The following is a summary of “Erythrocytosis Is Rare With Exogenous Testosterone in Gender-Affirming Hormone Therapy,” published in the May 2024 issue of Endocrinology by Krishnamurthy, et al.
Research has identified varying incidences of erythrocytosis among individuals using testosterone as part of gender-affirming hormone therapy (GAHT). For a study, researchers sought to investigate the impact of exogenous testosterone used in GAHT on hematocrit levels within a substantial North American cohort.
A cross-sectional analysis was conducted on testosterone and hematocrit laboratory values from 6,670 patients prescribed testosterone via Plume, a national GAHT provider. The prevalence of erythrocytosis, mean hematocrit at specific testosterone thresholds, and variations based on testosterone administration routes were assessed.
Among the 6,670 individuals, 560 (8.4%) had a hematocrit ≥50%, 182 (2.7%) ≥ 52%, and 60 (0.9%) ≥ 54%. Significant hematocrit variations were observed across different testosterone thresholds (T < 50 vs T 50-299 vs T 300-999 vs T ≥ 1,000 ng/dL) and within the male target range (300-1000 ng/dL) (P < .001). Mean hematocrit ranged from 41.84% (T < 50 ng/dL) to 45.68% (T 900-949 ng/dL). Intramuscular testosterone users exhibited higher mean hematocrit than transdermal users (44.96% vs 43.41%, P < .001). Both administration route (P < .001) and testosterone level (P < .001) correlated significantly with hematocrit.
While testosterone levels and administration routes correlated significantly with hematocrit changes, the absolute levels remained within the normal range, suggesting limited clinical significance. The findings, coupled with the low prevalence of erythrocytosis, alleviate concerns regarding testosterone use in GAHT.
Reference: academic.oup.com/jcem/article-abstract/109/5/1285/7442654
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