Iron Deficiency Without Anemia – Common, Important, Neglected

[madman]

My problem is HCT (56), HG (19) and RBCs (6.9) are the same no matter on the protocol.
I’ve done 100 mg once weekly, 40 mg every 3.5 days, 72 mg every 5 days, and currently:
70 mg every 4 days test cyp total weekly 122.5 mg
Numbers on trough below
TT 926
FT 23.2
E2 72 ( no high e2 sides )
SHBG 31

Numbers on trough much weaker on previous 72 mg every 5 days protocol
TT 600
FT 13.5
E2 35
SHBG 31

same blood numbers

70 mg every 4 days test cyp total weekly 122.5 mg
Numbers on trough below
TT 926
FT 23.2
E2 72 ( no high e2 sides )
SHBG 31

On your current protocol above using the newer TruT calculated method with a TT (trough) 926 ng/dL, SHBG 31 nmol/L, Albumin 4.3 g/dL (mean).....your FT (trough) is 33.07 ng/dL (just over the top end of the reference range of 16-31 ng/dL).

Your peak TT/FT levels will be a lot higher as your blood work for trough was done 4 days after your injection.

Numbers on trough much weaker on previous 72 mg every 5 days protocol
TT 600
FT 13.5
E2 35
SHBG 31

On the protocol above using the same FT calculator with a TT (trough) 600 ng/dL, SHBG 31 nmol/L, Albumin 4.3 g/dL (mean).....your FT (trough) is 20.48 ng/dL ( low/normal of the reference range of 16-31 ng/dL).

Again your peak TT/FT levels will be a lot higher as your blood work for trough was done 5 days after your injection.

When you were running the protocol above 72 mg every 5 days which had your FT (trough) at 20.48 ng/dl (low/normal of the reference range).....how long were you on such protocol as you would have needed to give it a good amount of time to see how the lower TT/FT levels truly effected your rbc's/hemoglobin/hematocrit levels?

Have you ever been tested from sleep apnea?

Regardless of your SHBG you could also look into injecting smaller doses of T more frequently as in daily which will keep your T levels very stable with minimal peak-->trough
levels.

 

[TorontoTRT]

I did a sleep study and came back negative. All protocols were around 3 months each. I’m tweeting the current one from 70 to 65 mg every 4 days. I donated today so ferritin surely went even lower. But I don’t feel any different.
Is it a bad idea to quickly start taking an iron supplement before the red cells go up again to at least boost my ferritin?

 

[madman]

I did a sleep study and came back negative. All protocols were around 3 months each. I’m tweeting the current one from 70 to 65 mg every 4 days. I donated today so ferritin surely went even lower. But I don’t feel any different.
Is it a bad idea to quickly start taking an iron supplement before the red cells go up again to at least boost my ferritin?

You are in a bind here as seeing your ferritin is already 22 which is just above the bottom end of the reference range 16.....by donating you most definitely crashed it so eventually you will develop iron deficiency if you do not start supplementation to get your ferritin levels back into a healthy range above 100.

You need to stop donating for at least 3-6 months now and start iron supplementation otherwise you will be causing more issues in the long run if you develop an iron deficiency.

I honestly think your best move would be to lower your overall weekly dose slightly and start daily injections using lower doses of T.

I think if you minimize your TT/FT peak--->trough levels which would be attainable using low doses of T injected daily and at the same time lower your overall weekly dosage slightly you may be able to find a TT/FT levels that is not too high/low.....as when injecting daily your T levels will be much more stable.

You also may need to look into getting a referral to a hematologist.

 

[TorontoTRT]

Yeah I went to a hematologist and all she did was told me to stop trt lol so useless. Will taking iron supplements increased hct hg and rbc even higher then they are now? Or will the new iron just go into storage in ferritin?

 

[madman]

Yeah I went to a hematologist and all she did was told me to stop trt lol so useless. Will taking iron supplements increased hct hg and rbc even higher then they are now? Or will the new iron just go into storage in ferritin?

It will definitely increase rbc's/hemoglobin/hematocrit levels but how much no one can say for sure.....that is why it is important to try and find a protocol where you can minimize your peak--->trough TT/FT levels and at the same time run the lowest dose possible in order to achieve a TT/FT level that is not too high and at the same time not too low where low-t symptoms become problematic again.

 

[TorontoTRT]

I hear yea. My only worry with lowering dosage is the experience I had with the 40 mg every 3.5 day protocol. All trt benefits disappeared yet bloods stayed high.

 

[TorontoTRT]

On the flip side I respond better then most to blood donations. I saw a 10% drop last time. HCT went from 56 to 50 and hemoglobin from 191 to 172

 

[Systemlord]

Yeah I went to a hematologist and all she did was told me to stop trt lol so useless. Will taking iron supplements increased hct hg and rbc even higher then they are now? Or will the new iron just go into storage in ferritin?

That sounds like a healthy option, return to low testosterone. Madmans advice is sound, daily dosing and start supplementing iron and blood donations.

I hematocrit was lowest on daily dosing, -4% (50%-->46%) even compared with my EOD protocol. My levels were about the same give or take 50 ng/dL.

If you start supplementing iron now, hematocrit might increase.

 

[TorontoTRT]

Hematocrit will increase immediately? It seems like my levels reach a certain high and stay there. Like hct 56 on any protocol. Like some studies say testosterone resets a new point for hemoglobin.
How quick will iron supplements increase blood markers? Weeks? Days? If it’s gonna increase anyway might as well boost the ferritin in the mean time. Honestly I can’t do daily. I noticed I felt the best on the widest gap between shots.

 

[Systemlord]

I recently had iron below range (40), now iron is 100 and ferritin 63 and my RBC and hematocrit is the same when iron was 62 and ferritin 35 three years ago.

No one can say for certain whether or not hematocrit will increase on iron supplementation. Start low and go slow on dosing. Try 25mg glycinate twice weekly and go from there.

 

[TorontoTRT]

is 25 mg daily iron bisglycinate enough?

 

[madman]

is 25 mg daily iron bisglycinate enough?

is 25 mg daily iron bisglycinate enough?

Your ferritin was 22 just before your most recent donation.....it is definitely crashed now.

I would use iron bisglycinate at 36 mg/day.....capsules come in 18 mg and 36 mg strength.

Would be more sensible to use two 18 mg capsules morning/evening as using lower doses spread out will improve absorption.

It will take a good 3 months to get your levels up.....but seeing as your levels are going to be crashed such dose 36 mg/day may only get your levels around 50 (only blood work in 3 months will tell).

To get your level 100+ it may take 6 months at such dose.

If after 3 months at such dose 36 mg/day your levels are still not high enough you could double your dose 36 mg twice daily.

I use Now Iron Bisglycinate (dirt cheap$$$) and purchase online from here as they deliver to Canada:

18 mg strength comes in 90/120 caps
Now Foods, Iron, 18 mg, 120 Veg Capsules


36 mg strength comes in 90/120 caps
Now Foods, Iron, Double Strength, 36 mg, 90 Veg Capsules

 

[TorontoTRT]

I just bought the SISU brand iron Bisglycinate and it’s 25 mg per capsule. Should I take 50 mg a day?
My HCT went from 56 (after donation it dropped to 50) and back to 56 in exactly 3 months. Would taking this iron speed things up and bring my hematocrit back to let’s say 56 again in like a month after today’s donation?
Strange that with all these high bloods my blood pressure is excellent. Mid 90s/mid70s.

 

[madman]

I just bought the SISU brand iron Bisglycinate and it’s 25 mg per capsule. Should I take 50 mg a day?
My HCT went from 56 (after donation it dropped to 50) and back to 56 in exactly 3 months. Would taking this iron speed things up and bring my hematocrit back to let’s say 56 again in like a month after today’s donation?
Strange that with all these high bloods my blood pressure is excellent. Mid 90s/mid70s.

Supplementing iron let alone when on trt will speed up the process but regardless seeing as your ferritin will be crashed it could take 3-6 months to get your levels into a healthy range.....most likely 6 months to get in the 100 range but we have no idea where it will put your ferritin until you have bloodwork done at 3 months.

Downfall is you have to stop donating until you get your ferritin fairly high again.....otherwise in 3 months if your ferritin is still sub-par than donating again will just lower it.

The only other way to lower your rbc's/hemoglobin/hematocrit is to lower your T dose and if anything trying daily injections using lower doses as again your peak--->trough levels will be minimal and blood levels will be very stable.....you just need to find the lowest TT/FT level you can run where you still benefit from replacement.

I know you stated that you did not like daily but it would be the most sensible protocol to try as in your case constantly battling the high rbc's/hemoglobin/hematocrit since you persist to keep running the protocols you are using than you may very well be stuck chasing your tail.....high rbc's/hemoglobin/hematocrit.....donate.....crashed ferritin.....so on and so forth!

 

[TorontoTRT]

One thing to note last donation only took my ferritin down 8 points or so. And I gained about 5 of those back before this donation.