Bloodwork Low Iron Small Red Blood Cells

SoCalSurfer · Dec 22, 2015

Hi
I reviewed my labs with my primary doc and it seems I know have low iron and smaller red blood cells. I have never had this problem before.
Anyone seen this after being on TRT for a while? Doc did just up my thyrod med to 125mg from 100mg.

[TABLE="width: 0"]
[TR]
[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]WBC[/TD]
[TD="class: infoCol"]3.4 - 10.8 x10E3/uL[/TD]
[TD="class: importantCol"]6.2[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]RBC[/TD]
[TD="class: infoCol"]4.14 - 5.80 x10E6/uL[/TD]
[TD="class: importantCol"]6.29[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]Hemoglobin[/TD]
[TD="class: infoCol"]12.6 - 17.7 g/dL[/TD]
[TD="class: importantCol"]15.6[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]Hematocrit[/TD]
[TD="class: infoCol"]37.5 - 51.0 %[/TD]
[TD="class: importantCol"]48.7[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]MCV[/TD]
[TD="class: infoCol"]79 - 97 fL[/TD]
[TD="class: importantCol"]77[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]MCH, POC[/TD]
[TD="class: infoCol"]26.6 - 33.0 pg[/TD]
[TD="class: importantCol"]24.8[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]MCHC[/TD]
[TD="class: infoCol"]31.5 - 35.7 g/dL[/TD]
[TD="class: importantCol"]32.0[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]RDW[/TD]
[TD="class: infoCol"]12.3 - 15.4 %[/TD]
[TD="class: importantCol"]14.9[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]Platelets[/TD]
[TD="class: infoCol"]150 - 379 x10E3/uL[/TD]
[TD="class: importantCol"]233[/TD]
[/TR]
[/TABLE]

Nelson Vergel · Dec 22, 2015

Where is the iron?

Your red blood cells are changing as your body is trying to adjust to the higher red blood cell production.

Hematocrit may stabilize after long term testosterone replacement

Although this study was done in mice, it may explain why hematocrit may eventually decrease and stabilize in men on TRT. I am one of those men who only went for therapeutic phlebotomy twice. There seems to be an adaptive mechanism that makes red blood cells hange form while hematocrit stabilizes.

Guo W, Bachman E, Vogel J, Li M, Peng L, et al. The Effects of Short-Term and Long-Term Testosterone Supplementation on Blood Viscosity and Erythrocyte Deformability in Healthy Adult Mice. Endocrinology.http://press.endocrine.org/doi/abs/10.1210/en.2014-1784

Testosterone treatment induces erythrocytosis that could potentially affect blood viscosity and cardiovascular risk. We thus investigated the effects of testosterone administration on blood viscosity and erythrocyte deformability using mouse models.

Blood viscosity, erythrocyte deformability, and hematocrits were measured in normal male and female mice, as well as in females and castrated males after short-term (2-weeks) and long-term (5-7 months) testosterone intervention (50 mg/kg, weekly).

Castrated males for long-term intervention were studied in parallel with the normal males to assess the effect of long-term testosterone deprivation. An additional short-term intervention study was conducted in females with a lower testosterone dose (5 mg/kg).

Our results indicate no rheological difference among normal males, females, and castrated males at steady-state.

Short-term high dose testosterone increased hematocrit and whole blood viscosity in both females and castrated males. This effect diminished after long-term treatment, in association with increased erythrocyte deformability in the testosterone-treated mice, suggesting the presence of adaptive mechanism.

Considering that cardiovascular events in human trials are seen early after intervention, rheological changes as potential mediator of vascular events warrant further investigation.

SoCalSurfer · Dec 22, 2015

Thanks Nelson.
Do I need to supplement Iron?

Nelson Vergel · Apr 21, 2016

6 Iron-Rich Food Combos—No Meat Required

Vince · Apr 21, 2016

Nelson Vergel said:
6 Iron-Rich Food Combos—No Meat Required

dark chocolate

gallan · Apr 21, 2016

Strangely my high hematocrit issues are getting worse after over 5 years on TRT. It's a constant battle of frequent phlebotomies and iron supplementation due to low ferritin. Perhaps it's no worse and I'm just doing more frequent labs and worrying about it too much but it's certainly not stabilizing. I do need 200 mgs a week just to bring me in the 800 range.