Phlebotomy, or drawing blood, is frequently used by men on testosterone and steroids who have a high red blood cell count. However, excessive phlebotomy comes with its own risks. In this video I discuss those risks in the context of a case study, as well as explain why the red blood cells are elevated in the first place: androgen induced erythrocytosis leading to polycythemia. Not all men on androgens experience this, but there are several risk factors to watch out for and steps you can take to monitor yourself and manage the condition if it does occur. If you’re on androgens or are a healthcare provider treating men who may be on androgens, please watch this video! For information on my practice and consultations, visit For anabolic recovery consults, visit: To ask questions in a webinar format, visit: TABLE OF CONTENTS: 01:24 - CASE HISTORY: 39 y.o. man with history of steroid use, now on TRT 03:10 - Symptoms: “heavy” heart beat, anxiety 04:02 - Began self phlebotomy (without consulting doc) 05:51 - Notable low iron status on blood tests 07:48 - ANDROGEN INDUCED ERYTHROCYTOSIS - Can lead to polycythemia - increased red blood cells 09:35 - 4 risk factors for androgen induced erythrocytosis 12:28 - POLYCYTHEMIA SYMPTOMS 13:35 - ERYTHROCYTOSIS / POLYCYTHEMIA DANGERS - Blood clots / hypercoagulable states 13:56 - Veins: DVTs, pulmonary embolism 14:29 - Arteries: heart attack & stroke 15:17 - MANAGEMENT FOR MEN ON ANDROGENS - Full history & physical, monitor with blood tests 16:51 - Manage TRT dosage, potentially stop 17:13 - Sleep apnea & why it increases red blood cells 17:46 - Careful phlebotomy Stay Strong and Healthy, Dr. O ____________ As the Anabolic Doc, since 2003, I’ve provided men who are using or have used anabolic steroids a confidential, ethical and professional medical venue to discuss their use. 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Aired: May 12, 2025
