Lipids / Iron / Ferritin Labs

[brookseth]

Attached are my current bloods.
I’m taking 140mg Test E (split into 2 shots biweekly) - 750iu HCG (also split into 2) - and 30mg Anavar Daily. Also 2mg Tesamorelin 5x days a week

Should I be concerned about the things out of range? I think my HDL was near the top of the range before taking the Anavar - only been on it for about 2-3 weeks.

Also I just can’t seem to get my ferritin up - I’ve even tried the cycle of taking iron every 6 hours for 4-5 days. Still hovers in the same area

 

[brookseth]

For comparison - these were from 8/25 - before taking Anavar or Tesa

 

[Systemlord]

If the HCT slightly over the range bothers you, go to a lab company with a 51 or 52% cutoff. Go live at elevations above 3000 feet and you’ll get the similar HCT levels when not on TRT.

Low-grade inflammation is enough to disrupt iron metabolism.

 

[brookseth]

If the HCT slightly over the range bothers you, go to a lab company with a 51 or 52% cutoff. Go live at elevations above 3000 feet and you’ll get the similar HCT levels when not on TRT.

Low-grade inflammation is enough to disrupt iron metabolism.

HCT I’m not concerned about at all. Mostly the cholesterol

 

[Systemlord]

HCT I’m not concerned about at all. Mostly the cholesterol

I know this is going to be hard to believe, but high cholesterol is healthy as long as your metabolic health is good. High cholesterol does not cause heart disease!

skip to index 13:15

 

[Jim Marlowe]

I understand many posters are concerned about low Ferritin.
Is there a link to a post on here that explains that rationale? Because to me, a ferritin of 58 is great. The Ray Peat folks, Ivor Cummins, Dr. Eugene Weinberg, and Mercola all concur that high ferritin is indicative of serious issues. Anything over 300 and something is going on. Over 1,000 and cancer risk goes through the roof.

Not an issue here with OP I realize, but the concern when ferritin is low and Hemoglobin is low (very low at first, but then not so low?- Anemia of Chronic Disease | Iron Disorders Institute) then supplementing iron is the wrong thing to do.

 

[Systemlord]

Is there a link to a post on here that explains that rationale?

There is a concern when ferritin is low when they’re unexplained symptoms, that cannot be explained through more comprehensive testing. If the symptoms fit the bill of iron deficiency only then is there a concern.

Iron deficiency without anemia – a clinical challenge

One should always consider iron deficiency (without anemia) as the cause of persisting, unexplained unspecific, often severe, symptoms, regardless of the primary underlying disease. The symptoms of iron deficiency may arise from the metabolic systems ...

www.ncbi.nlm.nih.gov

Ferritin (<30 μg/L) is most sensitive and specific indicator of iron deficiency, although its pitfalls need to be taken into consideration. However, the ferritin concentration may be near to normal, while iron staining of a bone marrow aspiration sample is devoid of iron. Furthermore, in determining the iron status, it is essential not to rely only on results of a single test but to consider the whole picture.

The question of which ferritin concentration signifies clinically symptomatic iron deficiency has been raised 5, 6. Patients with true iron deficiency anemia on the basis of negative bone marrow iron staining may have a serum ferritin concentration close to 50 μg/L 7. Patients with the restless leg syndrome should be considered iron deficient when their ferritin concentration is <75 μg/L 8. Furthermore, patients with negative bone marrow iron stores have been shown to present with serum ferritin levels of close to 100 μg/L.

Because to me, a ferritin of 58 is great.

Not to me, I feel like dogsh** with ferritin below 80.

 

[Jim Marlowe]

There is a concern when ferritin is low when they’re unexplained symptoms, that cannot be explained through more comprehensive testing. If the symptoms fit the bill of iron deficiency only then is there a concern.

Iron deficiency without anemia – a clinical challenge

One should always consider iron deficiency (without anemia) as the cause of persisting, unexplained unspecific, often severe, symptoms, regardless of the primary underlying disease. The symptoms of iron deficiency may arise from the metabolic systems ...

www.ncbi.nlm.nih.gov

Not to me, I feel like dogsh** with ferritin below 80.

Thank you, Systemlord. My ferritin was 400 15 months ago. It's under 30 now, and I feel much better.

 

[Systemlord]

Thank you, Systemlord. My ferritin was 400 15 months ago. It's under 30 now, and I feel much better.

Let’s hope that continues to be the case.

 

[Jim Marlowe]

I realize it is a view not universally shared, but here is Morley Robbins about ferritin:

"My take on reflecting upon my conversation with Dr. Kell, as well as after reading this stunner of an article:

• Ferritin does not belong in the serum, it should only be found inside the cell where it does its work to support the ongoing need for cellular iron proteins and iron-sulfur clusters.
• When ferritin does show up in the serum, it is a sign of pathophysiology, not a sign of “iron vitality!” This is a complete reversal of what we have been trained to believe."

Iron Toxicity Post #55: Ferritin is NOTHING, Hemosiderin is EVERYTHING! - The Root Cause Protocol

Ferritin in the serum is a sign of tissue pathophysiology. Without the ceruloplasmin ferroxidase enzyme, iron doesn't load properly into ferritin. So it gets damaged and takes on the properties of hemosiderin where iron is stored and doesn't come out.

therootcauseprotocol.com

 

[USMC]

I know this is going to be hard to believe, but high cholesterol is healthy as long as your metabolic health is good. High cholesterol does not cause heart disease!

skip to index 13:15

Great video!

 

[Fortunate]

There is a concern when ferritin is low when they’re unexplained symptoms, that cannot be explained through more comprehensive testing. If the symptoms fit the bill of iron deficiency only then is there a concern.

Iron deficiency without anemia – a clinical challenge

One should always consider iron deficiency (without anemia) as the cause of persisting, unexplained unspecific, often severe, symptoms, regardless of the primary underlying disease. The symptoms of iron deficiency may arise from the metabolic systems ...

www.ncbi.nlm.nih.gov

Not to me, I feel like dogsh** with ferritin below 80.

There are so many threads centered on ferritin, so I decided to pick one to throw out some questions, rather than start a new one.

Question #1: Do we all firmly believe that low ferritin without anemia can cause symptoms (fatigue, brain fog, etc)?

Question #1a: If so, how?
Question #1b: How low is low?

Reason for Question: My recent labs show HGB 15.9 with ferritin of 30.3 (range 24.0 - 336.0). I have been battling fatigue for over a year. I have systematically eliminated various potential causes for fatigue and am running into dead ends. TRT numbers look perfect (can post later). Ferritin is borderline (technically within normal limits, but low-normal)

Second Question: Do we think it matters if you draw labs on the day of a donation?

Reason for Question: The above labs and a bunch more were drawn at the same time of a donation. Even if the tubes going to the lab were drawn last, I would expect lab values to be pretty much the same at the beginning of the donation vs. the end, but this thinking could be flawed.

 

[Systemlord]

Question #1: Do we all firmly believe that low ferritin without anemia can cause symptoms (fatigue, brain fog, etc)?

It’s not a belief, it’s a fact. Read prior post above.

 

[Fortunate]

It’s not a belief, it’s a fact. Read prior post above.

I hear you, brother. But, I also understand some of your position on iron has changed recently?

 

[Belekas]

Thank you, Systemlord. My ferritin was 400 15 months ago. It's under 30 now, and I feel much better.

Why was your Ferritin at 400 and what was your TS% at the time being if I may ask? Interested if you found the root cause and how did you lower it. My Ferritin is 390 and also TS% is 52. This is concerning and now being looked into. Should have known better that Ferritin > 120 while on TRT is a major red flag and worth exploring for potential disorder.

 

[Systemlord]

I hear you, brother. But, I also understand some of your position on iron has changed recently?

I only needed iron supplementation due to being on daily and every other day cypionate injections, due to the static unchanging hormone levels, which dragged my ferritin levels down.

Then I switched over to Jatenzo three years ago. There were a couple of days where I forgot to take my iron supplements, and I noticed on these days I felt significantly better, which is why decided to stop the iron supplements in the first place.

This Friday will be week #6 without iron supplements and the side effects are still present but almost completely gone.

I can now handle 5000+ vitamin D3 without side effects.

 

[Fortunate]

I only needed iron supplementation due to being on daily and every other day cypionate injections, due to the static unchanging hormone levels, which dragged my ferritin levels down.

Then I switched over to Jatenzo three years ago. There were a couple of days where I forgot to take my iron supplements, and I noticed on these days I felt significantly better, which is why decided to stop the iron supplements in the first place.

This Friday will be week #6 without iron supplements and the side effects are still present but almost completely gone.

I can now handle 5000+ vitamin D3 without side effects.

The article your reference above is very interesting. I would love what he describes to be true for me (so I can solve my fatigue by supplementing iron). But it's a case series of one internist.

 

[Jim Marlowe]

Why was your Ferritin at 400 and what was your TS% at the time being if I may ask? Interested if you found the root cause and how did you lower it. My Ferritin is 390 and also TS% is 52. This is concerning and now being looked into. Should have known better that Ferritin > 120 while on TRT is a major red flag and worth exploring for potential disorder.

My suspicion was that I was taking fairly high dose Vitamin C amid the Covid madness. High dose vitamin C, high carnivore-based Keto, and low ceruloplasmin primed me for iron overload. Taking Vitamin C with food increases iron levels.

My Iron saturation was 29%, so it was fine. My ceruloplasmin was low at 18 mg-dl. I donated blood for 18 months as soon as I was eligible and schedule permitting. I felt great after each donation. I mean fantastic.
I've paused the blood donation because my ferritin got down to 11.
The strange thing is that I started supplementing copper in December 2022, 4 mg a day. I re-did the "Full Monty" (Morley Robbins - Root Cause Protocol Morley Robbins: How Balancing Copper, Iron, Magnesium and 1 Protein is the Solution that You're Looking For) labs this February (2024), and my ceruloplasmin was lower than before I started supplementing - at 14 mg-dl. So starting in February I started taking 8 mg copper per day (4mg, twice per day). Then I started going up to 12 mg for a while. I realize most people say 8 mg is the absolute max, but I have had no negative side effects. I want to repeat the Full Monty and see whether ceruloplasmin is up.
I have gone from eating Keto for 22 years to eating bioenergetic. That reduced my LDL without lowering by HDL or raising triglycerides. Unfortunately, my HbA1c went up during this time. I'm hoping that this is temporary. So for me the jury is still out on copper levels and HbA1c.
I think the Morley Robbins Root Cause approach make sense if you are high ferritin and low ceruloplasmin. I realize other people don't have that problem, but I did.

 

[Jim Marlowe]

There are so many threads centered on ferritin, so I decided to pick one to throw out some questions, rather than start a new one.

Question #1: Do we all firmly believe that low ferritin without anemia can cause symptoms (fatigue, brain fog, etc)?

Question #1a: If so, how?
Question #1b: How low is low?

Reason for Question: My recent labs show HGB 15.9 with ferritin of 30.3 (range 24.0 - 336.0). I have been battling fatigue for over a year. I have systematically eliminated various potential causes for fatigue and am running into dead ends. TRT numbers look perfect (can post later). Ferritin is borderline (technically within normal limits, but low-normal)

Second Question: Do we think it matters if you draw labs on the day of a donation?

Reason for Question: The above labs and a bunch more were drawn at the same time of a donation. Even if the tubes going to the lab were drawn last, I would expect lab values to be pretty much the same at the beginning of the donation vs. the end, but this thinking could be flawed.

How can drawing labs at the same time as donation NOT affect the results if the samples follow the phlebotomy? At a minimum it adds a potential confounder.

 

[ajax31]

How can drawing labs at the same time as donation NOT affect the results if the samples follow the phlebotomy? At a minimum it adds a potential confounder.

I’ve never donated at a blood bank where they check your ferritin. They don’t care as long as your hemoglobin is above 12, which is a finger prick in the pre-screening room.

The tubes of blood they take for testing purposes are drawn first, then they divert the blood flow back into the collection pouch.

If you want to get an accurate reading of your ferritin, wait at least 8 weeks after your last whole blood donation (or 16 weeks for double red cell).