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Home » What’s the link between testosterone and hemoglobin?
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What’s the link between testosterone and hemoglobin?

IShfaqBy IShfaqJuly 3, 2025
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Testosterone replacement therapy must be prescribed by a medical doctor licensed to practice in your area. That is because too much testosterone can lead to too much hemoglobin, and this is not the best condition for your body. We will explain why below. If you are interested in testosterone replacement therapy and are wisely searching for a physician, visit us at the HGH Doctor. 

What Is Hemoglobin?

Hemoglobin is a protein, and it exists within your red blood cells. 

The body needs oxygen to function properly, and the hemoglobin in your red blood cells transports oxygen everywhere it needs to go. Specifically, hemoglobin takes oxygen from the lungs to the organs and tissues in the body. It has the ability to do this because it contains iron. The iron makes it possible for the hemoglobin to “pick up” the oxygen and take it where it needs to go. 

After hemoglobin delivers oxygen to an organ, it becomes the transportation that carbon dioxide needs to travel through the body. Carbon dioxide is a waste product that the cell produces, so it needs to be eliminated. This is when the hemoglobin takes the carbon dioxide to the lungs so that it can be released when the person exhales. 

What Is Testosterone?

Testosterone is a hormone, and the sex gonads are primarily responsible for producing it. The testicles produce testosterone for males, and the ovaries produce estrogen for females. The male gonads produce much more testosterone than the female gonads. 

Males and females also have adrenal glands, and these adrenal glands produce dehydroepiandrosterone or DHEA, which is also a hormone. In males, the body converts DHEA into testosterone, and in females, DHEA becomes estrogen. 

Testosterone is the main androgen that produces male characteristics when a boy goes through puberty. For example, it leads to a deepening voice, facial hair, and muscle growth. 

What Does Testosterone Have to Do with Hemoglobin?

Studies have shown that testosterone increases hemoglobin by stimulating the bone marrow to produce more red blood cells. This means that people with higher testosterone levels often have better oxygen delivery throughout their bodies. That’s why testosterone therapy is sometimes prescribed for people with low testosterone and low hemoglobin levels. It can help improve both energy levels and overall wellness. 

Too Much Isn’t Better.

While boosting hemoglobin sounds like a good thing, too much testosterone can actually increase it too much. This can lead to a condition called “polycythemia,” where the blood becomes thicker. This increases the risk of clots, stroke or heart issues. 

Are Testosterone Injections the Cause of Polycythemia?

When you have high levels of testosterone, the body tends to produce a greater number of red blood cells. Therefore, if you are taking testosterone injections, it can lead to polycythemia. The blood is thicker with this condition, so it is more difficult for it to circulate through your system, and this increases the risk of stroke or hypertension. 

It is highly important to only use testosterone injections that are regulated by a medical doctor. This is not the case when you obtain your testosterone injections for bodybuilding, and it increases the risk that you will experience the adverse effects listed above. In addition to that, unregulated testosterone injections cause your testosterone levels to spike. During these spikes, the body increases its red blood cell production, and polycythemia is the result. 

Is There a Risk of Polycythemia with Testosterone Replacement Therapy or TRT?

Men have complained of loss of muscle mass, fatigue, and reduced sex drive. After a blood test, their physicians found that they had hypogonadism or low testosterone. The treatment was testosterone replacement therapy or TRT, but the patients were warned that polycythemia was the primary risk of this treatment. 

If you believe that TRT would help relieve your symptoms, you do not have to be concerned about being placed on testosterone replacement therapy. Your physician will monitor your red blood cell levels while you are on TRT. The first blood test will be before you begin therapy so that your physician knows your baseline level of red blood cells. After about three to six months, you will have another blood test. You may need to submit to additional blood tests every six months.

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