The idiots at my clinic tell me that my fluid intake shouldn't have anything to do with my levels...but every time I was dehydrated, I got high RBC, and whenever I drank a reasonable amount, I got noticeably lower levels within the range accepted by this clinic. My regular doctor says that the clinic has set the acceptable range too low.
I reduced my T to 80% of the original dose, and I try to drink more. Honestly, sometimes I just don't drink enough until right before I'm scheduled for a blood test. But, as I said, my doc feels that even my worst levels are well within acceptable limits.
He has also suggested that I donate blood on a regular basis or even have blood drawn as a medical procedure. If the damned blood bank would code me as male, I would donate a few times a year. As it is, I bloody well refuse (pun intended). Being listed as female caused all sorts of complications and embarrassment, and I'm just not going to put myself through that again. But if you are legally male and have never donated or never tried to donate before your transition, you should be able to present as male and get coded as male. My mistake? I tried to donate when I was in my twenties, and the blood bank still had my info on record and refuses to change my gender marker until I get bottom surgery. I should have found a "creative" way to answer the bottom surgery question, but I wasn't expecting it and was already freaked out that I was still in the system as female.
Someone told me that Red Cross guidelines (which my blood bank observes) have changed, but I haven't investigated. I have found no written description of any new guidelines.
Anyway, I'm not a doctor, but a lower dose and more water have helped me, and I suppose the blood donation probably helped as well except that I did it way before my next blood test.