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Question
I am 100% disabled veteran and have been taking testerone injections since the 2006. I was prescribed same as my PSA was very low and my health was ailing. Taking testerone gives me quality of life and make me feel normal as well as lessens my pain level of injuries.  My PSA are normal but recently my RBC have increased and have my Primary Care concerned.  He has advised getting off testerone all together. I take .5 cc every Week and after about 5 days I feel an extreme crashing and can not wait till the 7th day so I can get another injection. I use to take 1 cc every two weeks but crashed hard after about 8 days so they moved it to .5 cc a week. Within 24 hours I feel normal. Not taking it causes depression and withdrawal from society. As well as an increase of pain and other unwanted feelings and physical aspects. I have never had much faith in the VA system and I am not big into script drugs, would rather do things naturally if possible. Any advice if I discontinue use afraid of becoming withdrawn from society again. Maybe how to reduce RBC's while taking testerone? Testerone has been a life changer for me.

Answer
Tim:

Increasing red blood cell counts is a known side effect of testosterone supplementation.  There is no easy way to stop this except to stop taking the testosterone.  Your levels may not be optimal and you might benefit from switching from injections to a gel which tends to give more stable levels.  Or you might work with your physicians to come up with a modified dosing schedule that keeps you comfortable.  There is no "natural" substitute for the testosterone which sounds like it provides you with a significant benefit.

Concern about the elevated RBCs is justified as it can increase the work your heart does to pump blood.  Giving blood is one way to temporarily lower your RBC level, but it's only temporary.  

From what you've told me here, it would seem that you should probably continue the testosterone as you have indicated a very significant benefit.  You may want to discuss the pros and cons with an endocrinologist.  

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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