Now I am going to be up all night worrying

[FTMKyle]

I got a call at 8:30 pm from the place that prescribes my T, and now I am freaking out. I got blood work done last weak, so I am guessing that is why they called. I didn't answer because it seemed late for anyone I don't know to call. Now I wish I had answered. My blood work is always normal, and the last time I had it done was three months ago. No increases or decreases in T. The only thing I can think of is I might have a high platelet count from my surgery. I also stupidly drank a soda before going to my appointment. I don't know if that can efect anything, but I never drink or eat anything before getting blood work.

[mrs izzy]

If you was supposed to fast for any of the test the soda could be the trouble.

Have high readings.

Anyway at this point nothing can be done to change what results so get some sleep and call in the morning.

[FTMKyle]

No. They never tell me to fast. I just do it as precaution, but the last time I nearly forgot I had an appointment.

[Kreuzfidel]

What is the blood test measuring?

[Arch]

You say that you don't eat or drink before blood work. If you don't drink enough, you can run into problems; I did. And some trans clinics have much stricter ranges than regular doctors do, probably for liability reasons. So you could be fine, even if you are a bit high or low on some value or other.

I once received an urgent call from my regular physician about my T levels--I think the nurse called on a Friday and I had to wait until Monday. Anyway, since I was still coded as female, it turns out that they were freaking out about my outlandishly high T levels. Sure gave me a fright. Now that I am coded as male, I trust that this won't happen again!

It looks like you are going to have to sit tight and wait to find out what they wanted. Vibes. I know how difficult that is. But as long as they didn't say it was urgent, I wouldn't worry too much.

[Kreuzfidel]

I once received an urgent call from my regular physician about my T levels--I think the nurse called on a Friday and I had to wait until Monday. Anyway, since I was still coded as female, it turns out that they were freaking out about my outlandishly high T levels. Sure gave me a fright. Now that I am coded as male, I trust that this won't happen again!

Yeah that happened to me, too - only it wasn't my T levels, but my creatinine. 

[FTMKyle]

I do drink water usually. And I do eat earlier in the day since my appointments are in the evening. I called the number the woman who called gave me, and I got the nursing department. I left a message. That was at 9:22am. About an hour later I called the number I have when I want to make an appointment because that was the number that showed on my phone. I got transferred a couple of times until I reached a voice mail. It's just weird that they would call because they never do.

It is possible that someone somewhere messed up, and they need to redo the blood work. The doctor I got was someone I've never met before, and I am not entirely sure she knew what she was doing. Usually they give me a paper with the tests I need to bring to the lab. This time there was no paper. When I asked they said that they sent it electronically. Also they are supposed to ask for my name and birth date, but the guy who took my blood never asked for my birth date. I could have called him out on it, but I didn't think it was a big deal at the time.

I know they do a lipid panel and maybe a cbc. Sometimes some other tests. But because I didn't get that paper, I really have no clue what the tests were for.

You could say I am "just a little" worried. I stayed up until 3:30 last night watching cartoons on netflix. But I would rather be worried over nothing than to not worry at all and have it be serious.

[Kreuzfidel]

I know they do a lipid panel and maybe a cbc. Sometimes some other tests. But because I didn't get that paper, I really have no clue what the tests were for.

If you have recently had a sniffle or sinus infection, your WBC could be up and they will often ring you about it.  You could also be slightly anaemic.  That is, if you had a CBC. If you had a lipid panel, you could have slightly elevated "bad cholesterol" levels which is hella common - my doctor rang me freaking out about my cholesterol on several occasions.

You could say I am "just a little" worried. I stayed up until 3:30 last night watching cartoons on netflix. But I would rather be worried over nothing than to not worry at all and have it be serious.

Well, as much as I don't want you to worry - you're the captain of that ship, mate.  Your choice.

[FTMKyle]

I finally got a hold of the nurse who called me. Apparently my RBC count is high (red blood cell count). I didn't think to ask how high. They want me to go off T for a month and come back and redo the blood work. I asked if it is possible that my top surgery could have something to do with it, and she really didn't answer the question. She just asked if I had told the doctor that I had surgery (which I did) and repeated herself to go off the T and come back in a month.

Has anyone had a high RBC before while on T? What ended up being the cause and did it get better? 

[FTMKyle]

I also wonder if after my next blood test if everything turns out okay if I should ask my doctor if I should start injecting every other week. When I first started T my doctor had me injecting half the amount every week to try to stabilize my mood. Now I don't really get mood swings, and maybe that's just too much T in my system.

[Kreuzfidel]

Polycythemia is one of the potential side effects of T therapy, even for cismales.  Sometimes therapeutic phlebotomy is used to treat it - that is, basically being bled.  Why is the nurse telling you what to do?  Shouldn't these orders be coming from your doctor?  I would request a sit-down with him and go over your options.

[FTMKyle]

That is what the doctor told the nurse to tell me. This was all over the phone, and I have never had a doctor personally call me. I remember once my doctor mentioning a high RBC count when I first started T, but he said it was nothing to worry about. It must have not been that bad, and he was a different doctor. I haven't seen him in forever. But I might get to see him next time since my appointment is on a Thursday rather than a Tuesday, and I hear he is only there on Thursdays now.

[Kreuzfidel]

That is what the doctor told the nurse to tell me. This was all over the phone, and I have never had a doctor personally call me. I remember once my doctor mentioning a high RBC count when I first started T, but he said it was nothing to worry about. It must have not been that bad, and he was a different doctor. I haven't seen him in forever. But I might get to see him next time since my appointment is on a Thursday rather than a Tuesday, and I hear he is only there on Thursdays now.

I wouldn't do anything without speaking to him myself.  That or get yourself a second opinion/new doctor.

[Arch]

Sounds like the clinic I used to go to. Scare tactics and threats, a different doctor every time, blood test values that were too restrictive, instructions that didn't make sense (a mammogram after top surgery, really?), and some that were downright dangerous (like, I was told to cut my dose by 50% immediately, even though I have a documented mood disorder and was having mood problems when I injected biweekly. Uh, what do you think suddenly cutting the dose in half will do to me, morons?).

Plus one doctor who basically shouts. I always cringed when I had to see her. In a rare case of doctor consistency, I actually saw her a couple of times in a row. Glee. I take it back; I don't want to see the same doctor twice.

As someone noted, you might donate blood if you qualify.

[devention]

Wow, I feel lucky to have a consistent endo right now. Small town living ftw.
Seconding what the others are saying: do not stop without a direct doctor's order face to face. There are options besides stopping T to resolve high RBC. They wouldn't tell a cis guy to start taking T blockers as a first resort, and they shouldn't tell you to stop hormones add a first resort, either.

[Arch]

When my clinic told me to cut my dose in half, I heard it over the phone from a nurse who didn't know about my mood disorder; as it turns out, the doctor wasn't paying attention to it, either. That's just irresponsible and dangerous. I refused, of course; I started lowering my dose incrementally until I found my bottom threshold and stopped reducing. This clinic also told me that my fluid intake had no bearing on my test results. RUFKM?

Sorry about all of the anger, but this place messed with me and my buddy. AFAIK, he still goes there. I'm glad I have other options now.

We are not doctors here, but it seems safer to make plans to donate blood, book a clinic appointment ASAP, and take action only when directed to do so by a doctor face to face. A different doctor. But if this place is anything like my clinic, all of the doctors will be working under the same model and will prefer the dangers of stopping hormones cold turkey to the perceived dangers of having even one lab value even one increment high.

[SWNID]

High RBC and high hemoglobin are common when trans guys start T, I had the same problem but they went down to normal range after a few months. And I think it is irresponsible for your doctor to make such decision without discussing with you; apparently their are other treatment options other than telling a trans man to stop taking testosterone.

[Ayden]

I had a crazy high RBC and I just lowered my dose by half, but this was at the behest of my regular endo and she told me directly. It's your health so don't be afraid to ask questions if you don't feel that immediately stopping is safe for you to do.

[FTMKyle]

Donating blood huh? Well, I just had surgery, so I am not entirely sure I can donate. But I will look into it, and it will definitely be something to consider for the future. There just happens to be a place not too far away from me where I can donate.

I wasn't too thrilled when the nurse told me to quit taking T for a month. When I first started going to this place, the doctor I had was very against quitting T cold turkey. He told me that if I ever wanted or needed to stop to come in and he would start gradually lowering my dose. I think that is a much better and safer method. I think they want to try to rule out any other issue by having me quit. I'm assuming that if it is the T that quitting would cause my red blood cell count to go back to normal.

But like I said, I am not thrilled on just quitting. I think I will just take it upon myself to start lowering my dose. What do you guys think?

[Arch]

Oh, that's right. I forgot about your surgery. I don't know whether some blood banks/blood collection agencies have a waiting period after surgery, but my local blood bank says it's okay as long as you are healed and haven't had a blood transfusion in the last twelve months. There's a whole host of other exclusions, of course. This facility is abiding by general Red Cross guidelines (which is why the people there refused to code me as male), but I don't know how the for-profit blood collection centers are run. Check your local facility.

If you go to a blood collection agency, some are apparently prejudiced against trans people, so be expecting that.

Honestly, I think you should try to get hold of the doctor you saw originally. See if you can at least talk to him on the phone--or, better yet, see him in person ASAP. It's really not good for you to decide for yourself what to do. When I was told to cut my dose in half, I felt trapped. I knew I still had significant depression issues that the clinic was ignoring. I couldn't afford to see my regular GP or my old endo, so the clinic was all I had; but because of scheduling issues, I couldn't even make a follow-up visit with another clinic doctor! But it sounds like you might have better options. If you don't have scheduling issues, then make another appointment as soon as you can get in. If they allow drop-ins, you might even try that.

In the meantime, you might call back and find out precisely WHY they are recommending cold turkey when (1) your first clinic doctor EXPLICITLY instructed you not to stop suddenly, (2) you are worried about the dangers of doing so, and (3) you are perfectly willing to taper/reduce your dose (if, indeed, you are). Having conflicting instructions between two doctors is a real problem that needs addressing.

See that other doctor. In the meantime, get some more specific answers.