Low Iron Situation

[stevep]

I'm not 100% sure I'm asking this in the correct forum, if not a moderator can move it.

On my blood work in October my PCP found that my Iron level was low. I'm not sure how he concluded that from the October CBC Platelet and Differential since I don't see Iron specifically listed.

I advised him that I had donated a double red blood cell with the Red Cross about 3 weeks prior and that may be the cause (and 120 days prior to that as well). I met with him a couple days ago for a 90 day follow up and he ran a couple test to see if the iron level had return within range. It had not. Below are the results I have from October and this week:

January:
Hemoglobin (Hgb) - 14.9 (14.0-18.0 (gm/dL))
Hematocrit (HCT) - 48.7 (42.2-53.8 (%))
Iron - 24 (45-182 (ug/dL))

October:
Hemoglobin (Hgb) - 13.1 (14.0-18.0 (gm/dL))
Hematocrit (HCT) - 43.6 (42.2-53.8 (%))

Besides the blood donation the only thing that has changed is me adding daily Zinc and Magnesium. I'm not sure if either of these can contribute to the low iron results.

I've been eating additional meat for the protein since I'm hitting the weights harder at the gym. I really thought that and time might be enough to bring my Iron level up.

When I received the call from my PCP office they said he is going to put me on some drug for 30 days to see if that increases my Iron. Additionally, he wants to check my stools to ensure I'm not loosing blood that way. I'll go by his office tomorrow to get the RX and find out what he's putting me on for a month.

I've cancelled my whole blood donation I had scheduled for next Monday.

Any thoughts on this? Could the Zinc be the issue?

 

[Vince Carter]

The numbers you posted for HCT.HGB don't support a donation, at this time. You may indeed need to supplement iron though. I would not take whatever the Dr is prescribing unless its a specific iron supplement, and not a "drug". I just avoid drugs where ever I can. I've had iron problems, we've got plenty of iron threads in the recent weeks if you have the time to search though. There's some good tips on iron absorption like using atleast 2G of Vitamin-C, and using Lysine as well can aid iron absorption. I had to use this product to get my iron up: https://www.amazon.com/Ferretts-tab...8&qid=1516238057&sr=8-2&keywords=ferrets+iron

I had to use that twice per day to get my iron and ferritin to come up, I had used lesser supplements and nothing worked for me but Ferrets did have an improvement.

Your Dr should be running your Ferritin, too. Too if he's reading a CBC and looking at HGB and calling that "iron" you should probably find a new Dr because he's about as wrong as he can be.

 

[stevep]

The numbers you posted for HCT.HGB don't support a donation, at this time. You may indeed need to supplement iron though. I would not take whatever the Dr is prescribing unless its a specific iron supplement, and not a "drug". I just avoid drugs where ever I can. I've had iron problems, we've got plenty of iron threads in the recent weeks if you have the time to search though. There's some good tips on iron absorption like using atleast 2G of Vitamin-C, and using Lysine as well can aid iron absorption. I had to use this product to get my iron up: https://www.amazon.com/Ferretts-tab...8&qid=1516238057&sr=8-2&keywords=ferrets+iron

I had to use that twice per day to get my iron and ferritin to come up, I had used lesser supplements and nothing worked for me but Ferrets did have an improvement.

Your Dr should be running your Ferritin, too. Too if he's reading a CBC and looking at HGB and calling that "iron" you should probably find a new Dr because he's about as wrong as he can be.

Best I can tell he had to be going by my HGB to identify the low iron. Now the MCV, MCH, and MCHC in October were low as well while my RBC was slightly high.

I found some good post on here for previous iron discussions. I'll post tomorrow what he is prescribing. When I go to his office I'll see if I can get him to order Ferritin test too.

I'll order supplements and go that path. Thanks for the supplement suggestion.

 

[ratbag]

I've seen that before where a few blood donations can really deplete iron serum and or ferritin. So you may have been a low normal person and after donating twice you are low. That does happen. It happened to me and I didn't realise it until my symptoms got worse. As V Carter says vit C turned out to be crucial for me and I was able to get my iron back to normal and keep it there. This was self-induced, if I hadn't donated blood I wouldn't have gone thru this.

 

[Vince]

Vitamin C is a game changer in several areas. It's KEY with the absorption of elemental iron.


Vitamin C is up to ten times more effective at stopping cancer cell growth than pharmaceuticals such​

https://www.excelmale.com/forum/sho...-cancer-cell-growth-than-pharmaceuticals-such

 

[stevep]

I picked up my Rx from my PCP and he prescribed Ferrous Sulfate 325mg for 30 days. I believe this equals 65 mg of elemental iron.

I'll pick up some Vit C today. What is a recommended dose?

 

[Vince Carter]

I picked up my Rx from my PCP and he prescribed Ferrous Sulfate 325mg for 30 days. I believe this equals 65 mg of elemental iron.

I'll pick up some Vit C today. What is a recommended dose?

That's good actually what I've been using, too. I like to take it on an empty stomach, I've been using 2g or 2000mg of Vitamin C with it. I eat about 30 minutes later.

 

[stevep]

That's good actually what I've been using, too. I like to take it on an empty stomach, I've been using 2g or 2000mg of Vitamin C with it. I eat about 30 minutes later.

Great, thanks

 

[Vince]

I also take 1000mg twice a day but after a meal.

 

[Saul]

Steve, watch how much Vit. C you take or start slow. It can cause diarrhea for some at high doses. Also, it is my understanding that for the vitamin C (acidic drink/food/supplement) to increase iron absorption in your digestive track, it should be taken with the meal.

I agree with others, you should really get ferritin checked. That is an indicator of iron stores in the body, not just iron circulating in the blood. And, your double red donation is probably skewing your numbers from your normal range. I prefer more frequent whole blood donations than double red donations less often. Good luck.

 

[stevep]

Steve, watch how much Vit. C you take or start slow. It can cause diarrhea for some at high doses. Also, it is my understanding that for the vitamin C (acidic drink/food/supplement) to increase iron absorption in your digestive track, it should be taken with the meal.

I agree with others, you should really get ferritin checked. That is an indicator of iron stores in the body, not just iron circulating in the blood. And, your double red donation is probably skewing your numbers from your normal range. I prefer more frequent whole blood donations than double red donations less often. Good luck.

Thanks Saul. I'll keep an eye on my initial dose of Vit C to see how I handle it.

 

[Mike Wriley]

low iron, ferritin levels

Thanks Saul. I'll keep an eye on my initial dose of Vit C to see how I handle it.

I do HRT, IM testosterone, and HCG, radical prostatectomy 2008, PSA zero, used to donate blood, due to high hematocrit

last April, after feeling like crap for months, found out my ferritin was a 9, pretty low.
have been on pantiprazol for a few years for GERD, acid reflux, and I found that this can interfere with iron adsorption, rather severely in my case. switched to famitodine, and now back up to ferritin of 18, borderline. Had some checks for internal bleeds, colonoscopy, negative, so for the moment, looks like
pantiprazol was the culprit. SO BE ADVISED, low ferritin levels can not only make you feel very run down,
but the results on the rest of your blood chemistry will make you more vulnerable to infections, colds, flu, etc, I use ferricel, already has Vit C

 

[BuzzSaw]

Not sure if anyone has mentioned, but maybe look into iron IV?

 

[Vince Carter]

I did google some IV information but I was able to get my ferritin up with heavy doses, 325mg 2XD where lesser dosing wasn't working.

 

[BuzzSaw]

Quite expensive for IV, as in London it's about £200 - £300 per course!

I'm using Spatone with vit c, so hope this will get my ferritin lvls up soon. Can I ask how long you was on iron?

 

[John O'Connor]

Stevep - I've worked as a medical scribe over the last couple years reviewing lots of labs. Part of the CBC is MCV. If low (<80) it can indicate iron deficiency anemia. If high (>100) it can indicate low vitamin B12. It's not 100% accurate, for instance if your MCV is 90, you could actually be low in both iron and B12. In your case the most likely cause of low iron is the blood donations. I'd recommend checking your Vitamin D & B12 levels also. Vitamin D is required to absorb iron as well as other minerals (calcium, magnesium, zinc, etc). If your Vit D is low the iron supplement will not work as well as it should. Note Iron supplements is known to cause constipation. If that occurs, just back off. Maybe just take it every other day, instead of daily. Again, ask your doctor to check your Vitamin D & B12 levels if you have not had those checked.

 

[stevep]

I do HRT, IM testosterone, and HCG, radical prostatectomy 2008, PSA zero, used to donate blood, due to high hematocrit

last April, after feeling like crap for months, found out my ferritin was a 9, pretty low.
have been on pantiprazol for a few years for GERD, acid reflux, and I found that this can interfere with iron adsorption, rather severely in my case. switched to famitodine, and now back up to ferritin of 18, borderline. Had some checks for internal bleeds, colonoscopy, negative, so for the moment, looks like
pantiprazol was the culprit. SO BE ADVISED, low ferritin levels can not only make you feel very run down,
but the results on the rest of your blood chemistry will make you more vulnerable to infections, colds, flu, etc, I use ferricel, already has Vit C

Knock on wood I haven't had acid reflux. Actually, if the blood work hadn't come back as low iron I physically couldn't tell it was low. I felt and still feel fine.

I started the Ferrous Sulfate along with 1 gram of Vitamin C prior to going to bed. The first dose had my stool a bit loose, but it leveled out and I haven't had any issues. I'll be curious to see the results at the end of 30 days.

If its still low I can research/ask about the iron IV.

 

[Eli1947]

I developed erythrocytosis and was intersted in the mechanism of this syndrom in relation to TRT.
The medical research in that area claim that testosterone inhibit hepcidin which control the iron metabolism.
Hepcidin invove in controling absorption of iron, as such too much iron pump in. This is not all there is change in the utilization of iron in the body and increasing the activity of erythropoitin receptor which cause development of too many red blood cells. So I belive before starting supplamenting Iron it is a good idea to do blood work of free iron feritin and feritin saturation etc.

J Clin Endocrinol Metab. 2010 Oct;95(10):4743-7. doi: 10.1210/jc.2010-0864. Epub 2010 Jul 21.
Testosterone suppresses hepcidin in men: a potential mechanism for testosterone-induced erythrocytosis. J GerontolABiol Sci Med Sci. 2014 Jun;69(6):725-35. doi: 10.1093/gerona/glt154. Epub 2013 Oct 24.
Testosterone induces erythrocytosis via increased erythropoietin and suppressed hepcidin: evidence for a new erythropoietin/hemoglobin set point.Clin Endocrinol (Oxf). 2016 Nov; 85(5): 772&#8211;780.
Effect of Testosterone on Hepcidin, Ferroportin, Ferritin and Iron Binding Capacity in Patients with Hypogonadotropic Hypogonadism and Type 2 DiabetesSerum hepcidin: a novel diagnostic tool in disorders of iron metabolism[FONT=&quot]Serum hepcidin: a noveldiagnostic tool in disorders of iron metabolism[/FONT]Gaetano Bergamaschi[SUP]1[/SUP] and Laura Villani[SUP]2[/SUP]

Korean J Fam Med. 2013 Jan; 34(1): 66&#8211;68.

 

[BuzzSaw]

That's correct, I read somewhere how TRT slows down hepcidin production.

On a related note, aren't there drugs out there that causes the marrow (that produces RBC) to slow down RBC production?

From the NHS website:

Medication to reduce the production of red blood cells

In cases of PV, medication may be prescribed to slow down the production of red blood cells.
Many different medications are available and your specialist will take into account your age and health, response to venesection and red blood cell count when choosing the most appropriate one for you. Examples include:

• hydroxycarbamide &#8211; generally tolerated well, but shouldn't be taken by pregnant women or women trying to conceive
• interferon &#8211; can be taken in pregnancy, but may cause unpleasant side effects, such as hair loss and flu-like symptoms

https://www.nhs.uk/conditions/polycythaemia/

 

[Eli1947]

That's correct, I read somewhere how TRT slows down hepcidin production.

On a related note, aren't there drugs out there that causes the marrow (that produces RBC) to slow down RBC production?

From the NHS website:



Polycythaemia

[FONT=&quot]Busssaw "Polycythaemia, or erythrocytosis, means having a high concentration of red blood cells in your blood." NHS

[/FONT]True Polycythaemia and Erythrocytosis are used as interchangablly by many as in both red blood cell concentration is high but they are not the same . Polycytaemia Vera is actualy a cancer of the bone maraw and is due to mutation at the JAK2. you mentioned those drugs which are used as chemotherapy and there are new type of drug more specific
belong to the TKI family that are also used in some cases. in some cases Erythrocytosis is a responce to low oxygene such as at high altitude or sleep apneia. In the case of Testosterone the reasons are different , Testosterone increase the danger to get the situation by 300%! In this case it will not be treated with chemotherapy and what is sugested is that testosterone cause increase in erythropoietin receptor sensitivity and or iron metabolism change.
I felt that this apply to the group before trying to go on iron supplamentation with no reason. of caurse too many donations or medical phelbatomy may depleat iron storage and other important nutrients whis deserve supplamentation.
https://www.mayomedicallaboratories.com/it-mmfiles/Erythrocytosis_Evaluation_Testing_Algorithm.pdf