Testosterone has an erythropoietic stimulating effect that can cause polycythaemia, which manifests as an increase in hemoglobin, hematocrit, or red blood cell count. The incidence of polycythemia secondary to testosterone use ranges from 2.5% to 40% depending on the testosterone dose and administration method. When red blood cells are produced in great excess, it thickens the blood and therefore potentially makes the blood more viscous. Plethoric (red) face, breathlessness, fatigue, headache, nose bleed, high blood pressure, stroke and deep vein thrombosis (DVT) are all potential complications of polycythaemia.
These risks that can be minimised and therefore it is very important to monitor haemoglobin (Hb) and haematocrit (HCT) levels while on testosterone therapy. Testosterone can increase the body’s production of red blood cells. To a certain extent they are very beneficial in increasing oxygenation to the rest of your body to enhance endurance and strength. Nonetheless, when the red blood cells are produced in excess in large quantity due to prolonged stimulation of exogenous testosterone, it can cause health concerns.
It is even more important for those who blast and cruise (B&C) to achieve supra-physiological testosterone level for a long period of time. Therapeutic venesection is very effective in restoring the balance of haemoglobin and haematocrit level in this context. It is very similar to what happens when donating blood, but this procedure is prescribed by physician as a method to bring down blood viscosity, it takes about 1 hour to complete. In the United Kingdom, those who are on exogenous testosterone are not allowed to donate blood, and one may not want to involve his NHS GP to be referred to haematologist.
At Harley Street MD, we provide therapeutic venesection caused by exogenous testosterone replacement. Blood count will be checked before the procedure. Self-referral is accepted and your visit will be kept completely discreet. Repeat of blood test 7-14 days after procedure is also included in the package. A therapeutic venesection of ~1 pint of blood will generally lower haematocrit by about 3%. In certain cases, repeat therapeutic venesection is required to restore normal Hb and HCT levels.
Confirmation of polycythaemia by blood test will be conducted before the therapeutic phlebotomy, you might be giving medication to further minimise your risk before your follow up, which is usually between 7-14 days later, where a full blood count will be tested. Full blood count after the venesection is included in the price.
Call us today to book an appointment if you suspect you might have polycythaemia from testosterone replacement. Ensure you are fully hydrated before arrival and allocate 1 hour for the procedure.
Therapeutic venesection package includes:
– consultation up to 30 min
– blood test before treatment (bedside haemoglobin test)
– therapeutic venesection (up to 450 ml)
– follow up in 10-14 days with complementary blood test (full blood count)
We also offer wide range of other blood profiles:
Full blood count (£55): Full haematology profile including haemoglobin concentration (Hb) and haematocrit (Hct)
Standard Health Profile (£95): full blood count, kidney function test, liver function test, iron profile, bone profile, fasting blood sugar, full cholesterol breakdown and inflammatory marker
Advanced Health Profile (£165): full blood count, kidney function test, liver function test, iron profile, bone profile, fasting blood sugar, full cholesterol breakdown, inflammatory marker vitamin D level, complete thyroid profile (T3, T4, TSH)
Complete Health Profile (£195): full blood count, kidney function test, liver function test, iron profile, bone profile, fasting blood sugar, full cholesterol breakdown, inflammatory marker vitamin D level, complete thyroid profile (T3, T4, TSH) and Prostate Specific Antigen (PSA)
Complete Hormone Profile (£165): LH, FSH, testosterone, oestradiol (E2), prolactin, SHBG, free androgen index (FAI)
Complete Growth Hormone Profile (£195): Tumour Markers – CEA (bowel cancer), CA19.9 (pancreatic cancer), AFP (liver cancer), HbA1c (Diabetes Screening), IGF-1 (insulin-like growth factor-1)
Advanced Prostate Profile (£95): free PSA, total PSA, free:total PSA ratio
PROCEDURE TIME 45-60 minutes
BACK TO WORK Next day
ANAESTHETIC Topical / Local
FULL RECOVERY 1-2 days
DURATION OF RESULT 3-4 months
RESULTS 1-2 weeks