You have to look at the normal Hb/HCT range for a male if you're a female on a decent dose of T, in fact most labs/general chems. Now that I know you've been on T, that explains the elevated Hb/HCT. Everyone responds differently, some have a robust increase in RBCs others not as much. The levels you're at, given no other clotting issues are not that high. I have to find the recent paper on T and E relative to clotting risk, but E, not T increased clotting risk. I have a number of female clients on T pellets through various providers, all avoid any E in the pellet, only T and they all have some increase in Hb/HCT and their total T varies from 150 to 500 ng/dl depending on the dose of pellet and time from implant. Look at the trans lit (FTM), they all experience an increase in Hb/HCT depending on the type of T. There is no increase in clotting in the FTM, but there is in the MTF. Having said that, I like to see 52% as the upper limit for HCT, donate blood a couple times a year (but not too often) should resolve the issue. My non-medical two cents. Lastly, the FDA recommended that the black box warning for cardiovascular issues from testosterone (HRT dosing) be removed from T products (as of 2/28/25) based on all the new data.