If Hct > 54%, either reduce or stop testosterone therapy or initiate phlebotomy while continuing testosterone therapy.
Let’s look at the clinical practice guidelines:
2017 British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice:
2018 Evaluation and Management of Testosterone Deficiency: AUA Guideline:
Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline: