How do I treat my patient with testosterone supplement-induced erythrocytosis?

By William Aird

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:

J Sex Med. 2017;14:1504-1523.

2018 Evaluation and Management of Testosterone Deficiency: AUA Guideline:

J Urol. 2018;200:423-432.

Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline:

Erythrocytosis = hematocrit > 54%.