Iron Supplementation Protocol to Raise Ferritin FAST While on TRT

[magnus68]

""

The key to keeping the ferritin level in place is having a hemoglobin that's solid -- that's why an anemic woman with an HGB of, say, 12, will see an increase in ferritin fall right back.
We are especially suited to keeping our ferritin in the TRT community.
If we were to talk outside of that, then it's a big question mark.
I had a guy with hemochromatosis try it. Since in hemochromatosis, you don't make or don't use hepcidin, it failed. (So I added warning text to my page).
If you have chronic low ferritin, it could be the very early stages of hemochromatosis. I've seen it in two people now -- they had a hard time raising ferritin (even without my protocol, like generally, their ferritin didn't go up ever) and I told them to get genetic tests. Both of them showed as carriers for HFE mutations.
So there are situations where someone might have low ferritin and high HGB not on TRT where I would urge caution.
One situation I can think of not having to do with TRT is a chronic hypoxic condition driving RBCs, like apnea, or a B12 injection abuser, or a rare variant of Polycythemia Vera that is red-cell only (it actually does happen). In those cases, my protocol should work, but I haven't heard back from anyone with those situations yet.

I do have hemochromitosis...High hemoglobin 51 and Ferritin 34. TIBC off the charts and Iron in range. How would you recommend I get Ferritin a little higher?

 

[realdeal1977]

@FDV70

A Reddit poster turned me on to your page and this post after I asked some questions due to recent bloodwork. I read through everything. I am ready to take the plunge. I wanted to make a post to see if you had any additional insights on my situation, and verify some key points. Thanks for taking the time to write up your thoughts. Really great work.

Started T Cyp injections about 2 1/2 months ago. Taking 140 mg T weekly plus 1,400 units HCG. No AI as of yet. I am doing daily injections because of low SHBG.

T 500
Free T 170
SHBG 10
Hematocrit 46
Hemoglobin 15
E2 22
Iron Total 67 (almost in the red)
Iron Binding 396
% Saturation 17
Ferritin 11 (historically before TRT, 225)
I have sleep apnea and use a CPAP for the last 5 years
20 mg T Cyp per day
200 units of HCG per day
Losartan daily for HBP
Famotidine daily due to a Hiatal Hernia
Had my first kidney stone last month, and have been drinking 1 gallon a day since passing

A few items I wanted to clarify based off of your article:

- You mentioned not to do IV iron infusion. Before I found your site, I was looking into it. I believe you are saying not to do so because our Hemoglobin isn't crashed also, and doing so would cause liver issues. Correct?

- With my ferritin being very low, how many time should I run the protocol to get back closer to the 100 level you stated is hard to get above? How often can I run it? For example, if 4 days it the ideal, can I run that every week for one month? Of is that too much?

- I am doing daily pinning because of the lower SHBG, to try to smooth things out and avoiding E2. Would you recommend a different frequency, or does it not matter because of the half life of T Cyp and the level stays relatively consistent if you are doing every day or every other day? Or do you think something like once per week might assist here? I am guessing not because your natural graph shows intraday T level in a young man, and it varied significantly within the day of which none of what I mentioned will help.

- Once things are back to "normal", you recommend getting iron through food, mainly meats. I am assuming though that no matter what, bloodwork is essential to monitoring Hematocrit and Ferritin. Seems like it is just one of those things that requires this because there really is no way around it. If Hematocrit is up, you donate. This reduces your Ferritin. After donating, do the protocol to replace the Ferritin. How often would you monitor bloodwork? Monthly?

- Would a non T injection / cream protocol reduce all of this? Meaning, if someone was on HCG monotherapy or Enclomiphene only, because the body is producing natural T would this not be an issue? Or does that not matter because either way you will have a different EPO set point, it's just happening in a different way?

 

[magnus68]

Iron polysaccharide replaces ferritin directly.

But will it raise hematocrit

 

[mcs]

Oral supplemental delivery of iron to raise ferritin levels has been a total failure for me. I have tried most every form of iron available in the states and abroad. Too much interference with gut bacteria, I suspect. The ONLY form, I believe, that may protect against the wrong gut bacteria using it as food is a type of liposomal iron that I was able to get from this company, Also, sucrosomial iron may work to prevent this.

Anyone with even minor gut issues SHOULD STEER CLEAR FROM ORAL SUPPLEMENTAL IRON. There's too much interaction with potentially wrong type of gut bacteria that can use the iron as a food source and grow out of control, making the gut issues even worse and block absorption, defeating the purpose. This issue does not seem to apply to naturally-occurring iron in heme-rich foods, but eating liver and spleen (higher heme iron than liver) I cannot eat but once in a great while. I suspect that more than half of the people out there have some form of dysbiosis which makes taking oral iron supplementation a challenge. and at worst case, a total detriment.

I also looked into transdermal deliveries using electrophoresis patches, but I don't think the proposed product ever got off the ground.

I noticed that curcumin is a very potent iron chelator and completely wipes out my iron levels, ferritin, hemoglobin, hematocrit, RBCs, but I need it to reduce inflammation.

When it's all said and done, for those that need to replete iron and/or ferritin due to IDA/hypoferrinemia/gut issues, why not just opt for a physician monitored IV iron infusion and get it over with (obviously with strict iron panel/CBC monitoring)? And I mean very strict monitoring because iron itself WILL accentuate ROS (reactive oxygen species) and ferritin is an acute phase reactant and too much is PRO-INFLAMMATORY.

 

[realdeal1977]

@FDV70

A Reddit poster turned me on to your page and this post after I asked some questions due to recent bloodwork. I read through everything. I am ready to take the plunge. I wanted to make a post to see if you had any additional insights on my situation, and verify some key points. Thanks for taking the time to write up your thoughts. Really great work.

Started T Cyp injections about 2 1/2 months ago. Taking 140 mg T weekly plus 1,400 units HCG. No AI as of yet. I am doing daily injections because of low SHBG.

T 500
Free T 170
SHBG 10
Hematocrit 46
Hemoglobin 15
E2 22
Iron Total 67 (almost in the red)
Iron Binding 396
% Saturation 17
Ferritin 11 (historically before TRT, 225)
I have sleep apnea and use a CPAP for the last 5 years
20 mg T Cyp per day
200 units of HCG per day
Losartan daily for HBP
Famotidine daily due to a Hiatal Hernia
Had my first kidney stone last month, and have been drinking 1 gallon a day since passing

A few items I wanted to clarify based off of your article:

- You mentioned not to do IV iron infusion. Before I found your site, I was looking into it. I believe you are saying not to do so because our Hemoglobin isn't crashed also, and doing so would cause liver issues. Correct?

- With my ferritin being very low, how many time should I run the protocol to get back closer to the 100 level you stated is hard to get above? How often can I run it? For example, if 4 days it the ideal, can I run that every week for one month? Of is that too much?

- I am doing daily pinning because of the lower SHBG, to try to smooth things out and avoiding E2. Would you recommend a different frequency, or does it not matter because of the half life of T Cyp and the level stays relatively consistent if you are doing every day or every other day? Or do you think something like once per week might assist here? I am guessing not because your natural graph shows intraday T level in a young man, and it varied significantly within the day of which none of what I mentioned will help.

- Once things are back to "normal", you recommend getting iron through food, mainly meats. I am assuming though that no matter what, bloodwork is essential to monitoring Hematocrit and Ferritin. Seems like it is just one of those things that requires this because there really is no way around it. If Hematocrit is up, you donate. This reduces your Ferritin. After donating, do the protocol to replace the Ferritin. How often would you monitor bloodwork? Monthly?

- Would a non T injection / cream protocol reduce all of this? Meaning, if someone was on HCG monotherapy or Enclomiphene only, because the body is producing natural T would this not be an issue? Or does that not matter because either way you will have a different EPO set point, it's just happening in a different way?

I did some more research on myself. I found that before I was on TRT, way back in 2011 when I was 31, I had low Iron and low ferritin. Not as low as today, but still low below the lower band.

I recalled that I did 23 and me at one point, so I downloaded the raw data and put it into an analyzer. It does say something about heterozygous hemochromatosis. See attached. That means this method won't work for me?

 

[FDV70]

Thanks for you post. Please do correct me on such things.

I apologize that I conflated sleep issues directly with inflammation. I was referring to results of sleep apnea, and inflammation related to hypoxia. Probably not IL-6 related without other causative contributors?

How about we toss the sleep example and sub in a "fever from virus exposure" as possible phase reactant cause?

My point was that 7 points difference in ferritin labs is not terribly significant without further serial testing, and can just represent noise in testing methodology or movement from phase reaction. A longer term trend would be more useful and conclusive.

"My point was that 7 points difference in ferritin labs is not terribly significant"

It's plausible it's testing itself I suppose.

Hypoxia will drive up Hypoxia-inducible Factor 1-alpha which is inflammatory, but it's not the prime mover of hepcidin. But it can contribute. Hypoxia's biggest contributor is EPO up -> erythroferrone up -> hepcidin down. In the case of apnea, I would imagine HIF-1a is probably at a steady state, but EPO might be cyclical enough

"fever from virus exposure"

Absolutely would give a bump to ferritin, but when hemoglobin is 16 or higher, you actually keep the ferritin that goes up when it's under 70. We've seen it in guys on TRT after covid.

I think the lab measure difference makes a lot of sense.

 

[FDV70]

I do have hemochromitosis...High hemoglobin 51 and Ferritin 34. TIBC off the charts and Iron in range. How would you recommend I get Ferritin a little higher?

You can't. This is a REALLY long explanation, but high ferritin in cases of hemochromatosis happens after years, and I mean decades, of high serum iron because ferroportin lets all of it slip out of cells. Eventually there is so much iron that it has nowhere to go and starts piling up like a clogged drain at age 60 to 65 or so. Anyone doing my protocol with hemochomatosis will make their hemoglobin worse. That ferritin of 34 will never go over 50, about. Roughly. It's cellular overflow from things like liver cell injury. I mean like the explanation is LONG, but without hepcidin (which is what hemochrom is, it is either a lack of hepcidin, or too little, or the body cannot use it, there are 4 types of hemochrom known and 2 subtypes) you cannot predictably build ferritin. Unless you seriously overload your body, and then you are piling iron up to the point where it clogs cells and ferritin goes up unpredictably. Like to 500, and your doctor goes "Good God man, let's get you phlebotomized..."

 

[FDV70]

Test for the hemochromatosis gene (C282Y and H63D) came back negative.

Did another 4 days of your protocol and got my levels checked again and my ferritin was 35. So 1 point higher than last time but still lower than my original result of 40. Tsat, TIBC, and everything else was normal. Everything normal on CBC. Tests were done roughly 4 days after finishing the protocol.

The strange part is that my fatigue issues have gone away after the protocol despite my numbers not moving.

I am really not sure how to explain this meager increase unless your RBCs were in the 4.x range. The protocol leverages our erythrocytosis on TRT so guys with high RBC tend to get good results. I really am not sure whats going on unless you have vitamins or supplements that are killing hepcidin. I had one guy INSIST that he could not give up his seafoods which were high enough in vit D to cause my protocol to give him crap results. He re-ran and had better results. (I can't look up particulars because I've been reading reports in PMs and forums for a couple years from going on maybe 100 guys now.) You must skip any vitamins C and D during the 5 days. You mention nicotine and that should only raise RBCs, it should not affect anything else.

 

[jayman2239]

I am really not sure how to explain this meager increase unless your RBCs were in the 4.x range. The protocol leverages our erythrocytosis on TRT so guys with high RBC tend to get good results. I really am not sure whats going on unless you have vitamins or supplements that are killing hepcidin. I had one guy INSIST that he could not give up his seafoods which were high enough in vit D to cause my protocol to give him crap results. He re-ran and had better results. (I can't look up particulars because I've been reading reports in PMs and forums for a couple years from going on maybe 100 guys now.) You must skip any vitamins C and D during the 5 days. You mention nicotine and that should only raise RBCs, it should not affect anything else.

RBC was 5.62 last CBC I had done.

I’m pretty certain I was good about avoiding Vitamin C and D during the 2 times I ran the protocol, but in another week or so I’ll run it again and strictly eat just chicken/rice and protein powder for the 5 days and see if there’s any change and report back.

 

[Clear]

RBC was 5.62 last CBC I had done.

I’m pretty certain I was good about avoiding Vitamin C and D during the 2 times I ran the protocol, but in another week or so I’ll run it again and strictly eat just chicken/rice and protein powder for the 5 days and see if there’s any change and report back.

are you on an ace inhibitor by chance? read a study where that inhibited hepcidin as well. I'll see if I can find it again

I started the protocol two days ago, I'll update when I finish with labs

 

[realdeal1977]

I might have missed it somewhere. How long after the protocol should I get labs? Can I get them the day after day 5?

 

[realdeal1977]

Oral supplemental delivery of iron to raise ferritin levels has been a total failure for me. I have tried most every form of iron available in the states and abroad. Too much interference with gut bacteria, I suspect. The ONLY form, I believe, that may protect against the wrong gut bacteria using it as food is a type of liposomal iron that I was able to get from this company, Also, sucrosomial iron may work to prevent this.

Anyone with even minor gut issues SHOULD STEER CLEAR FROM ORAL SUPPLEMENTAL IRON. There's too much interaction with potentially wrong type of gut bacteria that can use the iron as a food source and grow out of control, making the gut issues even worse and block absorption, defeating the purpose. This issue does not seem to apply to naturally-occurring iron in heme-rich foods, but eating liver and spleen (higher heme iron than liver) I cannot eat but once in a great while. I suspect that more than half of the people out there have some form of dysbiosis which makes taking oral iron supplementation a challenge. and at worst case, a total detriment.

I also looked into transdermal deliveries using electrophoresis patches, but I don't think the proposed product ever got off the ground.

I noticed that curcumin is a very potent iron chelator and completely wipes out my iron levels, ferritin, hemoglobin, hematocrit, RBCs, but I need it to reduce inflammation.

When it's all said and done, for those that need to replete iron and/or ferritin due to IDA/hypoferrinemia/gut issues, why not just opt for a physician monitored IV iron infusion and get it over with (obviously with strict iron panel/CBC monitoring)? And I mean very strict monitoring because iron itself WILL accentuate ROS (reactive oxygen species) and ferritin is an acute phase reactant and too much is PRO-INFLAMMATORY.

I have been curious on the IV infusion side as well. The notes however said it would be hard on the liver and potentially sky rocket hemoglobin and hematocrit, unless I read it wrong. I would certainly be willing to do the IV infusion if it makes sense.

 

[FDV70]

I might have missed it somewhere. How long after the protocol should I get labs? Can I get them the day after day 5?

Yes, you can get labs right away.

 

[David B]

Due to unfortunate diet and a substantial increase in my testosterone dose over the past ~month, I think I may have tanked my already-low ferritin. My diet is effectively vegan and my ferritin, which I haven't measured in ~2 years, was 32. I have only donated blood once and it was 2+ years ago.

I began noticing uncharacteristic lethargy a few weeks ago. Normally I would get lab work done, but I am budget constrained at the moment and prices for lab work appear to have increased in the past two years.

I have been following your protocol for 4 days now and I feel much better. It is like I am a new person. It could be placebo, and I will not have the before-and-after labs to say either way, but I wanted to share my experience regardless.

I plan to continue the protocol through today and then stop (so ~5 days total).

hey man! i have been succesfull vegan as well - but after a blood donation my ferrtin was low as well. startet this protocoll as well. let's see!!! how did your levels improve? any prolems wit being on TRT and your ferritin while being vegan? Greetings from Germany!!!

 

[David B]

Hi all, I started TRT in 2001 and have been giving blood over the years and have always had issues with recovering my ferritin. Long story short, I got tired of waiting for others to do the research, so I did it myself, created a protocol, hired a hematologist in May 2021 who thought it could work, ran it by him, and tried it on myself. It worked (I was able on my first try to raise ferritin 10 points in 3 days, but I've learned more since then). I have shared it with other guys on TRT who have seen the same success. Now I'd like to share it with you.

How to raise ferritin, the short version
Three 60mg doses a day of Ferrous bisglycinate chelate spaced apart at 9am, 3pm, and 8pm all on the same day, at least 3 days in a row. You MUST NOT be taking vitamins C and D. Your Estradiol should ideally be 20-60pg/mL range. (I'm not saying never take vitamins C and D. Just not during these days.) The times of day absolutely do matter. Your initial dose of iron MUST be 60mg or higher. Subsequent doses may be 60 or higher. Right now I'm telling people do not exceed 300mg in a day.

The key to raising ferritin is understanding how hepcidin works. Saying that it "blocks absorption" as you see in a lot of blogs is incredibly misleading. It binds to and degrades ferroportin, trapping iron in cells and blocking export of iron into serum. A large portion of that trapped iron will become ferritin. Vitamins C and D both crush hepcidin (which obviously increases the amount of iron in your blood, but guys with high hemoglobin want to avoid that).

My ferritin drops 5 points with a donation of whole and 10 points with a double red donation. Most recently, my ferritin was at 26. I donated 455ml of RBCs, followed my post-donation protocol for 4 days, and my ferritin was at 28. My intention is to develop my protocol further with more days and use of Adenine. The point for now is that you can put ferritin back to where it was pre-donation.

I have this written up in lengthier form because it's a LOT, and I wanted to explain everything about it to doubters and put sources to it. I have the long explanation here on my own, non-commercial site:

Fixing High Hemoglobin or Hematocrit and Low Ferritin While on TRT

Dear FD!
i am now in my third day of your protocoll!!!

i have sent you a message via FB/added you - and maybe you'd like some "remarks" on your protocoll- dont get me wrong, i totally trust in your bio-chemistry knowledge! just some thoughts/remark on my end. thank you for all the freaking research!!!

 

[Over50Adventurer]

Hey there @FDV70, I was just about to start your protocol today and found a little note on your site that said, "this protocol is for guys with a hemoglobin of 16 or higher."

Now I'm wondering what to do to get my numbers right. Right now my numbers are:

Ferritin 13 ng/mL
HCT 44.3%
Hemoglobin 13.6%
MCH 24.7 pg
MCHC 30.7 g/dL

I have other numbers but not sure it matters.

So if I need to raise my hemoglobin before I do your protocol, should I just take a normal iron supplement for a while? Or add vitamin C to your protocol for one 5-day sprint? Something else?

Any guidance appreciated!

 

[andrewBwinter]

Ferritin lab results do not solely show stored iron level. Ferritin is also a phase reactant that responds to levels of inflammation. It can be wildy inaccurate. When I had a severe reaction to an infused cancer drug, my ferritin increased to 2000 for a short period, then resolved right back to normal level.

You are talking about single digit variations here. A change of 7 points. This much change could happen because your higher number was after a meal with something that slightly provoked you immume system, or you have a bad night's sleep, lack of oxygen leading to a little inflammation.

Interesting. I had arthroscopic surgery on my ankle and Canadian Blood Services declined to let me donate after 6 weeks of recovery (I was still limping). I decided to wait a year to donate and my ferritin went up to 126 from 26 (pre-TRT). If inflammation has an effect on ferritin then that seems positive. I started TRT in October 2021 and look what happened:

 

[Systemlord]

Interesting. I had arthroscopic surgery on my ankle and Canadian Blood Services declined to let me donate after 6 weeks of recovery (I was still limping). I decided to wait a year to donate and my ferritin went up to 126 from 26 (pre-TRT). If inflammation has an effect on ferritin then that seems positive. I started TRT in October 2021 and look what happened:
View attachment 30914

The decreasing ferritin could easily be explained by TRT, which did the same to my ferritin levels. I had a ferritin level at 128 and after a few months on TRT, ferritin dropped to 24 for a second time.

In cases of inflammation, you’ll often see high ferritin levels.

 

[andrewBwinter]

The decreasing ferritin could easily be explained by TRT, which did the same to my ferritin levels. I had a ferritin level at 128 and after a few months on TRT, ferritin dropped to 24 for a second time.

In cases of inflammation, you’ll often see high ferritin levels.

Can't argue with you on that. I was interested in the rapid rise of ferritin due to the potential inflammation from the surgery. Interesting concept to raise ferritin, just not sustainable to keep getting injured

 

[FDV70]

Hey there @FDV70, I was just about to start your protocol today and found a little note on your site that said, "this protocol is for guys with a hemoglobin of 16 or higher."

Now I'm wondering what to do to get my numbers right. Right now my numbers are:

Ferritin 13 ng/mL

Hemoglobin 13.6%

So if I need to raise my hemoglobin before I do your protocol, should I just take a normal iron supplement for a while? Or add vitamin C to your protocol for one 5-day sprint? Something else?

Any guidance appreciated!

I'm curious as to why you're under 14 and on TRT.

Sorry it took me so long to see.
You would need a higher hemoglobin, which you probably guessed.
Raising it would take:
50,000 units vitamin D, 1 gram vitamin C, and one 70mg iron dose all together at 9am every day for between 1 to 2 weeks.
This will move your hemoglobin north pretty rapidly.

Then... you have to wait a week for the vitamin D to clear. Half life and all that. Then check hemoglobin and start my protocol.