Blood Donation and Hematocrit Levels on Testosterone Replacement Therapy

December 4, 2023

Hemoglobin (Hgb or Hb) and hematocrit (Hct) levels are something that, if you’re on testosterone replacement therapy (TRT), you need to watch carefully because TRT can cause your red blood cell count to increase.

Hemoglobin is a protein inside your red blood cells that carries oxygen and carbon dioxide around your body. Hematocrit is just a measure of how much of your blood is made up of red blood cells.

When Hgb/Hct levels are higher than normal, it's called polycythemia, which can lead to health complications if not treated.

One way to manage polycythemia and maintain healthy Hgb/Hct levels is by donating blood. Donating blood not only helps people in need but also reduces the number of red blood cells in your body to safe levels.

TRT and Erythropoietin

Once you get on TRT and your testosterone levels increase, your production of the hormone erythropoietin also increases, which in turn stimulates the production of red blood cells.

While this can be beneficial for people with anemia or other conditions marked by low red blood cell count, it might not be healthy for people without these diseases.

However, not everyone on TRT will develop polycythemia, and not everyone with polycythemia will need to donate blood.

The Dangers of High Hgb and Hct

Having too many red blood cells might seem like a good thing, but it’s actually a potentially deadly condition.

All those extra red blood cells thicken your blood. When your blood is thicker than normal, it puts a strain on your heart and blood vessels, increasing your risk of heart attack, blood clots, and stroke.

By reducing the number of red blood cells in your body through blood donation, you lower your risk of these cardiovascular events and improve your blood flow.

Moreover, donating blood can also help in managing iron levels in your body. Excessive iron can lead to liver damage, diabetes, and other health issues. By donating blood regularly, you can reduce the amount of iron in your body and promote healthy iron levels.

Can You Donate Blood While on Testosterone?

Yes, however, your healthcare provider should be aware that you're on TRT before you donate blood. This is because TRT can affect certain blood parameters, so it's important for the blood donation center to have this information.

Most blood donation centers are familiar with patients who are on testosterone replacement therapy, so just make sure you tell them — many will even be happy to set up regular appointments for you.

Donating blood does not appear to have any significant impact on testosterone levels, so don’t worry about your levels dropping after donation.

The Basics of Blood Donation

Before making any decisions about blood donation, talk to your healthcare provider about the benefits and risks of donating blood.

While blood donation is generally safe, not everyone can donate blood for a variety of reasons, so you’ll want to make sure you can donate before going to a blood donation center. Certain medical conditions, medications, and lifestyle factors can make you ineligible to donate.

Donating blood is a simple process, but it’s not always quick. Many blood donation centers will allow you to donate by just walking in, but it’s usually better to make an appointment.

They may also be able to send you your screening questions in advance this way, which will save time once you get to the donation center.

You’ll likely have to wait a little bit before someone can help you — even if you have an appointment — so bring something to do. After a brief screening to ensure you're a suitable donor, a nurse will take you to a blood donation chair.

They’ll ask you which arm you prefer (unless you’re doing a double donation), and then they’ll clean the area where they’ll be inserting the needle. They’ll likely give you something to squeeze to make your vein easier to see and feel, then they’ll insert a needle into your arm when you’re ready.

Your blood will be collected into a bag, which will take some time — you’ll be glad you brought something to do at this point because you’ll be sitting in the chair for a while, though most centers have a TV or radio playing.

The whole process typically takes less than an hour, and most people can resume their normal activities immediately afterward, though you’ll want to stay away from lifting anything heavy for about 24 hours so that the wound doesn’t reopen.

In general, donating blood every 8 to 16 weeks can help maintain healthy Hgb/Hct levels and reduce the risk of complications, but you’ll always want to work with your healthcare provider to see what they think is best.

You may need additional time for your body to be able to replenish its supply, but as a general rule, donating one unit of blood can lower your hematocrit by about 3%, though this can vary for a variety of reasons.

The Benefits of Donating Blood

While donating blood can definitely help lower your red blood cell count, reducing your risk of complications like blood clots and stroke, it can also help keep your blood pressure in check, reduce your risk of heart disease, and even improve your mental well-being as a result of doing something nice for someone else.

It’s also a simple way to give back to your community — it’s very rare that hospitals have enough blood, and each donation can help save lives, so they’re always glad to have someone who can donate regularly.

If You’re on Testosterone Replacement Therapy, Talk to Your Healthcare Provider About Donating Blood

While elevated Hgb/Hct levels can be a health risk, blood donation is an effective way to manage them while also helping others. Talk to your healthcare provider to determine how often you should donate blood.

To learn more about testosterone replacement therapy and to see if it’s right for you, schedule an appointment today.