Non-Cancer Nightmares Literature Review: Erythrocytosis and Heart Attacks

I could scream reading these. I rehabilitate stroke patients for a living.

Erythrocytosis and thromboembolic events in transgender individuals receiving gender-affirming testosterone.

Thromboembolic = stroke

Erythrocytosis = fudge blood. Too many red blood cells that stick together causing embolism i.e. blood clots.

“Thromboembolic events occurred in 0.9%, of which 80% had developed erythrocytosis by either Hgb or Hct, including two cases each of superficial and calf vein thrombosis as well as one ischemic stroke”
”Hematocrit >50% occurs in up to 20% of transgender individuals receiving testosterone.” And remember that phrase - “loss to follow-up.” They’re not routinely testing them. And the only reason these events seem uncommon is that they’re doing this to children who still have stretchy vascular systems.

Effects of testosterone treatment on transgender males: A single-institution study

This study found “no increase in body weight” which is bizarre given that they were put on an an anabolic steroid, i.e., a drug that increases lean muscle mass. There SHOULD have been an increase in body weight, unless these individuals are getting on a scale every morning and staring at the number. This to me suggests that we’re dealing with a population known to be anorexic and motivated by control. See the episode Coralling Karens at the CHOP shop for more info on how they know this is the pro-ana movement of the decade.

Testosterone therapy and secondary erythrocytosis

In this review, we present the pathophysiology behind TT and secondary erythrocytosis, the evidence connecting TT, secondary erythrocytosis and major adverse cardiovascular events (MACE), and the data supporting varying interventions upon diagnosis of secondary erythrocytosis.

Effects of testosterone therapy on BMI, blood pressure, and laboratory profile of transgender men: a systematic review

”In another study, however, two patients developed hypertension, which was resolved after cessation of testosterone therapy. Decreases in HDL-cholesterol (the good kind) and increases in LDL-cholesterol (the bad kind) were consistently observed.” ”Overall, the quality of evidence was low, given the lack of randomized clinical/controlled trials and the small sample sizes”. “Long-term studies are needed to assess the long-term risks of testosterone therapy, particularly as they relate to cardiometabolic risks such as diabetes, dyslipidemia and the metabolic syndrome”

Erythrocytosis Following Testosterone Therapy

Even non trans men get this problem from roiding out (duh): “For men undergoing TTh, the risk of developing erythrocytosis compared with controls is well established, with short-acting injectable formulations having the highest associated incidence…The mechanism of the pathophysiology and its role on thromboembolic events remain unclear, although some data support an increased risk of cardiovascular events resulting from testosterone-induced erythrocytosis.”

It is well known that testosterone increases their rate of heart attacks. It’s one of the few entirely predictable complications they freely admit, with the caveat that “now we’re just like cis men.” They are fine with inducing preventable heart attacks. This is likely related to the known negative impact of testosterone on pancreatic function in females.