My Experiment to Optimize Hematocrit and Iron

[Lockout888]

I've been on TRT for about 3.5 years. I've been on the same protocol for about 3 years: Test Cyp: 80mg every 3.5 days SubQ, HCG: 250iu 3x week SubQ, Anastrozole: .25mg 1x per week, day after T injection. This gets my TT to about 650-750, when I do BW about 12 hours before T injection.

I have been donating blood every 8-12 weeks to keep Hematocrit in check. What I didn't realize was that was slowly tanking my iron and ferritin levels, and I was not able to replenish them before my next donation.

It slowly crept up on me, but I was feeling: tired all the time, out of breath easily during mild exercise, sweating easily etc. Sex was exhausting and sometimes I could never finish.

I was diagnosed with iron deficiency anemia this past June. My numbers were in the tank:
Hemoglobin 11.8 LOW (12.6-17.7)
Hematocrit 39.5 (37.5-51.0)
Iron, Serum 22 LOW (38-169)
Iron Saturation 6 ALERT LOW (15-55)
Ferritin, Serum 8 LOW (30-400)

I did a bunch of research, and talked with my Doctor about this. Found that it was going to take about 8 weeks to get my iron and ferritin levels back to somewhat normal. I found a great product called Blood Builder and started taking that twice a day for 8 weeks. It definitely got my numbers back:
Hemoglobin 17.2 (12.6-17.7)
Hematocrit 52.6 (37.5-51.0)
Iron, Serum 101 (38-169)
Iron Saturation 34 (15-55)
Ferritin, Serum 37 (30-400)

Since my Hematocrit was at 52.6% I decided to donate blood again. I wanted to see how much iron I lose from donating, so I took another blood test 36 hours later:
Hemoglobin 16.2 (12.6-17.7)
Hematocrit 50.4 (37.5-51.0)
Iron, Serum 44 (38-169)
Iron Saturation 13 LOW (15-55)
Ferritin, Serum 20 LOW (30-400)

Since my iron and ferritin were now low again, I kept taking the iron supplement. I decided to wait a little longer before donating this time (10 weeks) so I wouldn't lose all the iron. Here are my labs the day before I donated:
Hemoglobin 19.1 HIGH (12.6-17.7)
Hematocrit 55.8 HIGH (37.5-51.0)
Iron, Serum 87 (38-169)
Iron Saturation 30 (15-55)
Ferritin, Serum 63 (30-400)

I can't seem to replenish my iron and ferritin quick enough before I need to donate blood to keep Hematocrit down.

Even after this recent donation, my Hematocrit is probably around 53% and my iron and ferritin are now low again.

How do I keep my Hematocrit in check, while increasing my iron and ferritin?

Should I do a Double Red Cell Donation next time? Only take iron for 2 weeks after a donation?

 

[Vince Carter]

I started with some of the same thing, very low Ferritin in the teens. Took 62mg elemental iron every day for...60 days. Never felt 'better' or anything else. Next test showed Ferritin still very low, blood iron was up though. Didn't do anything for me and I *thought* it might be driving my HCT/HGB as I had some indication that my levels had been stabilizing for a few months.

 

[SoCalSurfer]

This is a good example of how everyone reacts differently to TRT.
I myself have never had to give blood. My MCV is lower so my blood cells are smaller so my blood is not thickening up. I recall there is something about that on the site, but I could not find it. It was on how your body and blood adjust to having more cells by making the smaller, so your blood does not thicken up. I do have low iron so I take a supplement for that along with Vit D, DHEA, and a few others off of Gene's Stack. One thing I think that might impact is the type of exercise that people do. I am a cyclist and ride between 4,000 - 5,000 miles a year. I think if I was training more with weights things might be different.

 

[mopes]

Trying to get my iron up as well as my ferritin and iron were both low. Had the same symptoms as you. I've been taking a double dose of liquid iron and also a dose of blue bonnet chelated iron. It's brought both iron and ferritin up luckily without hematocrit increasing. Still need to get my numbers up a bit as I've started on wp thyroid and am trying to find optimal dose. In my opinion best thing you could do right now to decrease hematocrit is adding in some cardio if you're not doing it already.

 

[Henry]

Hi,
Just curious, is there any medication you can take that would lower your HGB/HCT without the need for the blood donation, saving your iron and ferritin stores?

 

[Lockout888]

is there any medication you can take that would lower your HGB/HCT without the need for the blood donation, saving your iron and ferritin stores?

One thing that I have read that can do this is grapefruit juice, and specifically the ingredient naringin.

 

[CoastWatcher]

Hi,
Just curious, is there any medication you can take that would lower your HGB/HCT without the need for the blood donation, saving your iron and ferritin stores?

https://www.excelmale.com/forum/sho...y-testosterone-replacement&highlight=Losartan

The search function yielded a number of threads on the topic. Losartan is discussed in some detail here.

 

[Henry]

Thanks
Henry

 

[Lockout888]

Well, here is my plan for now. Let me know what you guys think:

I donated whole blood on 10/19 after these labs:
Hemoglobin 19.1 HIGH (12.6-17.7)
Hematocrit 55.8 HIGH (37.5-51.0)
Iron, Serum 87 (38-169)
Iron Saturation 30 (15-55)
Ferritin, Serum 63 (30-400)

After getting BW done before and after a donation last time, I'm guessing these are what my current numbers are now:
Hemoglobin 18.1 HIGH (12.6-17.7)
Hematocrit 53 HIGH (37.5-51.0)
Iron, Serum (38-169) 40
Iron Saturation (15-55) 14 LOW
Ferritin, Serum (30-400) 35

I can't donate again for 7 more weeks. So to keep my Hematocrit down until then, I lowered my test injections from 160/week to 120/week. I started taking nattokinase (4000 fu), and drinking grapefruit juice every day until the naringin I ordered comes in. I stopped taking supplemental iron, but will continue to eat foods with iron.

When I get close to the 8 week mark, I will re-test all the above to see where I'm at. If I'm still really high in hemo/hema - I will do a double red cell donation. If not, I will do a regular whole blood donation. I will bring my test injection levels back to normal and take supplemental iron for 2 weeks only. Then do another blood test of all the above to see the results.

 

[CoastWatcher]

How did you arrive at the adjusted testosterone dose? Not criticizing, just inquiring.

 

[Lockout888]

How did you arrive at the adjusted testosterone dose? Not criticizing, just inquiring.

I have labs from previous protocols. I wanted to lower it without going too low.

 

[Lockout888]

I decided to switch my HBP Meds from Quinaprill to Losartan, based on the hematocrit reducing abilities. I've been on it for 3 days now with no noticible sides.

I also decided to hold off on the naringin pills, due to possible interactions with meds.

 

[Lockout888]

Update:

Just got my lab results back, 8 weeks after my last results. Looks like I won't need to do the double-red cell donation:

Hemoglobin 17.8 HIGH (12.6-17.7)
Hematocrit 51.1 HIGH (37.5-51.0)
Iron, Serum 94 (38-169)
Iron Saturation 31 (15-55)
Ferritin, Serum 37 (30-400)

Looks like the reduced Test and switching to Losartan reduced my Hematocrit quite a bit.

 

[johndoesmith]

Update:

Just got my lab results back, 8 weeks after my last results. Looks like I won't need to do the double-red cell donation:

Hemoglobin 17.8 HIGH (12.6-17.7)
Hematocrit 51.1 HIGH (37.5-51.0)
Iron, Serum 94 (38-169)
Iron Saturation 31 (15-55)
Ferritin, Serum 37 (30-400)

Looks like the reduced Test and switching to Losartan reduced my Hematocrit quite a bit.

Looks like you even improved since your last blood draw and without donation! That's amazing.

That panel doesn't look too bad, slightly out of range, but iron and ferritin look okay.

Do you still feel good even with the reduced TRT dose?

 

[Vince Carter]

You're really making the process of simply donating blood every 7 weeks really really hard.

 

[Lockout888]

Looks like you even improved since your last blood draw and without donation! That's amazing. That panel doesn't look too bad, slightly out of range, but iron and ferritin look okay. Do you still feel good even with the reduced TRT dose?

I definitely noticed a difference, but not feeling bad. I'm not sure yet what my TT is on this dose, I can just guesstimate.

 

[Lockout888]

You're really making the process of simply donating blood every 7 weeks really really hard.

Here we are not allowed to donate until 8 weeks. But donating every 8 weeks tanked my iron and ferritin over time, and I became iron-deficient anemic. That felt worse than before going on TRT.

 

[Vince Carter]

Statement I recently read on the forum was another guy I think with the same problem and a Defy medical staff advised him to supplement 62mg elemental iron twice per day with 1000mg Vitamin C. Ive been doing that....can't say it's helped me in subjectively feeling, and I don't know what I'm running right now as far as HCT but I'm donating in a few days anyway.

 

[endopa-c]

Lockout888- There are many reasons for polycythemia. Are you a Defy patient? If so please call me so we can review your past medical history, medication list, and regimen to investigate why you are consistently having to donate blood. As you have discovered donating one pint lowers your ferritin levels approx 30 points. The goal is to correct the cause of the polycythemia and maintain a testosterone dose that is sustainable for the long term so you don't need to donate blood. More often than not the primary cause is obstructive sleep apnea. The hypoxia associated with OSA causes an increase in RBC production even more so than elevated testosterone levels. Have you had a sleep apnea test? They have the take home test now so you don't have to sleep in a clinic and its affordable even if you don't have insurance- around $200 last time I checked for a patient.

 

[Lockout888]

Lockout888- There are many reasons for polycythemia. Are you a Defy patient? If so please call me so we can review your past medical history, medication list, and regimen to investigate why you are consistently having to donate blood. As you have discovered donating one pint lowers your ferritin levels approx 30 points. The goal is to correct the cause of the polycythemia and maintain a testosterone dose that is sustainable for the long term so you don't need to donate blood. More often than not the primary cause is obstructive sleep apnea. The hypoxia associated with OSA causes an increase in RBC production even more so than elevated testosterone levels. Have you had a sleep apnea test? They have the take home test now so you don't have to sleep in a clinic and its affordable even if you don't have insurance- around $200 last time I checked for a patient.

I probably do. I have a deviated septum and was set to get nasal reconstructive surgery from my ENT Specialist. I had to put it off for reasons out of my control, but I will eventually get the surgery.