How do you manage testosterone replacement therapy-induced erythrocytosis?

Do you recommend therapeutic phlebotomy to a certain Hct goal? Any strong evidence for thromboembolic risk related to erythrocytosis or if this is mitigated by phlebotomy?

Answer from: at Academic Institution

Testosterone is a known risk for thromboembolism. What is not known is whether it is the hematocrit or the testosterone itself that is the trigger for thrombosis. Note also that epidemiologically, the age group that generally is prescribed testosterone also has a high prevalence of thrombosis. My a...

Comments

at Kaiser Permanente, Los Angeles Med Center
Thank you so much, Dr. @Rajiv Pruthi!!

at Mayo Clinic Arizona
I agree with the above comments. However, will add...

at Kaiser Permanente, Los Angeles Med Center
Thank you, Dr. @Jeanne Palmer!

Medical Oncologist at Pasco Hernando Onc Assoc
Thanks for the inputs. I would like to know what r...

Answer from: Medical Oncologist at Community Practice

I recommend discontinuing testosterone, treating the underlying cause in patients with secondary testicular failure, and using PDE inhibitors.

Answer from: Medical Oncologist at Community Practice

I would strongly urge patients to discontinue testosterone. It has no proven health benefit and the symptomatic improvement is likely functional. I would urge patients to try PDE inhibitors if sexual performance is an issue; they are much more safe and efficacious in that regard. I agree that the da...

Comments

at Kaiser Permanente, Los Angeles Med Center
Thank you, Dr. @Basem M. William!

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How do you manage testosterone replacement therapy-induced erythrocytosis?

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