Dr. Abraham Morgentaler

If somebody says you're anemic, it means your red blood cell count is too low, below 38 or whatever the number is for the lab. So there now have been two large randomized controlled trials where often when people are anemic, nobody knows the answer. It's called unexplained anemia, right? You're not bleeding from anywhere. You don't have a genetic abnormality.

If somebody says you're anemic, it means your red blood cell count is too low, below 38 or whatever the number is for the lab. So there now have been two large randomized controlled trials where often when people are anemic, nobody knows the answer. It's called unexplained anemia, right? You're not bleeding from anywhere. You don't have a genetic abnormality.

The doctors say, we don't know, but it's not dangerous. So you're okay. And it turns out that testosterone is better than placebo in these trials at making people not anemic anymore. Amazing. Because testosterone increases the rate blood cell count.

The doctors say, we don't know, but it's not dangerous. So you're okay. And it turns out that testosterone is better than placebo in these trials at making people not anemic anymore. Amazing. Because testosterone increases the rate blood cell count.

I had a guy years ago, a young guy, who just before he'd seen me for sexual symptoms that turned out to be related to low testosterone, he'd had a whole big GI workup because he was anemic. They did this whole workup. They looked with a telescope from above. They looked with a telescope from below. They did these other tests. Final diagnosis, we don't know. But you're okay. We don't know.

I had a guy years ago, a young guy, who just before he'd seen me for sexual symptoms that turned out to be related to low testosterone, he'd had a whole big GI workup because he was anemic. They did this whole workup. They looked with a telescope from above. They looked with a telescope from below. They did these other tests. Final diagnosis, we don't know. But you're okay. We don't know.

And when I treated him with testosterone, his blood count became normal. And he said to me, if I had seen you before them, would I have needed those tests? And the answer is no, you wouldn't have, right? He would have had a normal hematocrit. So because testosterone can raise the hematocrit, some people may go up beyond what we want them to do. And so we say that's one of the risks.

And when I treated him with testosterone, his blood count became normal. And he said to me, if I had seen you before them, would I have needed those tests? And the answer is no, you wouldn't have, right? He would have had a normal hematocrit. So because testosterone can raise the hematocrit, some people may go up beyond what we want them to do. And so we say that's one of the risks.

But the truth is we don't know anything hard, hard evidence that that's dangerous. The Endocrine Society has helped everybody in this way. They're normally a very conservative group. And they put a number at 54, which actually gives a lot of room for people to go above the normal range of 50. And they say it shouldn't be above 54. It's an arbitrary number.

But the truth is we don't know anything hard, hard evidence that that's dangerous. The Endocrine Society has helped everybody in this way. They're normally a very conservative group. And they put a number at 54, which actually gives a lot of room for people to go above the normal range of 50. And they say it shouldn't be above 54. It's an arbitrary number.

But if somebody is at 53 or 52, I don't think you need to do anything.

But if somebody is at 53 or 52, I don't think you need to do anything.

Yeah. Yeah. And, you know, there's a, so in medicine, as I've discovered, there is a lack, often a lack of what I would call common sense. So it turns out that people who live at altitude have high hematocrites, right? If you go and you live in the mountains of Colorado, their normal range for these things can be up to 54, right?

Yeah. Yeah. And, you know, there's a, so in medicine, as I've discovered, there is a lack, often a lack of what I would call common sense. So it turns out that people who live at altitude have high hematocrites, right? If you go and you live in the mountains of Colorado, their normal range for these things can be up to 54, right?

So guidelines say, well, don't treat anybody whose hematocrit is too high. But these people live with a hematocrit that's too high, and no one has ever shown that they're at any increased risk of anything because of them.

So guidelines say, well, don't treat anybody whose hematocrit is too high. But these people live with a hematocrit that's too high, and no one has ever shown that they're at any increased risk of anything because of them.

So the Colorado docs are cool about this. Amazing. I know a couple. They come to the meetings. One in particular says, it's an everyday occurrence for me to see somebody not on testosterone with hematocrit of 54. So why can't I treat them with testosterone? They're already used to that hematocrit.

So the Colorado docs are cool about this. Amazing. I know a couple. They come to the meetings. One in particular says, it's an everyday occurrence for me to see somebody not on testosterone with hematocrit of 54. So why can't I treat them with testosterone? They're already used to that hematocrit.

So the labs don't really make that distinction. That's why I say the normal range is usually between 38 and 50, and it applies to both men and women. But listen, I don't think that having a somewhat higher hematocrit does anything. The concept is theoretical. It's not based on anything. The theory is if you have more red blood cells, your blood may be more viscous, more thick.

So the labs don't really make that distinction. That's why I say the normal range is usually between 38 and 50, and it applies to both men and women. But listen, I don't think that having a somewhat higher hematocrit does anything. The concept is theoretical. It's not based on anything. The theory is if you have more red blood cells, your blood may be more viscous, more thick.