High Iron - Low Ferritin

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Whereicomefrom

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On my last blood test (June 21st) my Iron is too high and my Ferritin is at the bottom of the range. I've read Ferritin needs to be at least over 70 ng/mL but around 100 ng/mL is optimal. My last blood donation was April 08, I stopped donating because on May 07 my Iron and Ferritin was really low. My liver enzymes checked good and no infections. I eat a lot of red meat so should be getting Heme Iron. Any suggestions why my Ferritin is not increasing like my Iron did? My doc just emailed and said to donate blood again, I've not been able to have a conversation with him yet. Some test results below.

April 08, 2024 - Last Blood Donation

May 07, 2024 - Test Results
Ferritin - 15 ng/mL (L) (22-322)
Iron - 36 ug/dL (L) (65-175)
Transferrin - 430 mg/dL (H) (215-365)
TIBC - 538 ug/dL (H) (218-385)
%SAT - 7% (L) (20-50)

June 21, 2024 - Test Results
Ferritin 37 ng/mL (30-400)
Iron - 206 ug/dL (H) (38-169)
TIBC - 447 (250-450 ug/dL)
UIBC - 241 (111-343 ug/dL)
Iron Saturation (TSat) 46 (15-55%)
RBC - 6.53 (H) (4.14-5.80)
Hemoglobin - 16.8 (13.0-17.7 g/dL)
Hematocrit - 51.6 (H) (37.5-51.0 %)
MCHC - 32.6 (31.5-35.7 g/dL)
RDW - 17.5 (H) (11.6 - 15.4%)
Platelets - 219 (150 -450)
 
 
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Are you on TRT? With all these blood donations and your numbers going up and down, how do you feel overall? I would def look for natural ways to reduce hmg, hct snd rbc, exhaust them first. Iron dynamics/metabolism is very complicated stuff and I wouldn't mess with it, esp if theres no need. Ferritin goes up with Inflammation as well as Iron gets shuttled into to furnice and to starve of bacteria. We look at all Iron panel and not in isolation. So that being said I would def work on fixing all without donating more blood going forward.
 
Whereicomefrom said:
On my last blood test (June 21st) my Iron is too high and my Ferritin is at the bottom of the range. I've read Ferritin needs to be at least over 70 ng/mL but around 100 ng/mL is optimal. My last blood donation was April 08, I stopped donating because on May 07 my Iron and Ferritin was really low. My liver enzymes checked good and no infections. I eat a lot of red meat so should be getting Heme Iron.
Any suggestions why my Ferritin is not increasing like my Iron did?

It takes time to 'refill' ferritin. It did increase!


My doc just emailed and said to donate blood again, I've not been able to have a conversation with him yet.

What is his reason to do that? If it's just because of the reference range, then look up posts here regarding TRT and hematocrit.


Some test results below.

April 08, 2024 - Last Blood Donation

May 07, 2024 - Test Results
Ferritin - 15 ng/mL (L) (22-322)
Iron - 36 ug/dL (L) (65-175)
Transferrin - 430 mg/dL (H) (215-365)
TIBC - 538 ug/dL (H) (218-385)
%SAT - 7% (L) (20-50)

June 21, 2024 - Test Results
Ferritin 37 ng/mL (30-400)
Iron - 206 ug/dL (H) (38-169)
TIBC - 447 (250-450 ug/dL)
UIBC - 241 (111-343 ug/dL)
Iron Saturation (TSat) 46 (15-55%)
RBC - 6.53 (H) (4.14-5.80)
Hemoglobin - 16.8 (13.0-17.7 g/dL)
Hematocrit - 51.6 (H) (37.5-51.0 %)
MCHC - 32.6 (31.5-35.7 g/dL)
RDW - 17.5 (H) (11.6 - 15.4%)
Platelets - 219 (150 -450)
 
Click to expand...
 
Belekas said:
Are you on TRT? With all these blood donations and your numbers going up and down, how do you feel overall?
Click to expand...
Yes, TRT is why I have to do the blood donations. My doc is insane about keeping hematocrit 50 and under. I'm going to hold off donating for a while and keep testing levels.
 
Whereicomefrom said:
Yes, TRT is why I have to do the blood donations. My doc is insane about keeping hematocrit 50 and under. I'm going to hold off donating for a while and keep testing levels.
Click to expand...
Like I said, you need to find another doctor that knows what he’s doing. Your doctor is operating out of fear and lack of knowledge.

You shouldn’t be donating blood with even a 51% hematocrit! The guidelines for TRT are under 54%.

This doctor of yours is going to cause more harm than good in the long run.
 
While I agree that your doc may be a bit over-aggressive on Hematocrit, Iron overload is certainly not something you want and my understanding is that TIBC is one of the best measures of that. Donating blood is one of the only ways (for men) to get iron out of the cells. You may have some sort of genetic anomaly going on. You may want to consider a consult with Chris Masterjohn (no affiliation) who specializes in genetic issues and has been focused on Iron/ferritin recently. You can read his recent substacks to get a feel for his thinking, but I don't think any of us here are near his level when it comes to a combined knowledge of biochemical pathways and genetic tendencies, and neither are the overwhelming majority of mainstream medicine practitioners.
 
DorianGray said:
Get genetic testing done by 23andme or another such service. It will reveal if you have a variant for the HFe gene, which could confound your expectations for TRT.
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I just checked 23andMe and it says I do not have the two genetic variants we tested.

That's interesting, I didn't know anything about that.
 
Systemlord said:
Like I said, you need to find another doctor that knows what he’s doing. Your doctor is operating out of fear and lack of knowledge.

You shouldn’t be donating blood with even a 51% hematocrit! The guidelines for TRT are under 54%.

This doctor of yours is going to cause more harm than good in the long run.
Click to expand...
I agree I need a new doctor. Finding one that knows a lot about TRT, in my location is not easy. I swear his knowledge of TRT is, Total T, Hematocrit and PSA. That's it
 
Whereicomefrom said:
I swear his knowledge of TRT is, Total T, Hematocrit and PSA.
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This is typical within mainstream medicine which is sorely lacking in the field of male hormone management! The guidelines your doctor is following were meant for the general practitioner unfamiliar with TRT rather than someone trained in this field of medicine.

You’ll most like have to go private and pay for your TRT out of pocket. My endo isn’t concerned with a 54.9% hematocrit. He even said I don’t know at what level of hematocrit is too high for you.

He’s more concerned with the hemoglobin level.
 
Last edited:
DorianGray said:
Get genetic testing done by 23andme or another such service. It will reveal if you have a variant for the HFe gene, which could confound your expectations for TRT.
Click to expand...
Agree. 23andme checks only for 2 variants of HH, AncestryDNA for 5+ I believe when you run there raw DNA data through checkiron.com algo. Got the sample sent myself and waiting for DNA results which should be done in 6 weeks time. NHS checked me for type 1 HH only which I'm negative, so looking to see what other mutations I have. I think absolutely more people should pay attention to it, esp the Carnivore crowd, as if you are loading Iron and smashing Beef on the daily basis without anything else to inhibit Iron absorbtion and without even knowing you have issues- it won't end well on the longer-term perspective.
 
I assumed he takes an iron supplement, and could reduce the dosage. I don't get how you jumped to iron overload , DNA etc, without asking/knowing about his nutrition and supplements. However, interesting Infos about dna testing.
 
Guided_by_Voices said:
While I agree that your doc may be a bit over-aggressive on Hematocrit, Iron overload is certainly not something you want and my understanding is that TIBC is one of the best measures of that. Donating blood is one of the only ways (for men) to get iron out of the cells. You may have some sort of genetic anomaly going on. You may want to consider a consult with Chris Masterjohn (no affiliation) who specializes in genetic issues and has been focused on Iron/ferritin recently. You can read his recent substacks to get a feel for his thinking, but I don't think any of us here are near his level when it comes to a combined knowledge of biochemical pathways and genetic tendencies, and neither are the overwhelming majority of mainstream medicine practitioners.
Click to expand...
So Chris masterjohn basically says that TIBC is one of the best measures of iron status? Didn’t know that. I’ll have to look back on all my iron panels and look at TIBC a bit closer
 
DorianGray said:
Get genetic testing done by 23andme or another such service. It will reveal if you have a variant for the HFe gene, which could confound your expectations for TRT.
Click to expand...
I also don’t have any variants for this gene. Can u sum up what this means real quick? Does this mean I would be less prone to iron overload, compared to someone who does have a variant or two?
 
Gman86 said:
So Chris masterjohn basically says that TIBC is one of the best measures of iron status? Didn’t know that. I’ll have to look back on all my iron panels and look at TIBC a bit closer
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I actually heard that from other people so I don't know what his view is. I think from a post of his several weeks ago that he looks at a variety of things including other related minerals such as copper and manganese, but it's certainly not to rely on ferritin. But the bottom line is that is that for most men, iron overload is a much bigger risk than iron deficiency, and if someone thinks they are iron deficient, then the question is, Where did the iron go? since, excluding ultra-endurance exercise and chelation, blood loss of some kind is the only way iron gets removed from the body that I know of.

Also, there are other somewhat theoretical anti-aging reasons for donating blood (that is a longer discussion) as well as good-old-fashioned altruism. So, as I've long maintained, a lot of this hematocrit discussion is a moot point since there are at least three other reasons to be regularly donating blood.
 
Guided_by_Voices said:
I actually heard that from other people so I don't know what his view is. I think from a post of his several weeks ago that he looks at a variety of things including other related minerals such as copper and manganese, but it's certainly not to rely on ferritin. But the bottom line is that is that for most men, iron overload is a much bigger risk than iron deficiency, and if someone thinks they are iron deficient, then the question is, Where did the iron go? since, excluding ultra-endurance exercise and chelation, blood loss of some kind is the only way iron gets removed from the body that I know of.

Also, there are other somewhat theoretical anti-aging reasons for donating blood (that is a longer discussion) as well as good-old-fashioned altruism. So, as I've long maintained, a lot of this hematocrit discussion is a moot point since there are at least three other reasons to be regularly donating blood.
Click to expand...
Would u be able to DM me to go over a few things in more detail? Interested to hear the other reasons to donate, other than the obv

Been following Morley Robbin’s work for years, and definitely believe that chronic iron overload is one of the worst things for the human body
 
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Gman86 said:
Would u be able to DM me to go over a few things in more detail? Interested to hear the other reasons to donate, other than the obv

Been following Morley Robbin’s work for years, and definitely believe that chronic iron overload is one of the worst things for the human body
Click to expand...
I'll do a post in the Anti-aging section when I have a chance so everyone can see it
 
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