Warning for Men on TRT: Low Ferritin is Bad

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Fortunate said:
I keep replying and for some reason, it won't post. My apologies if this is a repeat.

Great stuff. I have more to share but want to wait until I have more information.

Meanwhile, any advice on avoiding the GI distress? Does black, liquid sludge come to mind...?
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What is the Protocol???
 
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FDV70 said:
Our objective is merely to "trick" or trigger the body's natural iron overdose mechanism into releasing a massive amount of hepcidin for 7 days. In order to accomplish this, we overwhelm the intestines with iron.

Unfortunately, we need it all to sit there, triggering hepcidin release, not absorbing. Gut cells shed after about 3 days, absolutely loaded with unabsorbed iron (this is a good thing).

The only options are a probiotic or use of fiber pills (do NOT overdo it) to make life easier, but no matter what, that iron unfortunately has to pass the hard way.
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Well, I have a completely unscientific anecdote with an N of 1 and too many variables to make this meaningful, but I thought I would report the following out of interest. Maybe we can get some volunteers to validate my observation?

Summary:
  • I have had fatigue for over a year (sometimes debilitating)
  • TRT during this time was been mostly cream or Xyosted
    • Recently, consistently on cream 100 mg scrotal AM and 50 scrotal PM
    • Levels starting about a year ago (when fatigue started) have generally a fair bit higher than my prior TRT experience, as I used Natesto a lot in the past, prior to cream
  • I have done a big workup and I narrowed down culprit to two possible variables:
    • low ferritin (lowest measurement was 18), or
    • obstructive sleep apnea (Had in house test. Results show mild apnea with a total AHI around 10. Supine around 19).
  • Started CPAP about six weeks ago (still adjusting to it)
  • Recent ferritin (8/30) before CPAP was 18 (didn't have H/H drawn at that time)
  • Advised by sleep doc to try iron to raise ferritin (reduce restless leg syndrome)
    • decided to try it, but also knew I had to check labs for erthryocytosis
  • Did iron 65 mg a day for two weeks and checked labs four hours after AM cream dose. They were very concerning.
    • Ferritin up to 56 (prior measurement was 18)
    • But H/H = 18.2/55.3
    • test 988
  • Stopped iron and cream immediately (one week ago)
  • Started Natesto as soon as I stopped cream
  • Knew I may have to donate, but just wanted to wait at least a week and recheck labs, just to see the trend. Wanted to know if reducing test and adding variability in levels would nudge things in the right direction
  • Labs done a week later show huge increase in ferritin
    • Ferritin all the way up to 116 (from 56 to 116 in one week)
    • Unfortunately, HCT only down to 54.7
The punchline is in the second to last bullet point. Pre-Iron supplement ferritin was 18, after two weeks, it came up to 56, but I went from 56 to 116 in one week and I suspect the primary variable was stopping cream and starting Natesto.

As I said in my disclaimer above, I realize this is highly anecdotal and there may be numerous variables at play. But, I have checked ferritin 5 times in the last six months. The three levels prior to iron and prior to the above Natesto break have never been above 45. So, this level seems significant.

Take home point: Maybe stopping your TRT regimen and using Natesto for a week is enough to let your ferritin recover on its own???

I still feel like I gotta go donate some damn blood because my Hct is still 54.7. And, I really don't like Natesto long term. But, I'd certainly be willing to do it periodically if it worked at least as well as the Vorck protocol.

So, anyone out there on the iron/ferritin/trt hamster wheel, feel free to try this for a week and report back here!
 
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