Anemic with very low BP's since starting trt gel

ratt57 said:

MCV, MCH

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Systemlord said:

No, it's the opposite. Iron is blood, so anemia would increase blood pressure. You have more issues going on than just low-T.

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• irritability
• weakness
• shortness of breath
• low blood pressure (especially when going from lying or sitting to standing)
• sore tongue
• brittle nails
• unusual food cravings (called pica) such as for ice or dirt
• decreased appetite (especially in children)
• headache

Systemlord said:

If your ferritin is <30, the dosages I stated are standard for someone with iron deficiency.

Where are you getting your recommendations for iron dosing?

Individualized treatment for iron deficiency anemia in adults

Iron deficiency is one of the most common disorders affecting mankind, and iron deficiency anemia continues to represent a major public health problem worldwide. It is especially common among women of childbearing age due to pregnancy and menstrual blood ...

www.ncbi.nlm.nih.gov

The link below is highest absorption iron that I have used for years and is the only type of iron that works for me. Beware, gentle iron or GI friendly iron is low absorbing iron.

https://www.vitaminshoppe.com/p/iron-28-mg-300-capsules/vs-1203

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ratt57 said:

So were you taking 9 of these 28mg tablets a day with no side effects at all?

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ratt57 said:

It's looking like the drop in BP is from the anemia.

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Low blood pressure (hypotension) - Symptoms and causes

www.mayoclinic.org

ratt57 said:

Only experiencing the shortness of breath when I stand up and am active

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Systemlord said:

This sounds similar to symptoms of long Covid.

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ratt57 said:

Hi. I'm new to the forum and happy to be here. I'm noticing a lot of posts are about trt gel, which I started 6 weeks ago; I joined a trt forum on Reddit and no one seemed to be taking my questions very seriously because I wasn't doing injections.

After about three days of starting Androgel 1.62% (two pumps), my insomnia, which I've been fighting for years, went away, which was a major improvement. Instead of tossing and turning for two hours I now sleep ten-fifteen minutes after my had hits the pillow. I also noticed after a couple of weeks of trt I felt calmer and had more of a sense of well-bring. All good.

But I'm also experiencing some negative symptoms that are getting worse. I've become very anemic and my systolic BP's drop to 70-90's when I stand up. My muscles also feel very weak, even from doing something like just making my bed. I had labs drawn last week and my RBC's, hematocrit and hemoglobin were all below normal. At first I thought I was dehydrated, but no matter how much water I drink, it doesn't seem to change anything. Strangely, I also mostly experience these symptoms more in the mornings than the afternoons or evenings.

I don't know what's going on, because the anemia and low-BP's seem to be the opposite of what I should be experiencing once I started trt. I'm thinking I may have to come off it, which I don't want to do.

Has anyone else experienced these symptoms or has any suggestions as to why they're happening? Thanks for any help.

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ratt57 said:

Just spoke with my doc. We're running some new iron levels, ferritin, etc. He said he'd prescribe me a high dose of iron if the levels are low. Thanks for your help and info, I really appreciate it.

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ratt57 said:

My ferritin levels came back perfectly normal at 286.

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Systemlord said:

I'm starting to wonder if iron deficiency was your original issue that lead you to being placed on TRT.

TRT can cause ferritin levels to decline in some individuals. If you're on TRT, and you can't maintain normal ferritin, it’s because TRT increases EPO which increased erythroferrone, lowering hepcidin and ferroportin lets iron release from hepatocytes and therefore ferritin doesn't rise.

The obvious solution is to supplement iron.

I would check ferritin, MCV, MCH, MCHC and iron saturation.


I experienced the same symptoms for the first 2.5 years on TRT, at which point my ferritin levels were 24, stopped TRT for a couple of months at which point ferritin recovered, started TRT again and ferritin declined to 24 for a second time.

This is when my endocrinologist recommended iron supplementation.

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magnus68 said:

I have the same issue with my Ferritin.. BUT my HCT was 17.4, so how would one increase ferritin without raising HCT too high

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ratt57 said:

All these levels and what ranges they should be in has become really confusing.

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Systemlord said:

Doctors only care about normal, what's best, optimal for you, they don't get paid enough to care, in fact they could care less.

So next time your doctors tells you you're normal, take it with a grain of salt.

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Systemlord said:

I'm starting to wonder if iron deficiency was your original issue that lead you to being placed on TRT.

TRT can cause ferritin levels to decline in some individuals. If you're on TRT, and you can't maintain normal ferritin, it’s because TRT increases EPO which increased erythroferrone, lowering hepcidin and ferroportin lets iron release from hepatocytes and therefore ferritin doesn't rise.

The obvious solution is to supplement iron.

I would check ferritin, MCV, MCH, MCHC and iron saturation.


I experienced the same symptoms for the first 2.5 years on TRT, at which point my ferritin levels were 24, stopped TRT for a couple of months at which point ferritin recovered, started TRT again and ferritin declined to 24 for a second time.

This is when my endocrinologist recommended iron supplementation.

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