Low Iron & Ferritin - Blood Test

[Whereicomefrom]

I donate blood because I always have high HCT on TRT(150 per week/split Mon & Thurs). My HCT usually runs around 53-54 if I'm behind on donation. Blood test was 1 month after last blood donation. Doc's thoughts was to not take iron supplement, to just let things ride for now. No symptoms other than I do seem more fatigued. Wanted to get your alls opinion.

Ferritin - 15 ng/ml (22-322) Low
Iron - 36 ug/dl (65-175) Low
Transferrin - 430 mg/dl (215-365) High
TIBC - 538 ug/dl (218-385) High
% SAT - 7% (20-50) Low

HGB - 16.5 g/dl (13.5-17.8) Normal
HCT - 49.6% (40-53) Normal
RBC - 6.54 MIL/uL (4.2-5.6) High
MCV - 75.8 fL (80-100) Low
MCH - 25.2 pg (26.5-33.5) Low

 

[Systemlord]

Doc's thoughts was to not take iron supplement, to just let things ride for now.

Your doctor is an idiot! You will not recover iron stores on your current path! For things to improve, you have to change something, either stop donating, lower your Test dosage or try a different delivery method/treatment option.

You don't even mention what your current hormones levels are.

If you want to rid yourself of having problems with secondary erythrocytosis, thus forcing donation and crashing of ferritin levels, the newer oral testosterone options, Jatenzo, Kyzatrex and Orlando in the clinical trials had zero cases of secondary erythrocytosis due to the PK profiles!

Testosterone injections typically have the highest number of cases of secondary erythrocytosis due to the longer half-life of 5-7 days, creating a near constant hormone levels across days compared to the newer orals of 6 hour half-life.

 

[Whereicomefrom]

Your doctor is an idiot! You will not recover iron stores on your current path!

He did say to stop donating for now as my HCT at 49% was good. He just made the point if I take iron it will increase it and will have to donate again. He said since I didn't have symptoms like edema or RLS, I could go either way.

He didn't test my testosterone levels this time. They usually run high 800's to low 900's. I'm afraid next time he will lower my dosage now that blood donations are dropping my iron. I was more worried if there was any danger to iron and ferritin levels being so low.

I'm going to try subcutaneously injections and split 3 days a week. Also I'll read up on the Jatenzo orals. Might be a good option. Thanks for that info.

 

[madman]

I donate blood because I always have high HCT on TRT(150 per week/split Mon & Thurs). My HCT usually runs around 53-54 if I'm behind on donation. Blood test was 1 month after last blood donation. Doc's thoughts was to not take iron supplement, to just let things ride for now. No symptoms other than I do seem more fatigued. Wanted to get your alls opinion.

Ferritin - 15 ng/ml (22-322) Low
Iron - 36 ug/dl (65-175) Low
Transferrin - 430 mg/dl (215-365) High
TIBC - 538 ug/dl (218-385) High
% SAT - 7% (20-50) Low

HGB - 16.5 g/dl (13.5-17.8) Normal
HCT - 49.6% (40-53) Normal
RBC - 6.54 MIL/uL (4.2-5.6) High
MCV - 75.8 fL (80-100) Low
MCH - 25.2 pg (26.5-33.5) Low

Still at this all these years later I see.

You crashed your iron/ferritin from being caught upon that donating blood too frequently in order to manage elevated hematocrit merry go round most likely due to running too high a trough FT level!

You are injecting 150 mg T/week split (75mg every 3.5 days).

Blood work needs to be done at the true trough which would be 84 hrs post-injection.

Post labs trough TT, FT, estradiol and throw your SHBG in there too!

Hope your still not messing with those AAS especially the shitty compound that should be left for the cattle!

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[madman]

He did say to stop donating for now as my HCT at 49% was good. He just made the point if I take iron it will increase it and will have to donate again. He said since I didn't have symptoms like edema or RLS, I could go either way.

He didn't test my testosterone levels this time. They usually run high 800's to low 900's. I'm afraid next time he will lower my dosage now that blood donations are dropping my iron. I was more worried if there was any danger to iron and ferritin levels being so low.

I'm going to try subcutaneously injections and split 3 days a week. Also I'll read up on the Jatenzo orals. Might be a good option. Thanks for that info.

If you are hitting a trough TT 800-900s with normal let alone low SHBG then it is a given your trough FT will be high/very high!

Switching over to subcutaneous injections will most likely result in the same outcome if you are still hitting a high/very high trough FT level!

 

[madman]

Your doctor is an idiot! You will not recover iron stores on your current path! For things to improve, you have to change something, either stop donating, lower your Test dosage or try a different delivery method/treatment option.

You don't even mention what your current hormones levels are.

If you want to rid yourself of having problems with secondary erythrocytosis, thus forcing donation and crashing of ferritin levels, the newer oral testosterone options, Jatenzo, Kyzatrex and Orlando in the clinical trials had zero cases of secondary erythrocytosis due to the PK profiles!

Testosterone injections typically have the highest number of cases of secondary erythrocytosis due to the longer half-life of 5-7 days, creating a near constant hormone levels across days compared to the newer orals of 6 hour half-life.

Need to clear this up!

*mean increases from baseline in hematocrit were observed in both treatment groups at each study visit but remained within the normal range in most men (97% oral TU; 100% topical T).

*Shifts from normal hematocrit values at baseline to above the normal range were observed in 3% of oral TU patients at the final visit, compared with none of the topical T patients




From the Swerdloff paper!

Significant decrease in SHBG with the use of Oral TU (JATENZO)

SIGNIFICANT DECREASE IN SEX HORMONE-BINDING GLOBULIN WITH USE OF TESTOSTERONE UNDECANOATE CAPSULES (JATENZO) IN MEN WITH HYPOGONADISM (2022) Alyssa Yee*, Maria Uloko, Irwin Goldstein, San Diego, CA INTRODUCTION AND OBJECTIVE: Jatenzo (Clarus Therapeutics) which consists of the highly...

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Safety Results

Investigator-reported TEAEs which occurred more frequently in oral TU patients than in the topical T group were increased hematocrit, hypertension, and decreased high-density lipoprotein (HDL). Each of these events (occurring in 3–5% of oral TU patients) was reported as mild or moderate in intensity and none resulted in premature discontinuation from the study. Decreased HDL events occurred at the higher oral TU doses (316 mg and 396 mg BID), whereas events of increased hematocrit and hypertension were not related to TU dose.

As expected, based on the pharmacological actions of T, mean increases from baseline in hematocrit were observed in both treatment groups at each study visit but remained within the normal range in most men (97% oral TU; 100% topical T). Shifts from normal hematocrit values at baseline to above the normal range were observed in 3% of oral TU patients at the final visit, compared with none of the topical T patients

Erythrocytosis Associated With Oral Testosterone Replacement

Abstract Background A growing prevalence of male hypogonadism has led to increased interest in the most common adverse event, erythrocytosis. Defined by hematocrit (HCT) > 49-51%, the incidence varies depending on the testosterone formulation.3 The formulations with the lowest risk of...

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*The formulations with the lowest risk of erythrocytosis are intranasal testosterone (0-2%) and oral testosterone (0.03%).3 A phase 3 clinical trial of testosterone undecanoate (Jatenzo) reported 4.8% patients experienced an increase in hematocrit, although not severe enough to warrant therapy discontinuation.2

 

[Whereicomefrom]

Still at this all these years later I see.

You crashed your iron/ferritin from being caught upon that donating blood too frequently in order to manage elevated hematocrit merry go round most likely due to running too high a trough FT level!

Yes still on that merry go round. lol The only way I can keep HCT in acceptable ranges (without blood donations) is around 70mg a week of Testosterone. Which personally I feel horribly on that low dose.

The only thing he test concerning hormones is Total Test. I couldn't even get him to test my E2 before. Have to do those I my own. Which I will and use the 84 hrs. He does ask me to plan my shot 4 days before my blood test. .

My doc is a stickler for keeping HCT 50% and below. And no I don't use any of AAS anymore, I was only using micro doses at the time. I have been using HCG lately 250iu 3x a week.

 

[madman]

Yes still on that merry go round. lol The only way I can keep HCT in acceptable ranges (without blood donations) is around 70mg a week of Testosterone. Which personally I feel horribly on that low dose.

The only thing he test concerning hormones is Total Test. I couldn't even get him to test my E2 before. Have to do those I my own. Which I will and use the 84 hrs. He does ask me to plan my shot 4 days before my blood test. .

My doc is a stickler for keeping HCT 50% and below. And no I don't use any of AAS anymore, I was only using micro doses at the time. I have been using HCG lately 250iu 3x a week.

Your doctor has your arms tied here!

As long as you have no underlying health issues and you are not experiencing any negative sides I see no issue with running a hematocrit 50-54%.

You are in a bind here seeing as you are caught up on the donating blood too frequently merry go round to try and manage your elevated hematocrit 53-54% most likely due to running too high a trough FT level.

You crashed your iron/ferritin in order to achieve the so called needing to stay within the reference range syndrome most doctors preach!

As you stated your hematocrit 49% is now within the reference range due to the frequent blood dumping.

The downfall here is you crashed your iron/ferritin which can open up another can of worms in the long run.

Definitely not healthy running around with those levels long-term!

If you are dead set on needing to run a high trough FT level then there is no way around this unless you plan on getting your ferritin/iron healthy, avoid the blood dumping and deal with the elevated hematocrit.

Unfortunately your doctor will most likely not let this happen.

Any of the oral TU formulations would be something to look into if you want to get off injections especially when it comes to having a minimal impact on HCT.

Testosterone Therapy and Erythrocytosis - the most common dose-limiting effect of testosterone therapy

https://www.thebloodproject.com/cases-archive/testosterone-therapy-and-erythrocytosis-2/ Introduction Androgens play a crucial role in the development and maintenance of: Male reproductive and sexual functions Body composition Erythropoiesis Muscle and bone health Cognitive function...

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*Note: hematocrit of ≥54% appears to be consistent threshold to discontinuing or reducing treatment utilized by major urologic governing bodies, while the evidence for this specific cutoff is lacking.

*However, clinical practice guidelines generally recommend intervention if hematocrit of ≥54% while taking testosterone therapy; interventions include stopping testosterone therapy altogether, changing the dose or route of administration or instituting a phlebotomy regimen

 

[Systemlord]

My doc is a stickler for keeping HCT 50% and below.

The normal ranges for some doctors replaces good old fashion knowledge.

I wonder what your doctor would do for all the people living at high elevation with an HCT at 52% who aren't on TRT.

 

[Daveleeander]

My hat has been 54% for years now. My bp is normal (121/72 last time taken). I donate two or three times a year (power reds) because the Red Cross needs blood. Although my lab numbers will go down for a couple weeks, they always just come back up. I have normal white count and no other alarms. I wouldn’t worry about hct

 

[Big_Alan]

Watch Dr Andrew Winge's videos on this, don't worry about secondary erythrocytosis at any level caused by TRT. The studies that showed that problems from high Hematocrit were exclusively from *primary* erythrocytosis which included platelet dysfunction that caused the clotting.