Warning for Men on TRT: Low Ferritin is Bad

[Gman86]

I'm actually having to go in tomorrow for a blood test and to have my blood pressure taken. They've been texting me for the past two weeks to book myself in, but because i ignored them, yesterdays text said they couldn't issue my next prescription until i've had it done (i'm on ramipril for blood pressure). Six months ago i went through all this, and the doc called me a week later to say my cholesterol was raised and she wanted me to go on statins. I'd read enough to know i didn't want them, and told her so. She kept on about my apparent risk so to get her off my case i said "i'll have a think, maybe try me again next year" - i thought she'd forget!! Anyhow, whatever she says this time i shall be making it clear i'm not interested. My elder brother went on statins recently. I asked him "why?". "Because the doc said i should" he replied. "Any side effects brother?" He had plenty - "bedroom trouble" being one of them!! "Plus muscle pains" - sounds great, lol!!!

I’m a nurse, and have been in the medical field for the past 20 years. Cholesterol lowering medications are the worst medications u can be prescribed to take regularly, imo. And that’s saying a lot, considering how many medications there are out there. Imo, there’s nothing worse than limiting the amount of cholesterol ur body has access to. Second being medications that inhibit stomach acid.

And don’t even fill ur BP med prescription. Here’s a list of things u can do to keep BP in range without meds. Even doing a few of the things will make a big difference, let alone all of them. This is something I sent to someone on here one time. Saved it to copy and paste going forward instead of rewriting it over and over

It’s all about doing everything u can to keep ur blood vessels flexible and relaxed. So ya, magnesium is a huge one. I personally use Remag. It’s a high quality liquid magnesium chloride. I put it in my water and sip on it throughout the day. So I’m slowly getting magnesium in my system all day.

-A huge thing when it comes to BP is hydration. I personally only drink mineral water. And then throw in some Celtic sea salt, for extra electrolytes, and the magnesium, every time I open one. So i recommend everyone drink mineral water, with some added electrolytes. That has helped a ton, in regards to keeping my BP in a perfect range

-haven’t messed with high dose vitamin E. It’s usually not good to megadose anything. The body works in a balance system, so usually megadosing something will cause an imbalance somewhere else. For example, vitamin E and vitamin K have an inverse relationship. So too much of one can deplete the other. I do take a vitamin E supplement tho. Barry tan’s Annatto-e supplement. Just one cap per day

-but speaking of vitamin K, K2 is an extremely important vitamin in regards to cardiovascular health and keeping the blood vessels nice and relaxed. K2 helps guide calcium to the parts of the body that it should go to. Like nails, bones and teeth, for a few examples, opposed to going to arteries where it can increase a persons risk of atherosclerosis (build up plaque in arteries that can cause narrowing of blood vessels) which can result in blood pressure increasing, since the same amount of blood has less space to fit through

-the other main thing is to keep ur fasting insulin levels as low as possible. Aka be as insulin sensitive as possible. Being insulin resistant will make ur blood vessels stiff and brittle, and have a huge impact on BP, obv in a negative way. Anytime cells are insulin resistant, insulin has less of an effect, and blood sugars stay elevated longer in the blood than they should. This does two main things. Sugar in the blood makes the blood thick and sticky. Think of things high in sugar. Honey, syrup, high fructose corn syrup, etc. U want ur blood thin and viscous. The other thing elevated sugar in the blood does is turn ur blood vessels hard and brittle. Consequently the blood vessels don’t flex as much, and cause blood pressure to increase. And on a side note, when elevated blood sugar levels cause the blood vessels to become brittle and stiff, they’re subject to cracking. Think of an old rubber band. When it’s new, it’s super flexible and stays in one piece. When it’s old and brittle it doesn’t stretch as much, and when u try to stretch it, it causes it to have a bunch of cracks. When this happens in the blood vessels, deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin (these are all the substances that plaque is made up of) fill in the cracks, which then can cause narrowing of the blood vessels and blockages over time

-Then u want to decrease inflammation as much as possible. The main offenders, at least when it comes to diet, are usually pasteurized/ grain fed dairy (basically 99% of dairy people consume/ have access to), gluten, unhealthy fats/ oils, and 99.99% of all processed foods/ beverages

-there’s obv other things u can do, like optimize sleep, and minimize stress. These will also have huge positive effects on BP when optimized

-but overall, u want to do ur best at optimizing everything I mentioned above. It’s hard to list them in a tiered manner, just because they’re all so important, if optimizing BP is the goal. But I would recommend someone just try to at least implement one recommendation at a time, let it become a habit to do, and then add another recommendation, and so on. And if u need help optimizing ur diet and becoming as insulin sensitive as possible, I can definitely help u out with that as well

-Oh, and ur potassium to sodium ratio is also important. Most people dont get enough potassium. So making sure ur intaking enough potassium everyday will also help decrease water retention, which can help lower blood pressure

-cardio has also been shown to be beneficial, in regards to keeping BP in a healthy range

 

[seppuku]

I’m a nurse, and have been in the medical field for the past 20 years. Cholesterol lowering medications are the worst medications u can be prescribed to take regularly, imo. And that’s saying a lot, considering how many medications there are out there. Imo, there’s nothing worse than limiting the amount of cholesterol ur body has access to. Second being medications that inhibit stomach acid.

And don’t even fill ur BP med prescription. Here’s a list of things u can do to keep BP in range without meds. Even doing a few of the things will make a big difference, let alone all of them. This is something I sent to someone on here one time. Saved it to copy and paste going forward instead of rewriting it over and over

It’s all about doing everything u can to keep ur blood vessels flexible and relaxed. So ya, magnesium is a huge one. I personally use Remag. It’s a high quality liquid magnesium chloride. I put it in my water and sip on it throughout the day. So I’m slowly getting magnesium in my system all day.

-A huge thing when it comes to BP is hydration. I personally only drink mineral water. And then throw in some Celtic sea salt, for extra electrolytes, and the magnesium, every time I open one. So i recommend everyone drink mineral water, with some added electrolytes. That has helped a ton, in regards to keeping my BP in a perfect range

-haven’t messed with high dose vitamin E. It’s usually not good to megadose anything. The body works in a balance system, so usually megadosing something will cause an imbalance somewhere else. For example, vitamin E and vitamin K have an inverse relationship. So too much of one can deplete the other. I do take a vitamin E supplement tho. Barry tan’s Annatto-e supplement. Just one cap per day

-but speaking of vitamin K, K2 is an extremely important vitamin in regards to cardiovascular health and keeping the blood vessels nice and relaxed. K2 helps guide calcium to the parts of the body that it should go to. Like nails, bones and teeth, for a few examples, opposed to going to arteries where it can increase a persons risk of atherosclerosis (build up plaque in arteries that can cause narrowing of blood vessels) which can result in blood pressure increasing, since the same amount of blood has less space to fit through

-the other main thing is to keep ur fasting insulin levels as low as possible. Aka be as insulin sensitive as possible. Being insulin resistant will make ur blood vessels stiff and brittle, and have a huge impact on BP, obv in a negative way. Anytime cells are insulin resistant, insulin has less of an effect, and blood sugars stay elevated longer in the blood than they should. This does two main things. Sugar in the blood makes the blood thick and sticky. Think of things high in sugar. Honey, syrup, high fructose corn syrup, etc. U want ur blood thin and viscous. The other thing elevated sugar in the blood does is turn ur blood vessels hard and brittle. Consequently the blood vessels don’t flex as much, and cause blood pressure to increase. And on a side note, when elevated blood sugar levels cause the blood vessels to become brittle and stiff, they’re subject to cracking. Think of an old rubber band. When it’s new, it’s super flexible and stays in one piece. When it’s old and brittle it doesn’t stretch as much, and when u try to stretch it, it causes it to have a bunch of cracks. When this happens in the blood vessels, deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin (these are all the substances that plaque is made up of) fill in the cracks, which then can cause narrowing of the blood vessels and blockages over time

-Then u want to decrease inflammation as much as possible. The main offenders, at least when it comes to diet, are usually pasteurized/ grain fed dairy (basically 99% of dairy people consume/ have access to), gluten, unhealthy fats/ oils, and 99.99% of all processed foods/ beverages

-there’s obv other things u can do, like optimize sleep, and minimize stress. These will also have huge positive effects on BP when optimized

-but overall, u want to do ur best at optimizing everything I mentioned above. It’s hard to list them in a tiered manner, just because they’re all so important, if optimizing BP is the goal. But I would recommend someone just try to at least implement one recommendation at a time, let it become a habit to do, and then add another recommendation, and so on. And if u need help optimizing ur diet and becoming as insulin sensitive as possible, I can definitely help u out with that as well

-Oh, and ur potassium to sodium ratio is also important. Most people dont get enough potassium. So making sure ur intaking enough potassium everyday will also help decrease water retention, which can help lower blood pressure

-cardio has also been shown to be beneficial, in regards to keeping BP in a healthy range

Thanks for that, some great info there. I actually already do some of it (been a supplement junkie since childhood) - i take around 600mg of magnesium a day (glycinate / malate / citrate combo), currently 10,000iu vit d3, vit k2 (mk7 plus mk4), 200iu mixed tocopherols, cod liver oil for vitA (2,500iu, some days 5000iu). Also boron, vit b complex, 500mg vit c, curcumin, high strength omega 3's (10 grams/day currently). I do eat dairy, but i'm low carb except for Saturdays, and have been for many years. My blood pressure just before i went on ramipril was around 140/80 (ish). But at the time i was a fairly muscular, but also fairly fat 122kg at 5'8". I decided to take it as i was going to start testosterone, and it seemed to make sense incase the trt put my bp higher. I had to lose weight to get both my hips replaced, and i float around 95 - 100kg now. My bp is much lower, and i have been wondering if the weight loss itself was enough to bring it down and whether or not i should see what happens if i come off the ramipril. Something for me to consider i guess

 

[Gman86]

Thanks for that, some great info there. I actually already do some of it (been a supplement junkie since childhood) - i take around 600mg of magnesium a day (glycinate / malate / citrate combo), currently 10,000iu vit d3, vit k2 (mk7 plus mk4), 200iu mixed tocopherols, cod liver oil for vitA (2,500iu, some days 5000iu). Also boron, vit b complex, 500mg vit c, curcumin, high strength omega 3's (10 grams/day currently). I do eat dairy, but i'm low carb except for Saturdays, and have been for many years. My blood pressure just before i went on ramipril was around 140/80 (ish). But at the time i was a fairly muscular, but also fairly fat 122kg at 5'8". I decided to take it as i was going to start testosterone, and it seemed to make sense incase the trt put my bp higher. I had to lose weight to get both my hips replaced, and i float around 95 - 100kg now. My bp is much lower, and i have been wondering if the weight loss itself was enough to bring it down and whether or not i should see what happens if i come off the ramipril. Something for me to consider i guess

That’s awesome that ur already so on top of ur health. And it sounds like u most likely don’t need the BP med anymore. U actually didn’t even need it before u lost the weight. Check out this vid when u get a chance. 140/80 might actually be a pretty healthy BP, believe it or not. And I’m sure ur BP is even better now that ur down a pretty significant amount of weight. So I would put money on u definitely not needing any medical interventions to control ur BP atm

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[FDV70]

Having just read through (most of) this, i thought i'd ask chatgpt about ferritin levels and thyroid. Gotta say, it's good fun using AI, (although i do know the answers to questions aren't always right).

You said:​

Do ferritin levels affect thyroid?

ChatGPT said:​

Yes, ferritin levels can affect thyroid function.

Ferritin is a protein that stores iron, and iron is essential for the proper functioning of the thyroid gland. Here’s how they’re connected:

1. Thyroid hormone production: Iron is a key component of the enzyme thyroid peroxidase (TPO), which is necessary for the synthesis of thyroid hormones (T3 and T4). Low ferritin can impair this process, potentially leading to hypothyroid symptoms.
2. Conversion of T4 to T3: Iron also helps in the conversion of the inactive hormone T4 into the active hormone T3. Low iron stores can reduce this conversion, affecting metabolism and energy levels.
3. Symptoms overlap: Iron deficiency and hypothyroidism share symptoms like fatigue, hair loss, cold intolerance, and brain fog, so one may be mistaken for the other if both aren't checked.

Optimal ferritin for thyroid function is often considered to be 70–100 ng/mL, though lab reference ranges may list lower normal levels.

Would you like to dig into how to raise ferritin or interpret lab results?

You said:​

Can eating red meat once a week help raise low ferritin?

ChatGPT said:​

Eating red meat once a week can help raise low ferritin levels, but it may not be enough on its own—especially if your levels are significantly low or if you have high iron needs (like with heavy periods, pregnancy, or certain health conditions).

Here’s a breakdown:

Why red meat helps:​

• It’s rich in heme iron, the most easily absorbed form of iron.
• Beef, lamb, and liver are particularly high in iron.
• Your body absorbs heme iron 2–3 times better than non-heme iron from plants.

How much it helps:​

• Once a week can provide a boost, but increasing to 2–3 servings per week may make a bigger impact if your ferritin is low.
• Pairing it with vitamin C-rich foods (like bell peppers, oranges, or tomatoes) can improve iron absorption even more.

Other tips:​

• Limit tea, coffee, and calcium-rich foods during iron-rich meals—they inhibit absorption.
• If your ferritin is very low (e.g., <30 ng/mL), diet alone may not be enough, and a supplement might be needed short-term.

Do you know what your ferritin level is currently? That could help gauge how much dietary change is needed.

You said:​

Yes, my recent ferritin blood test came back at 49 ug/l. This was three months after a hip replacement operation where i lost quite a lot of blood. I am also on testosterone replacement therapy, so need to be careful not to raise my hct or hg levels too high

ChatGPT said:​

Memory updated
Thanks for the context—that helps a lot.

A ferritin level of 49 µg/L is actually a decent recovery point three months after surgery, especially with blood loss involved. It’s in the “okay” range, but not quite at the optimal level for thyroid support or energy (typically 70–100 µg/L). Given your testosterone therapy, it’s smart to be cautious about pushing iron too aggressively, since TRT can already elevate hemoglobin and hematocrit.

Here’s a safe approach to nudge ferritin upward without risking high HCT/Hg:​

1. Red meat once or twice a week is fine—especially lean cuts like sirloin or lamb, maybe some liver occasionally if you tolerate it.
2. Iron-rich plant foods + vitamin C (spinach, legumes, pumpkin seeds + citrus or bell peppers) can help support iron without overloading.
3. Avoid supplements for now unless ferritin drops or symptoms pop up, to prevent overcorrecting and raising HCT/Hg.
4. Recheck labs in 2–3 months: Ferritin, hemoglobin, hematocrit—and maybe iron saturation and TIBC if available—to fine-tune your plan.
5. Keep an eye on thyroid markers (especially T3) if you're still feeling off—low ferritin can subtly hold back conversion even at mid-range levels.

Let me know if you want help mapping out a sample weekly meal plan or interpreting your TRT labs alongside all this.

Remember that you need to train your AI model first. AI has NO IDEA that we cannot build ferritin on TRT, never mind why. It's why AI says dumb shit like take vitamin C. Consume heme iron (JFC NO THAT WILL NOT HELP, CLAUDE!!!!!). Everything it tells you to do will drive hemoglobin higher.

Having AI read my site might be a good idea because I am literally the one and only person who published a resource on TRT and erythroferrone flooding. It's the driver of the problem. Erythroferrone was only discovered in 2014, and no one has done any deep dive research on it in relation to iron metabolism. I asked Dr. Tomas Ganz (who discovered hepcidin and erythroferrone) about this stuff. (Well, i read like 20+ studies and papers he wrote, THEN I wrote what's on my site, then had a hematologist review it, then had Ganz read it to make sure I wasn't wrong.)

 

[seppuku]

Remember that you need to train your AI model first. AI has NO IDEA that we cannot build ferritin on TRT, never mind why. It's why AI says dumb shit like take vitamin C. Consume heme iron (JFC NO THAT WILL NOT HELP, CLAUDE!!!!!). Everything it tells you to do will drive hemoglobin higher.

Having AI read my site might be a good idea because I am literally the one and only person who published a resource on TRT and erythroferrone flooding. It's the driver of the problem. Erythroferrone was only discovered in 2014, and no one has done any deep dive research on it in relation to iron metabolism. I asked Dr. Tomas Ganz (who discovered hepcidin and erythroferrone) about this stuff. (Well, i read like 20+ studies and papers he wrote, THEN I wrote what's on my site, then had a hematologist review it, then had Ganz read it to make sure I wasn't wrong.)

I gave chatgpt the link to your site, asked it to read what's there, then give me an easy to understand summary instructing how to raise ferritin on trt. This is what it came back with.....

ChatGPT said:​

Testosterone Replacement Therapy (TRT) can lead to erythrocytosis, a condition characterized by an increased production of red blood cells. This process utilizes iron stores, potentially lowering ferritin levels, which represent the body's iron reserves. Maintaining adequate ferritin is crucial for overall health and effective oxygen transport.BioBalance Health+2PMC+2Defy Medical+2

Strategies to Raise Ferritin Levels While on TRT:

1. Iron Supplementation: Incorporate iron supplements into your regimen to replenish iron stores. It's essential to consult with a healthcare provider to determine the appropriate dosage and monitor iron levels to avoid potential toxicity.
2. Dietary Adjustments: Increase the intake of iron-rich foods such as red meat, leafy green vegetables, and legumes. Combining these with vitamin C-rich foods can enhance iron absorption.
3. Monitor Hematocrit Levels: Regularly check hematocrit and hemoglobin levels to ensure they remain within a safe range. Elevated levels may necessitate adjustments to your TRT protocol or additional interventions.Defy Medical
4. Phlebotomy Considerations: In cases of significantly elevated hematocrit, therapeutic phlebotomy (blood donation) might be recommended. However, frequent phlebotomies can further deplete iron stores, so this approach should be balanced with strategies to maintain ferritin levels.Bioscientifica
5. Consult Healthcare Professionals: Work closely with your healthcare provider to tailor a plan that addresses both erythrocytosis and low ferritin, ensuring safe and effective management of your TRT.

By implementing these strategies under medical supervision, you can help maintain healthy ferritin levels while undergoing TRT.

 

[FDV70]

I gave chatgpt the link to your site, asked it to read what's there, then give me an easy to understand summary instructing how to raise ferritin on trt. This is what it came back with.....

ChatGPT said:​

Testosterone Replacement Therapy (TRT) can lead to erythrocytosis, a condition characterized by an increased production of red blood cells. This process utilizes iron stores, potentially lowering ferritin levels, which represent the body's iron reserves. Maintaining adequate ferritin is crucial for overall health and effective oxygen transport.BioBalance Health+2PMC+2Defy Medical+2

Strategies to Raise Ferritin Levels While on TRT:

1. Iron Supplementation: Incorporate iron supplements into your regimen to replenish iron stores. It's essential to consult with a healthcare provider to determine the appropriate dosage and monitor iron levels to avoid potential toxicity.
2. Dietary Adjustments: Increase the intake of iron-rich foods such as red meat, leafy green vegetables, and legumes. Combining these with vitamin C-rich foods can enhance iron absorption.
3. Monitor Hematocrit Levels: Regularly check hematocrit and hemoglobin levels to ensure they remain within a safe range. Elevated levels may necessitate adjustments to your TRT protocol or additional interventions.Defy Medical
4. Phlebotomy Considerations: In cases of significantly elevated hematocrit, therapeutic phlebotomy (blood donation) might be recommended. However, frequent phlebotomies can further deplete iron stores, so this approach should be balanced with strategies to maintain ferritin levels.Bioscientifica
5. Consult Healthcare Professionals: Work closely with your healthcare provider to tailor a plan that addresses both erythrocytosis and low ferritin, ensuring safe and effective management of your TRT.

By implementing these strategies under medical supervision, you can help maintain healthy ferritin levels while undergoing TRT.

Wow that's fucked up.
I am on ChatGPT 4.o and typed:
"read this Fixing High Hemoglobin or Hematocrit and Low Ferritin While on TRT then I want to ask questions"
"Tell me what causes low ferritin while on TRT and how to fix it."

It gave completely wrong information, as it did to you.

I then said "All of this is incorrect. You did not read the article."
The AI gave this, which is COMPLETELY fucked up:
Vorck Ferritin Restoration Stack (Summarized):
Turmeric/Curcumin (to support hepcidin and inflammation modulation)
Zinc (25 mg) — supports hepcidin production
Copper (1–2 mg) — balances zinc and supports iron mobilization
Vitamin A (5,000 IU) — essential for iron regulation
Magnesium (200–400 mg)
Vitamin D3 (2,000–4,000 IU)
Vitamin C (250–500 mg) — NOT near meals; just for general health

I then typed:
"All of those supplements should not be taken. the protocol actually says to take 70mg of non-heme iron three times daily at precise times to raise hepcidin. How is it you keep getting this completely wrong?"

And it finally gave the correct protocol. I guess I better figure out a way to get AI to scan correctly.

 

[seppuku]

Wow that's fucked up.
I am on ChatGPT 4.o and typed:
"read this Fixing High Hemoglobin or Hematocrit and Low Ferritin While on TRT then I want to ask questions"
"Tell me what causes low ferritin while on TRT and how to fix it."

It gave completely wrong information, as it did to you.

I then said "All of this is incorrect. You did not read the article."
The AI gave this, which is COMPLETELY fucked up:
Vorck Ferritin Restoration Stack (Summarized):
Turmeric/Curcumin (to support hepcidin and inflammation modulation)
Zinc (25 mg) — supports hepcidin production
Copper (1–2 mg) — balances zinc and supports iron mobilization
Vitamin A (5,000 IU) — essential for iron regulation
Magnesium (200–400 mg)
Vitamin D3 (2,000–4,000 IU)
Vitamin C (250–500 mg) — NOT near meals; just for general health

I then typed:
"All of those supplements should not be taken. the protocol actually says to take 70mg of non-heme iron three times daily at precise times to raise hepcidin. How is it you keep getting this completely wrong?"

And it finally gave the correct protocol. I guess I better figure out a way to get AI to scan correctly.

Blimey, that's a bit scary to be honest. It's great the way it comes back with answers in a conversational way, like chatting to a friend. Just it's one of those friends that aren't as bright as they think!!