Controlling the polycythemia effect associated with TRT

The goal of this study was to determine how to minimize the secondary polycythemia effect observed in patients on testosterone replacement therapy (TRT). Patient hemoglobin, estradiol (E2) and total testosterone (TT) levels were used in this study to determine when a patient became “stable” on treatment. Stability was defined in this study as the point at which a patient’s symptoms have resolved, secondary polycythemia has stopped, and testosterone cypionate (TC) dosage has remained consistent for at least three months. Currently, secondary polycythemia associated with TRT is commonly being controlled by frequent blood donations, or therapeutic phlebotomies. However, this study shows that it is possible to minimize fluctuations in TT and E2 levels, which then minimizes side effects including secondary polycythemia. In this study, we found that the patients stabilized at TT levels between 605–1051 ng/dL. The effects of stable TC dosing were tracked and discussed in terms of total cholesterol, Prostate Specific Antigen (PSA) and A1c levels as well. These were not necessarily the focus of the study, but significant trends were noted once data was collected to warrant their inclusion in the study.