crumbled.
Have a powerful day,
~ Austinite
Last edited:
