Low ferritin but high iron levels??

[BJE]

My hematocrit is 55% on Jatenzo, I'm one of the small percentage of men that get erythrocytosis on the newer oral testosterone. I have found that the higher hematocrit and hemoglobin aren't the cause of my ED, low libido and palpitations, it's the iron levels causing these symptoms.

Your iron is high, that's it! I recently discovered I had been using large doses of iron to treat hypotension, symptoms very similar to iron deficiency which I experienced more than once in my lifetime.

Whenever I'd lower my iron dosage, I unknowingly was experiencing hypotension that I mistook for iron deficiency. You see excess iron increases blood pressure, and for someone experiencing low blood pressure, the iron treats the hypotension and for years I always suspected I was using iron to treat an unknown medical condition and recently stopped my beta-blocker and hypotension cured.

So my ferritin and iron are on lower end of the ranges and my hematocrit and hemoglobin are unchanged, still elevated yet the symptoms (irritability, heart palpitations, libido/sexual dysfunction) are starting to go away.

High iron essentially means high transferrin, so your body because of very low iron previously is shuttling iron around as fast as it can to make up for lost time. This will keep the ferritin low while iron (transferrin) is rising.

You should check for iron overload or hemochromatosis and check for the C282Y genes. If you have it, you have your reason for needing TRT because hemochromatosis causes low-T.

If he has low ferritin he does not have iron overload. The indicator of iron overload is high ferritin.

 

[Systemlord]

If he has low ferritin he does not have iron overload. The indicator of iron overload is high ferritin.

TRT increases EPO which increased erythroferrone, lowering hepcidin and ferroportin lets iron release from hepatocytes and therefore ferritin doesn't rise. So the iron has to go somewhere.

 

[BJE]

My SHBG has always been low. Even when I was taking 200mg/wk. Always floats around the 20 mark. Thanks for the advice and I agree about not donating for at least a year. As for my other health. I am pretty healthy and don’t take a lot of supplements. I have some joint issues from sports so I currently take:
Fish Oil - Omega 3s
Glucosamine+Chondroitin
Magnesium (glycinate)
B-12 injections

I eat a pretty clean diet consisting mostly of fish and chicken. On occasion I have red meat but only a few times per month. I don’t smoke and have a few beers a week. Workout and play sports 4-5 days per week and I am in good shape.

How do I get my iron levels back down?

I don’t believe high blood iron levels are a problem so long as your stored iron isn’t high. Fertitin being an indicator of stored iron. As I said in another comment, my blood iron is always high. On an iron panel my iron level is high, my % saturation is usually around 110%. This can be a couple weeks after donating blood.

 

[BJE]

I had done the 23andMe about 6 months ago so I just went in and paid to see if I had the C282Y genes. I am negative for both!!
How do I check to see if I have iron overload or hemochromatosis?

If you have low ferritin you do not have iron overload.

 

[BJE]

I would also suggest that your testosterone is too low. I keep mine between 800-1100

 

[BJE]

TRT increases EPO which increased erythroferrone, lowering hepcidin and ferroportin lets iron release from hepatocytes and therefore ferritin doesn't rise. So the iron has to go somewhere.

I’ll admit that I don’t have a clue what you are saying here but I have hemochromatosis and have monitored iron levels for years. A ferritin level of over 300 is indicative of iron overload. My blood iron level and saturation level is always high but I have driven my ferritin too low by blood donation. I’m supposed to be keeping it 30-50. As long as ferritin is not high, high blood iron is not a problem. High blood iron is moved to storage and drives up ferritin. I can’t control the fact that I absorb too much iron but I can control my ferritin level.

 

[madman]

I would also suggest that your testosterone is too low. I keep mine between 800-1100

He has lowish SHBG, if he bumped his trough TT from 446 ng/dL--->700 ng/dL his trough FT would be high!

Push the poor chaps trough TT 900-1000+ ng/dL and his trough FT would be absurdly high.

Show me a healthy young natty male walking around with a high-end TT let alone 1000+ with FT through the roof that has low/lowish SHBG.

Such does not exist!

Hope you understand that a FT 20-25 ng/dL is high!

Judging by his opening thread the last thing he wants to do is drive his trough FT too high!

Although his trough TT may seem far from stellar he has lowish SHBG and his trough FT 10.6 ng/dL is hovering around the mean.

Does he have room to push it higher.....sure but it is not low!

Age-stratified reference ranges for directly measured (ED LC-MS/MS) serum free testosterone in healthy men

Just to be clear up any confusion this is Fiers camps data for mFT reference ranges not the harmonized reference range being worked on by the CDC. *Serum samples were analyzed from healthy men participating in the SIBLOS/SIBEX and EMAS studies, both population-based cohort studies * mFT...

www.excelmale.com

*We established mFT reference ranges for healthy men aged 18 to 69 years




We present 95% mFT age-stratified reference ranges

Age category (years)	Median mFT (ng/dl)	95% mFT reference range (ng/dl)
18-29 (n=140) 30-39 (n=252)	12.0 9.8	6.7-25.3 4.9-18.5
40-49 (n=207)	8.1	4.3.14.2
50-59 (n=146)	7.1	3.8-12.8
60-69 (n=126)	6.4	3.4-11.7
70-79 (n=125)	5.6	2.7-8.7

*The gold-standard for the determination of FT levels is considered to be directly measured free testosterone (mFT) using equilibrium dialysis followed by mass spectrometry (ED LC-MS/MS). However, no widely accepted reference ranges are available for this clinical parameter. We established mFT reference ranges for healthy men aged 18 to 69 years









*Serum samples were analyzed from healthy men participating in the SIBLOS/SIBEX and EMAS studies, both population-based cohort studies


* mFT levels were measured in 867 men using ED LC-MS/MS as previously reported (1).

Reference: 1. Fiers T, Wu F, Moghetti P, Vanderschueren D, Lapauw B, Kaufman JM. Reassessing Free-Testosterone Calculation by Liquid Chromatography–Tandem Mass Spectrometry Direct Equilibrium Dialysis. J Clin Endocrinol Metab. 2018;103(6). doi:10.1210/jc.2017-02360


This is the well known paper that got everyone's dick hard!

You have some of those same clowns on here turning a blind eye now because they can't handle the fact let alone admit that a FT 20 ng/dL is high LMFAO!

Reassessing Free-Testosterone Calculation by Liquid Chromatography–Tandem Mass Spectrometry Direct Equilibrium Dialysis

Reassessment of FT in women and men with state-of-the-art methodology confirms previously established FT percentages but highlights limitations of differen

academic.oup.com

In the current study, we used a state-of-the-art direct ED method to reassess FT in sets of representative serum samples. This method takes advantage of the ability of a highly sensitive and accurate measurement of T by liquid chromatography–tandem mass spectrometry (LC-MS/MS) to reliably measure the low FT concentration directly in the dialysate after ED. This more straightforward method avoids potential sources of inaccuracy in indirect ED, such as those resulting from tracer impurities or from measures to limit their impact (e.g., sample dilution). We then used the measured FT results to re-evaluate some characteristics of two more established and a more recently proposed calculations for estimation of FT.

 

[BJE]

He has lowish SHBG, if he bumped his trough TT from 446 ng/dL--->700 ng/dL his trough FT would be high!

Push the poor chaps trough TT 900-1000+ ng/dL and his trough FT would be absurdly high.

Show me a healthy young natty male walking around with a high-end TT let alone 1000+ with FT through the roof that has low/lowish SHBG.

Such does not exist!

Hope you understand that a FT 20 ng/dL is high!

Judging by his opening thread the last thing he wants to do is drive his trough FT too high!

Although his trough TT may seem far from stellar he has lowish SHBG and his trough FT 10.6 ng/dL is hovering around the mean.

View attachment 46649

Does he have room to push it higher.....sure but it is not low!

Age-stratified reference ranges for directly measured (ED LC-MS/MS) serum free testosterone in healthy men

Just to be clear up any confusion this is Fiers camps data for mFT reference ranges not the harmonized reference range being worked on by the CDC. *Serum samples were analyzed from healthy men participating in the SIBLOS/SIBEX and EMAS studies, both population-based cohort studies * mFT...

www.excelmale.com

*We established mFT reference ranges for healthy men aged 18 to 69 years




We present 95% mFT age-stratified reference ranges

Age category (years)	Median mFT (ng/dl)	95% mFT reference range (ng/dl)
25-29 (n=148)	10.3	5.6 - 17.1
30-39 (n=252)	9.7	4.9 - 18.1
40-49 (n=207)	8.0	4.3 - 13.5
50-59 (n=146)	7.0	3.8 - 12.6
60-69 (n=114)	5.9	3.3 - 11.9

*The gold-standard for the determination of FT levels is considered to be directly measured free testosterone (mFT) using equilibrium dialysis followed by mass spectrometry (ED LC-MS/MS). However, no widely accepted reference ranges are available for this clinical parameter. We established mFT reference ranges for healthy men aged 18 to 69 years








*Serum samples were analyzed from healthy men participating in the SIBLOS/SIBEX and EMAS studies, both population-based cohort studies


* mFT levels were measured in 867 men using ED LC-MS/MS as previously reported (1).

Reference: 1. Fiers T, Wu F, Moghetti P, Vanderschueren D, Lapauw B, Kaufman JM. Reassessing Free-Testosterone Calculation by Liquid Chromatography–Tandem Mass Spectrometry Direct Equilibrium Dialysis. J Clin Endocrinol Metab. 2018;103(6). doi:10.1210/jc.2017-02360


This is the well known paper that got everyone's dick hard!

You have some of those same clowns on here turning a blind eye now because they can't handle the fact let alone admit that a FT 20 ng/dL is high LMFAO!

Reassessing Free-Testosterone Calculation by Liquid Chromatography–Tandem Mass Spectrometry Direct Equilibrium Dialysis

Reassessment of FT in women and men with state-of-the-art methodology confirms previously established FT percentages but highlights limitations of differen

academic.oup.com

In the current study, we used a state-of-the-art direct ED method to reassess FT in sets of representative serum samples. This method takes advantage of the ability of a highly sensitive and accurate measurement of T by liquid chromatography–tandem mass spectrometry (LC-MS/MS) to reliably measure the low FT concentration directly in the dialysate after ED. This more straightforward method avoids potential sources of inaccuracy in indirect ED, such as those resulting from tracer impurities or from measures to limit their impact (e.g., sample dilution). We then used the measured FT results to re-evaluate some characteristics of two more established and a more recently proposed calculations for estimation of FT.

I did not pay attention to the low SHBG. Mine is generally in the 40’s so I have to be over the top of the total range before I get to the top of the free range. A total level of around 800 only gets my free level to about mid range.

 

[madman]

I did not pay attention to the low SHBG. Mine is generally in the 40’s so I have to be over the top of the total range before I get to the top of the free range. A total level of around 800 only gets my free level to about mid range.

Glad you cleared that up!

Yes if one had SHBG in the 40s a trough TT 1000 ng/dL would have FT high!

FT 20-25 ng/dL is high!

Even then need to keep in mind injection frequency when speaking about trough.

Big difference between one running a high (20-25 ng/dL) or better yet absurdly high (30 ng/dL) trough FT injecting daily vs every 3.5 days let alone once weekly!

A healthy young male has a daily peak/trough, the peak is short-lived, trough is 20-25% lower.

Even if you took the outlier nattys hitting a high-end FT again this is a short-lived daily peak.

Not a trough - depending on injection frequency - 2 days later (EOD), 3 days later (M/W/F), 3.5 days later (twice-weekly), let alone 7 days later (once weekly)!

Get the point I am trying to stress here!

You have men on TTh running around with high let alone absurdly high FT levels at trough and this would be 3.5 f**king days post-inject on a twice-weekly protocol or 7 days post-injection on a once weekly protocol.....go figure!