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Therapeutic Phlebotomy calculations, my method.

Thrasymachus

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I thought since I removed blood a 3 days ago I would go through what I use for calculating what I need to remove.

First off I hyper respond to anabolics. My hct is currently 63.5% before blood removal, which is obviously extremely high. My father also has this problem so it's genetic when he is on exogenous testosterone.

This method is completely done without the help of any labs. I simply remove the blood myself and fill a 10ml EDTA tube that is well mixed with whole blood and let it settle in a vertical position for 72hrs to establish my hct. Using this method I subtract 1.5% of my hct because I don't have a centrifuge that would allow me to completely express the plasma that is trapped between rbcs.

I remove volumes of blood that are clearly too much for most people, this will cause tachycardia(heart speeding up for 2 days to compensate for blood loss). This does require rest for 24hrs with no physical work. Hydration has to be well done before and after blood removal to keep from getting sick to the stomach due to rapid volume loss of blood/plasma.

Calculations for blood removal are based on weight of blood which is 1.10 grams/ml due to higher volume of rbcs for anabolic users.

I removed 3 pounds of whole blood. We know that 1 pound is 454 grams x 3 (pounds) which will give you 1361 grams total removal. 1361 grams whole blood/1.10 = 1237 ml of whole blood that were removed.

For the hct calculation it is simple. The 10ml edta tube was in a vertical position for 72hrs, the plasma is complete clear with a buffy coat of white blood cells sitting on the top of the packed red cells. Use a mm ruler to measure the total volume of the tube(don't include the rounded bottom of the tube, this will allow you to subtract your 1.5% hct to compensate for not having a centrifuge).

My numbers are 74mm of total volume in the tube. 47mm of packed rbcs. 27mm of plasma volume. Add the 47 + 27 to make sure it equals 74mm.
To calculate hct we simply divide 47mm rcbs / 74mm total volume = 63.5% hematocrit in my case.

Each unit of donated blood is typically 450ml. And each unit donated will lower you hematocrit by 3% (0.03).

I removed approximately 1250ml of whole blood. We divide 1250ml / 450ml to get the total units removed which is 2.78 units and this is multiplied by 0.03 to get the total hematocrit drop.
2.78 x 0.03 = 8.3% hematocrit that will be lowered from my 63.5%. So after this blood removal I now sit at 63.5% - 8.3% = 55.2%.

In order to get my current hematocrit down to say 48.6% I would need to move 1000ml or 1 liter of whole blood in addition to what I have already removed.

1000 ml removed whole blood / 450 ml per unit = 2.22 units removed x 0.03 =6.6%. 55.2% my current hct - 6.6% would give me 48.6% hct.

That is if all anabolics were out of my system and I remove blood again in perhaps 4-6 weeks.

This issue is fairly complex and there's lots of variables when removing blood.

Average man will have between 6 to 8 liters of blood. I consider myself to be larger than most men at 6'2" 230lbs. So I put my blood volume because of increased muscle mass at 7.5 liters.

Safe donations are limited at 10% of blood volume to prevent excess fluid loss, forcing the heart to speed up to compensate. This would put a person at my size at no more than 750ml (7500 ml total blood volume x 10%) with maximum allowed per donation. I obviously exceed this volume by a fairly large amount and I am taking health risks when I do this as it does take me about 72hrs to feel good again. So know that there is a risk doing this.

There is no substitute for blood removal, if there is excess the only method to resolve the problem is to remove blood. This can cause other issues like decreased iron stores, but the risk of having a really high hct is far greater than a lowered iron level that can quickly be fixed with supplementing iron at 18.5mg/day which is the maximum absorption.

For me the signs of too high a hct is inability to sustain a high heart rate when doing cardio, I will feel a tightness in my chest with really labored breathing where I feel like I can't get enough air due to slower turnaround of oxygen/CO2 exchange from blood that is like sludge moving past the capillaries in my lungs.
 

DGainz

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You know you can buy hemocrit meters that are similar to the latest blood sugar testing devices use pretty much the same strips and are quite accurate you get your results in seconds and you could track what compounds do what to you in what stacks and what dosages. For a few hundred bucks I am seeing one as well worth it to be able to stay on top of my hemo issues also. I can get script phlebo's no issue though so that's different from your situation though. I have been at 77 in the past so I know what's up for you in your struggle that's for sure. I am also on a thinner prescribed and made some changes over the last 4-5 years to get a handle on things somewhat.
 

Thrasymachus

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You know you can buy hemocrit meters that are similar to the latest blood sugar testing devices use pretty much the same strips and are quite accurate you get your results in seconds and you could track what compounds do what to you in what stacks and what dosages. For a few hundred bucks I am seeing one as well worth it to be able to stay on top of my hemo issues also. I can get script phlebo's no issue though so that's different from your situation though. I have been at 77 in the past so I know what's up for you in your struggle that's for sure. I am also on a thinner prescribed and made some changes over the last 4-5 years to get a handle on things somewhat.
Readable range would be my only concern when it comes to the higher values that we have.

That said a hemoglobinometer would be something I'd use in addition to the method that I use with a 10ml EDTA vacutainer tube to serve as a comparison.

I tend to not like capillary samples compared to venous as they almost always read 1 gram higher, which isn't that big of deal when you have hemoglobins as high as ours.
 
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