Here is what I am thinking on this based on discussions and communications with Dr. Keith Nichols, polycythemia vera is a bone marrow disease where there is an unregulated proliferation of hematopoietic clonal stem cells which leads to over production of red blood cells, white blood cells, and platelets. This is a primary erythrocytosis. Testosterone on the other hand use does not cause primary erythrocytosis. Instead it causes a secondary erythrocytosis which is an increase in red blood cells only leading to an increase in hemoglobin and hematocrit. The two are not the same and should not be treated as such. A secondary erythrocytosis is also seen in other conditions such as smoking, obstructive sleep apnea, chronic obstructive pulmonary disease, and living at high altitude.
While a primary erythrocytosis has been well established as a risk factor for thromboembolic events the secondary erythrocytosis from testosterone therapy has not been shown to cause an increase in thromboembolic events in any randomized control trial or prospective study to date.
There is currently no clinical evidence that rusfertide treats secondary erythrocytosis. All rusfertide trials to date have exclusively enrolled patients with polycythemia vera, and no studies, guidelines, or approvals extend to secondary causes (e.g., hypoxia from chronic lung disease, high-altitude living, smoking, tumors producing erythropoietin, or certain medications).
If you think you have polycythemia vera , then see a doctor and have a JAK2 gene mutation blood test done. My doctor was sending me to do blood dumps and I had this test run and was absolutely negative. So I stopped the nonsense, quit dumping blood and gradually my HCT returned to a what most consider a normal level.
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