Therapeutic phlebotomy, colloquially known as bloodletting and used to manage red blood cell counts and Hematocrit levels, has a very long history in medical practice. The technique has been used for hundreds if not thousands of years across the globe.
The original logic behind bloodletting is simple but flawed. If disease lives within the blood, then removing the blood must also remove the disease. Of course, today we know that disease isn’t quite that simple. Modern medical practice discarded the technique as ineffective and dangerous.
Recent evidence, though, has brought therapeutic phlebotomy back in very specific cases. There are some medical conditions which can be treated or managed by the controlled removal of red blood cells and iron from the body, and the technique has found new life among today’s doctors.
One such condition that responds to therapeutic phlebotomy is polycythemia. The word literally translates to “many blood”, and refers to an overproduction of red blood cells in the body. People suffering from polycythemia have blood that is thick, viscous, or “sticky”, and the condition can be fatal. Blood in this state is more difficult for the heart to handle, potentially leading to high blood pressure, heart attack, or stroke.
The disorder can be brought on by a number of factors.
The rise of testosterone replacement therapy has led to an increased instance of polycythemia. Testosterone treatments are wonderfully effective in a variety of cases, but like any medical treatment, it must be administered with care by a medical professional.
Testosterone, as well as assisting with mood support, building physical capability, and its other positive effects, stimulates the body to produce more red blood cells. Increased blood production is beneficial in some cases, such as in anemic patients, but can result in polycythemia if not carefully monitored.
Men are more prone to developing the condition, as they are usually prescribed much higher doses of testosterone than women.
Generally, the doctor administering testosterone therapy will manage the treatment to minimize the risk of side effects such as polycythemia. If red blood cell counts creep up too high, the excess blood can be drained away using the old technique of therapeutic phlebotomy, or bloodletting.
Removing a single pint of blood is usually enough to bring red blood cell counts back to normal. The blood can also be donated to a blood bank, if the patient’s blood is eligible.
Repeated bloodletting sessions are indicated in some cases if polycythemia recurs.
The effects of therapeutic phlebotomy are immediate, since they involve the physical removal of blood from the body. Symptoms such as high blood pressure subside instantly, and most patients report feeling better right away.
Due to the instance of polycythemia in patients receiving testosterone replacement therapy, regular follow-up testing is extremely important even after the treatments are complete. Among other measurements, doctors will measure the Hematocrit and Hemoglobin in patients who have received testosterone treatments.
This measures the quantity of red blood cells in the body, or hematocrit, a component of the blood. When this is too high, the blood becomes thicker or more viscus and if not managed properly could put more strain on the body. Ensuring blood cell count and hematocrit levels remain within the normal range is important to anyone’s health, but especially so for recipients of testosterone therapy.
Medications are often used for long-term management of hematocrit levels, as well as therapeutic phlebotomy sessions if hematocrit rises too high.
As well as effectively managing polycythemia, bloodletting is sometimes used as a treatment for hypertension, or high blood pressure. Removing a pint of blood has been shown to decrease blood pressure and “bad” cholesterol levels, during a study performed at Immanuel Hospital in Berlin.
The inspiration for the study was the finding that regular blood donors had a reduced instance of high cholesterol, as well as reduced risk of coronary disease and stroke.
The idea that removing blood from the body would reduce blood pressure seems obvious in retrospect. The technique is an ancient one, but still has merit today under controlled circumstances.
Different studies have also shown that therapeutic phlebotomy can aid diabetics in controlling blood sugar levels.
Finally, most patients report increased energy levels and feelings of health after bloodletting. Although this is not necessarily a reason to receive the treatment in and of itself, patients and doctors alike often consider it a nice bonus.
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