Therapeutic phlebotomy

Therapeutic phlebotomy is a medically supervised blood draw used to lower elevated hematocrit/hemoglobin, sometimes relevant for men on TRT who develop high red blood cell levels. This tag covers when it’s indicated, how it’s monitored, and how it can support cardiovascular safety while maintaining performance goals.

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How to lower hematocrit on trt safely and effectively

How to lower hematocrit on trt safely and effectively

Dr. Alexander Grant, MD, PhD avatar
Dr. Alexander Grant, MD, PhD: Urologist & Men's Health Advocate
Dec 11, 2025 · 10 min read

The safest way to lower hematocrit on TRT is to reduce testosterone peaks—by lowering the dose and/or switching from infrequent injections to more frequent micro-dosing or a steadier transdermal method—because testosterone increases red blood cell production through kidney-driven erythropoietin (EPO) signaling. Since elevated hematocrit affects roughly 5% to 66% of men on therapy, the goal ...

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