Need to build my Ferritin Back up. Need suggestions please.

[Vince Carter]

I sent a PM just don't take that from the poeple on the desk at Defy. They're directing your medical care by doing that and they're not qualified to do so.

Donate blood and go back on the Feosol or argue with the Defy office attendent when he see's my HCT and demands I donate blood and pay for a retest before I can schedule a consult?

 

[madman]

Sorry grayiron I don't need your book on iron.

Update to this thread.
I did a mini blood test last week, thank you Nelson for DiscountedLabs, just to see how the ferritin was recovering and since TT/FT was on sale for 30 buck who could resist that.
I had stopped the 45mg Feosol Carbonyl iron tablets and 4 boiled chicken livers after one month. Probably need to go back on them for another month?

What do you guys think?
Donate blood and go back on the Feosol or argue with the Defy office attendent when he see's my HCT and demands I donate blood and pay for a retest before I can schedule a consult?

As you guys may or may not know I live south of Denver about 6000 ft above sealevel. My HCT pre TRT is 49.

Your at a catch 22.....as you know when ones ferritin is really low from too frequent donations it takes time when supplementing for levels to build back up.

Seeing as your HCT pre-trt is naturally 49 it has only jumped up a little.....you still need to improve upon your ferritin and if you donate right away you will be back to square one even if you start up the iron supplementation again.

What I see is you could look into lowering your overall testosterone dose as your free t is almost double the top end of the physiological range and your total is high so lowering your dose would be sensible.

I know you feel great on the protocol you are on but you have lots of room to bring down your free t.

Even if you decide to start supplementing the iron again and than start donating you will just be chasing your tale struggling to bring up your ferritin as you will be losing it every time you donate.

When one has really low ferritin one needs to stop blood donations for awhile and start supplementing iron until they can get their ferritin in a healthy range.

I would say lowering your testosterone dose and start iron supplement again before donating right away.

 

[madman]

4 over the last 14 months of being on TRT.
To be fare. no one PCP or TRT doc ever checked my ferritin. I asked for it to be added on my retest HCT post blood donation.

My first blood donation was May 22 2017, then Jul 20 2017, then Sep 21 2017, and finally Jan 25 2018

Getting my ferritin back to a healthy lvl is priority one. I don't care where my HCT goes during this process.

I have a theory my Jan 2018 51.7 HCT was a bad/botched blood test. Who goes from 43.0 to 51.7 in 8 weeks?
No one goes from 51.7 to 45.9 with one pint whole blood donation.

This bad blood test caused me to donate when I did not need it.

Donating every 60 days as you did in May/July/September was way too often and likely what caused you tanking your ferritin.....mind you pre donating you may have already had low/normal levels of ferritin.

Donating more than 2-3 times per year will increase ones chances of ending up with low ferritin as once levels are very low it takes at least 3-4 months to build them back up.....hence when supplementing to bring ferritin back up without stopping donating for a while will results in one chasing their tale.

 

[Deleted member 16042]

Hate to say it FL, I know you have been adjusting your T dosage downwards until you feel symptoms, but your total T and especially free T number have a lot of room to decrease.

I am in the exact same predicament except I live at more than 50% even higher elevation. Ferritin is too low and HCT still at 51. Saya is actually OK with that, as long as I am asymptomatic, attributing my situation to the altitude, but I am not OK with it, hence my further reduction in T dosage.

Just something to consider.

 

[ratbag]

My HCT is also like 53 but my MD locally said it has nothing to do with polycythemia so I am fine and not to worry about it. When I had my appoint with Dr. Saya he saw that and then looked at the rest of my CBC and claimed my MD was correct and not to worry about my HCT. Clearly high HCT by itself is not the issue they worry about.

I find way too many people here get derailed over high HCT because they assume high HCT by itself is a problem. You add to that those who live with altitude and everyone makes the assumption high HCT is bad... it isn't unless you have polycythemia. Also the large majority of TRT MD's do not even look at HCT let alone Rx phlebotomies. Dr. Crisler doesn't consider it all anymore unless he see's ones platelets are high. Also you never hear of patients on TRT dying of high HCT or polycythemia anywhere.

When my iron was really low and I was taking iron supps my HCT was at 57 and again my local MD said not to worry about it and I felt great at the time.

 

[FeelingLost]

Hi Madman and Blackhawk,
Thank you guys for looking over my thread and offering up some great suggestions.

Just so you know. This TT/FT test was my peak NOT trough.
I wanted to know what my peak was on a M/W/F protocol since we all process T differently
I knew I needed to measure it that there are no app for that like determining FT. An who could resist Nelsons sale on TT/FT.

So this number is just another piece of my puzzle along the way. I need my trough number E2 and prolactin at this protocol. Then my plan is to drop to .18 (36mg)

In case anyone is interested my original protocol:
.25(50mg) M/W/F T cyp, 400HCG M/T (800/wk) .125 AI same day as injections.
results after 2 months TT trough 1175 FT 33, E2 29, HCT 51.7

My current protocol:
.20(40mg) M/W/F T cyp, 200HCG (600/wk) .125 AI as I feel the need. Currently 1 around Thursday.
and I have NOT donated blood since I got the crashed ferritin blood results. So i am going on 7 months with no blood letting. haha

What do you think? am I approaching this slow enough an in the right way?

Given Defy might withhold my protocol consult on Julys upcoming blood test do to the 51.3HCT should I start taking the Feosol and donate a pint before the July blood draw?

 

[FeelingLost]

My HCT is also like 53 but my MD locally said it has nothing to do with polycythemia so I am fine and not to worry about it. When I had my appoint with Dr. Saya he saw that and then looked at the rest of my CBC and claimed my MD was correct and not to worry about my HCT. Clearly high HCT by itself is not the issue they worry about. I find way too many people here get derailed over high HCT because they assume high HCT by itself is a problem. You add to that those who live with altitude and everyone makes the assumption high HCT is bad... it isn't unless you have polycythemia. Also the large majority of TRT MD's do not even look at HCT let alone Rx phlebotomies. Dr. Crisler doesn't consider it all anymore unless he see's ones platelets are high. Also you never hear of patients on TRT dying of high HCT or polycythemia anywhere.

Hi ratbag, thanks for the post.
You might be missing the point. Please look back at post 32.
The front office held my TRT Doctor consult hostage until I fix my 51.7 HCT.
You are right I don't worry about my HCT I monitor my blood pressure daily and know when my HCT starts getting high.

 

[madman]

My HCT is also like 53 but my MD locally said it has nothing to do with polycythemia so I am fine and not to worry about it. When I had my appoint with Dr. Saya he saw that and then looked at the rest of my CBC and claimed my MD was correct and not to worry about my HCT. Clearly high HCT by itself is not the issue they worry about.

I find way too many people here get derailed over high HCT because they assume high HCT by itself is a problem. You add to that those who live with altitude and everyone makes the assumption high HCT is bad... it isn't unless you have polycythemia. Also the large majority of TRT MD's do not even look at HCT let alone Rx phlebotomies. Dr. Crisler doesn't consider it all anymore unless he see's ones platelets are high. Also you never hear of patients on TRT dying of high HCT or polycythemia anywhere.

When my iron was really low and I was taking iron supps my HCT was at 57 and again my local MD said not to worry about it and I felt great at the time.

You make many good points but do understand regardless of one having higher HCT numbers thicker blood is thicker blood and much harder on ones cardiovascular/endothelial health as the heart has to work harder to pump the blood.

57 is way too high regardless of lack of symptoms.

I would prefer to have my number in the mid-nornal range or under the top end.

 

[HealthMan]

My HCT is also like 53 but my MD locally said it has nothing to do with polycythemia so I am fine and not to worry about it. When I had my appoint with Dr. Saya he saw that and then looked at the rest of my CBC and claimed my MD was correct and not to worry about my HCT. Clearly high HCT by itself is not the issue they worry about.

I find way too many people here get derailed over high HCT because they assume high HCT by itself is a problem. You add to that those who live with altitude and everyone makes the assumption high HCT is bad... it isn't unless you have polycythemia. Also the large majority of TRT MD's do not even look at HCT let alone Rx phlebotomies. Dr. Crisler doesn't consider it all anymore unless he see's ones platelets are high. Also you never hear of patients on TRT dying of high HCT or polycythemia anywhere.

When my iron was really low and I was taking iron supps my HCT was at 57 and again my local MD said not to worry about it and I felt great at the time.

How was you BP when your HCT was at 57?

 

[HealthMan]

Sorry grayiron I don't need your book on iron.

Update to this thread.
I did a mini blood test last week, thank you Nelson for DiscountedLabs, just to see how the ferritin was recovering and since TT/FT was on sale for 30 buck who could resist that.
I had stopped the 45mg Feosol Carbonyl iron tablets and 4 boiled chicken livers after one month. Probably need to go back on them for another month?

What do you guys think?
Donate blood and go back on the Feosol or argue with the Defy office attendent when he see's my HCT and demands I donate blood and pay for a retest before I can schedule a consult?

As you guys may or may not know I live south of Denver about 6000 ft above sealevel. My HCT pre TRT is 49.

Try to lower your dosage a bit more

 

[FeelingLost]

So I checked my records and I have 7 weeks until I need to draw blood for my 6 month TRT checkup.
Should I change my protocol now?
I don't want to make changes too fast and be in some kind of hormone limb and waste the money spent on the big blood test where I check everything twice a year with Defy.

I've got missing pieces to my puzzle at 50mgx3(150/wk) my trough was 1175, FT 33 and E2 29 I have no clue what my peak was.
Now at 40mgx3 (120/wk) my peak is 950 but I don't know what my trough is.

If I change my protocol the most logical number would be 36mgx3 (108/wk) what do you guys think?
Keep the current protocol until after my consult or change now and hope to be stable?

I've pretty much decided I need to go back on the iron45mg/C1g pills and donate a pint 2 weeks before my defy blood draw.
It will be my only donation this year.

 

[HealthMan]

So I checked my records and I have 7 weeks until I need to draw blood for my 6 month TRT checkup.
Should I change my protocol now?
I don't want to make changes too fast and be in some kind of hormone limb and waste the money spent on the big blood test where I check everything twice a year with Defy.

I've got missing pieces to my puzzle at 50mgx3(150/wk) my trough was 1175, FT 33 and E2 29 I have no clue what my peak was.
Now at 40mgx3 (120/wk) my peak is 950 but I don't know what my trough is.

If I change my protocol the most logical number would be 36mgx3 (108/wk) what do you guys think?
Keep the current protocol until after my consult or change now and hope to be stable?

I've pretty much decided I need to go back on the iron45mg/C1g pills and donate a pint 2 weeks before my defy blood draw.
It will be my only donation this year.

If you are feeling good and all your bloodwork looks fine wait until next consult. I don’t think you need to donate blood with your HCT at these levels. You will just get you ferritin lower again. Your body needs time off from blood donation to achieve iron homeostasis again. See where your HCT will sit once you get bloodwork done for your next consult. If creeping up try to lower the dosage to 100mg/week then check HCT monthly if possible until it shows signs of getting stable. Keep donating blood and supplementing iron and you will never know where your HCT would sit at your current dosage and you will never achieve homeostasis. You might end getting stable HCT at around 51 and i think this should be alright specifically if you have no symptoms. And even if a lower dosage does not allow you to completely stop donating blood it might allow you to only need to donate twice a year. And that shouldn’t mess with your ferritin. But first you need to get your ferritin higher and if that mean letting HCT go up a bit so be it (if your doctor is ok with that)
Also the more i read about testing free testosterone directly the more i tend to look at total testosterone and calculated free testosterone.

 

[Rockyo317]

Hello Fellow Members Hope Your All well! I Received My Blood work back Last wk Finally For All Those Tests some members mentioned To Get Done! My Ferritin Has Crashed as well and other stuff! I posted on another fourm! Well Here They Are Below and some other blood labs below that! Please if you guys can look and see whats up with me and can help me!! Please start chimming in! Please if you can help me out and start posting thanks everyone Rocky





PS also here are the other Blood Labs I Had Done 3 wks Here They are Repost and my T Is Still So Low Too! Please help thank You!!


Thyroxine (T4) Free, Direct, S
T4,Free(Direct)
1.22NORMAL
Reference*Range:0.82-1.77ng/dL

Triiodothyronine (T3)
Triiodothyronine (T3)
103NORMAL
Reference*Range:71-180ng/dL

TSH 5.490 High uIU/mL 0.450 - 4.500 01

hCG,Beta Subunit, Qnt, Serum hCG,Beta Subunit,Qnt,Serum <1 mIU/mL 0 - 3 01 Roche ECLIA methodolog

Prolactin 15.7 High ng/mL 4.0 - 15.2 01

Testosterone,Free and Total Testosterone, Serum 293 ng/dL 264 - 916 01! Fee Testosterone(Direct) 7.2 pg/mL 7.2 - 24.0 01

Vitamin B12 1619 High pg/mL 232 - 1245 01

 

[ratbag]

I don`t believe just because you have high HCT you have thick blood. Neither do my MD`s. This is a misconception from many here. All I`m saying. I`ve had high BP since I started TRT and it was resolved by taking Losartan.

 

[FeelingLost]

I don`t believe just because you have high HCT you have thick blood. Neither do my MD`s. This is a misconception from many here. All I`m saying. I`ve had high BP since I started TRT and it was resolved by taking Losartan.

For me I don't have high blood pressure and don't take any meds for BP. However my BP dose go up when my HCT get high. YMMV

 

[Dr Justin Saya MD]

Feelinglost - no need to donate at HCT 51.3, ESPECIALLY when attempting to have ferritin recover. Taking iron supplementation and then donating is like running on a treadmill...not going to get anywhere except back to square one. The ideal approach is to hold donations, but also hold iron supplementation (and ideally lower free T) to achieve a slow and steady balance of improving ferritin which will only happen without the need for donating. This is a true balancing act...one that becomes very challenging if other factors are putting upward pressure on the HCT (sleep apnea being a big one especially if concurrent with high altitude or smoking).

 

[FeelingLost]

Feelinglost - no need to donate at HCT 51.3, ESPECIALLY when attempting to have ferritin recover. Taking iron supplementation and then donating is like running on a treadmill...not going to get anywhere except back to square one. The ideal approach is to hold donations, but also hold iron supplementation (and ideally lower free T) to achieve a slow and steady balance of improving ferritin which will only happen without the need for donating. This is a true balancing act...one that becomes very challenging if other factors are putting upward pressure on the HCT (sleep apnea being a big one especially if concurrent with high altitude or smoking).

Thank you Dr Saya,
No smoking or sleep apnea.
My first protocol with Defy was 150mg/wk and my TT and FT number were too high after 2 months. Your nurse gave me permission to experiment with my T dose. I wanted to see how little I could take before I felt something was missing. That amount was .16(32mg) M/W/F 96mg/wk. I maintained that protocol for 45 days. My next dose was .20(40mg) M/W/F and the mini blood test you see above is the result. I don't know why I did not try .18(36mg) M/W/F that would have been the logical next step.

I will not donate blood before my July blood test/protocol checkup. But if I get flack from your front office about my HCT being 51.X I will be screen shoting your post and including it in my reply to schedule my 6 month consult.

Thank you for responding by the way. I can't thank you and Defy enough. Your clinic honestly safed my life.

 

[Dr Justin Saya MD]

Thank you Dr Saya,
No smoking or sleep apnea.
My first protocol with Defy was 150mg/wk and my TT and FT number were too high after 2 months. Your nurse gave me permission to experiment with my T dose. I wanted to see how little I could take before I felt something was missing. That amount was .16(32mg) M/W/F 96mg/wk. I maintained that protocol for 45 days. My next dose was .20(40mg) M/W/F and the mini blood test you see above is the result. I don't know why I did not try .18(36mg) M/W/F that would have been the logical next step.

I will not donate blood before my July blood test/protocol checkup. But if I get flack from your front office about my HCT being 51.X I will be screen shoting your post and including it in my reply to schedule my 6 month consult.

Thank you for responding by the way. I can't thank you and Defy enough. Your clinic honestly safed my life.

I agree 36mg TIW seems reasonable for now.

Make sure you’re VERY well hydrated at the time of labs as well.

You’re very welcome by the way!

 

[HealthMan]

Feelinglost - no need to donate at HCT 51.3, ESPECIALLY when attempting to have ferritin recover. Taking iron supplementation and then donating is like running on a treadmill...not going to get anywhere except back to square one. The ideal approach is to hold donations, but also hold iron supplementation (and ideally lower free T) to achieve a slow and steady balance of improving ferritin which will only happen without the need for donating. This is a true balancing act...one that becomes very challenging if other factors are putting upward pressure on the HCT (sleep apnea being a big one especially if concurrent with high altitude or smoking).

Dr Saya,
How reliable is the direct free testosterone test? I have read some papers putting into question direct FT measurement (Madman posted some here lately). My last bloodwork for example showed a significant increase in FT relative to TT without changes in albumin or SHBG. I too have been lowering my dosage with the goal to control my HCT without the need for blood donations. However when looking at FT direct my levels have stayed high despite lower dosage and TT. So should we use FT direct as a gauge for FT or use calculated FT or something else? Thank you for your time!