@ljgfitness's TRT bloodwork analysis, fact-checked

What did @ljgfitness actually say?

The creator shared blood work taken eight weeks into what they describe as a supraphysiologic testosterone cycle, running "300 kilograms of tests" (clearly a verbal slip for 300 milligrams). Their main concern was elevated hematocrit, hemoglobin, and red blood cell count. To address it, they recommended hydration, methylene blue (sold via their bio link), and therapeutic phlebotomy. They also commented on creatinine, liver enzymes, and lipids, framing most results as "pretty optimal."

One thing worth flagging immediately: this person describes themselves as being on TRT and then "upping" the dose substantially. That is not TRT by any clinical definition. That is a performance-enhancing drug cycle. The framing matters, because it shapes how 21,000 viewers interpret the risks involved.

Does the science back this up?

On hematocrit elevation from testosterone, yes, the evidence is solid. Erythrocytosis is one of the most consistently documented adverse effects of testosterone therapy, with rates varying by formulation and dose.

Research backs this clearly. Coviello et al. (2008, Journal of Clinical Endocrinology and Metabolism) found dose-dependent increases in hematocrit among men receiving testosterone, with supraphysiologic doses producing the most pronounced effects. The Endocrine Society guidelines flag hematocrit above 54% as a threshold requiring dose reduction or treatment pause. Therapeutic phlebotomy is a legitimate intervention used in clinical practice for this purpose.

On creatinine elevation from high protein intake and resistance training, that is also supported. Baxmann et al. (2008, Kidney International) confirmed that dietary protein and muscle mass significantly influence serum creatinine, making it a poor standalone marker for kidney function in athletes. So far, so reasonable.

Where things get shakier is the methylene blue recommendation.

What did they get wrong (or right)?

Let's start with what they got right. Hematocrit monitoring during testosterone use is genuinely important. Phlebotomy is a real, clinically used intervention. The lipid advice, tracking diet and doing cardio, is consistent with evidence that aerobic exercise attenuates HDL suppression from anabolic steroid use (Hartgens and Kuipers, 2004, Sports Medicine). These are not nothing.

Now, what they got wrong. The methylene blue recommendation is a problem. The creator says it "helps with blood thickening" and directs viewers to a purchase link in their bio. There is no peer-reviewed clinical evidence that methylene blue reduces erythrocytosis or lowers hematocrit in this context. Methylene blue has legitimate medical uses, including methemoglobinemia treatment, but selling it as a hematocrit remedy to a fitness audience while monetizing the link is misleading at best.

The framing of this as "TRT blood work" when the dose described is supraphysiologic also misrepresents the risk profile. Viewers using actual replacement doses should not assume these results apply to them in the same way. And describing liver enzymes as "pretty optimal" while casually mentioning oral steroid use pre-workout without advising against it is a gap worth calling out.

What should you actually know?

Elevated hematocrit from testosterone use is not a minor inconvenience. Hematocrit above 52-54% raises the risk of thromboembolic events including stroke and deep vein thrombosis. Glueck et al. (2014, Clinical and Applied Thrombosis/Hemostasis) documented increased clotting risk in men on testosterone with erythrocytosis. This deserves more than a casual mention between lipid results.

Phlebotomy works, but it should be supervised. Donating blood is one way some men manage this, though donation centers have varying policies on accepting blood from people using androgens.

Creatinine alone tells you very little in this population. eGFR calculated using creatinine will be artificially lowered in people with high muscle mass, which can create false alarms or, conversely, mask early kidney stress. Cystatin C is a more reliable marker and worth requesting.

• Anyone running supraphysiologic testosterone should be under medical supervision, not self-managing based on TikTok blood work reviews.
• Methylene blue has no established role in managing testosterone-induced erythrocytosis. Do not buy it for this purpose.
• "Optimal" is doing a lot of work in this video. Results that look acceptable at eight weeks can deteriorate significantly with continued use.

The bottom line

This creator is more transparent than most in this space, and some of what they say is factually grounded. But calling a supraphysiologic cycle "TRT," monetizing an unproven supplement recommendation, and glossing over the cardiovascular stakes of elevated hematocrit are real issues. This is not a template for managing your own blood work.