Should You Donate Blood On Cycle?

Prompted by /u/medit4tive. I'm sorry I couldn't get it out sooner, releasing it as soon as I could.

The need to donate blood is often hand in hand with androgen use. Androgens increase the number of red blood cells, leading to 'thick blood'. This can be seen on blood tests as elevated hematocrit. The reason is that Testosterone and other androgens have an erythropoietic stimulating effect.

Or in plain English, your kidneys secrete erythopoietin as they detect decreased O2 circulation due to androgen use, which increases hemoglobin / hematocrit / RBC.

Aside from high hematocrit, it's a great practice to do (saving lives, bro!), and you may benefit from it yourself one day. If you have a rare or useful/broadly compatible blood type, even more reason to do so. But is it safe for those on the receiving end to get your blood?

Testosterone / TRT Use

Those who are participating in TRT may be encouraged to donate blood in order to keep red blood cell levels optimal and viscosity within normal limits.

Hemoglobin concentrations were elevated in donors on TRT, and significant numbers had hemoglobin levels above those recommended by current guidelines.

There are otherwise no restrictions on donating blood when on testosterone beyond being unsuitable from overly high RBC count:

If your medication was prescribed by a doctor registered in Australia, you can donate. However in some cases testosterone may cause your haemoglobin levels (a protein in your blood that transports oxygen) to increase to above the acceptable range for donation.

(That said, note that blood donation is only a temporary solution and does not maintain hematocrit at healthy levels by itself)

Why Don't Androgens In Donated Blood Affect At Risk Groups?

When you donate blood on-cycle, the concern is you may confer similar risks and side effects to the recipient. Due to short half-lives, the risk of very short-term slightly elevated blood pressure, virilization and getting swole is not an issue for most recipients. The exception being 'at risk' groups, and specifically pregnant women (I'm less concerned about Grandma & Grandpa - they've been looking a little skinny lately anyway, and could use some additional muscle).

Won't Somebody Please Think Of The Children?

There are several protections, which I have broadly summarized into three groups:

  1. Increases in SHBG - bound androgens are of little use to their target tissue and pass more or less right through without binding to AR
  2. Competition for AR - progesterone spikes 10x, inhibits other androgens binding to AR, despite its low binding affinity. It may also stop conversion of test to the more potent DHT
  3. Aromatization by the Placenta - this is key:

It has been demonstrated that the placenta has a massive ability to convert androgens to estrogens. It is therefore likely that the placenta affords a protective mechanism to both the mother and the female fetus from virilization by metabolizing androgens to estrogens. In one report, the maternal concentration of testosterone was 15,000 ng/dL, while the cord level was 252 ng/dL, or 1.7% of the maternal level. The estradiol level in the cord serum was elevated compared to that of the mother, suggesting that testosterone was converted to estradiol as part of a protective mechanism against the passage of testosterone from mother to fetus. Other evidence consistent with the placental protective mechanism hypothesis includes the observation that female infants in pregnancies where there is a deficiency of placental aromatase are virilized. In one such infant, cord serum levels of testosterone, DHT, and androstenedione were markedly elevated compared with normal infants, whereas estrone, estradiol, and estriol concentrations were somewhat lower than expected.

So key take away for test users: generally OK to donate blood. After all, pregnancy is associated with clear-cut increases in total and free androgens, yet women and their infants are not virilized.

How about SARMs?

Up until this point, we're talking about the mainstream compounds, specifically test and its variations. As usual when it comes to SARMs, we have NFI and clinical trials have always excluded this group. We have no data on if the same protections that a fetus and mother enjoys would include SARMs, but certainly #1 & #2 of the above points would still have some benefit. Given SARMs selectivity, I'm not clear what protection the placenta would offer the fetus, if any.

For those that do choose to give blood while on a SARM, they likely do so because they believe that the typical short half-life (~24 hours, depending on compound), lack of significant side effects, and the selective nature of SARMs (i.e. tissue, not organs) is not likely to pose much of a risk to anyone.

In the female results of an Ostarine trial of most concern would be the tanked SHBG. At 3mg, SHBG decreased from 64.1nmol/L to 12.66nmol/L. That will mean more free androgen circulating... still, given the massive increase in SHBG (from 114nmol/L to 724noml/L) that pregnant women have (see #1 above), a very high amount of Ostarine would end up bound, not in the target tissue, and will circulate harmlessly until excreted.

How about GH?

Folks who have taken pit-HGH in the past are not permitted to give blood as it is linked to Creutzfeldt-Jakob disease. This restriction is specific to pit-HGH only, and that 'Such deferral is not necessary for recipients who have received only recombinant growth hormone available'. So the concern is not around elevated GH per se, but on the type of GH received.

GH agonists, such as MK677, increase the bodies ability to produce GH and increases circulating IGF-1. This is not likely to cause any issue for receiving folks, as above.

So What?

Those on compounds derived from test seem to be OK to donate, as are those using HGH, MK677 or another GH agonist. SARMs need more investigation to make a determination one way or another. Please note that I am not a medical professional by any stretch - use your own judgment here and follow local guidelines. Also good to let you know at this point that common antiandrogens such as Finasteride would exclude you from donating blood for at least a year, depending on your region. Those compounds are considered teratogenic, or harmful to a fetus.