How can this happen low ferritin

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magnus68

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magnus68

Member
Can happen if you are having phlebotomies for high hematocrit. Or you may simply be iron deficient which can happen from lack of dietary iron intake or malabsorbtion.
I do get phlebotomy s and last time did a double red. My HCT climbs rather fast so I have to get them. 200 mg test e a week. Puts me at about 900- 1000 so I don't feel like that's over doing it.
 

Blackhawk

Member
I do get phlebotomy s and last time did a double red. My HCT climbs rather fast so I have to get them. 200 mg test e a week. Puts me at about 900- 1000 so I don't feel like that's over doing it.

This is a common problem for men taking too much testosterone, Happened to me too. When I started on injections at 150mg/week my HCT was too high. It took reducint to 84 mg/week to bring HCT in normal range. 200mg/week is just a very high dose.

Do a search here. There are dozens of discussion on this topic. You will also find recommendations for how to boost ferritin. Certain supplemental iron products plus vitamin C can help very much.

But, you are on a supraphysiological dose of T which causes this very problem. Search for discussions about what is TRT vs AAS. I assume 900-1000 means your total testosterone level which seems reasonable, but if you HCT is too high on an ongoing basis, it is over doing it. That's just medical reality.
 

madman

Super Moderator
I do get phlebotomy s and last time did a double red. My HCT climbs rather fast so I have to get them. 200 mg test e a week. Puts me at about 900- 1000 so I don't feel like that's over doing it.

Need to rethink that one!

Although your TT 900-1000 ng/dL may not seem absurdly high I would put money on it that this is your trough level (7 days post-injection) as you are injecting a whopping dose of 200 mg T once weekly.

Your peak TT, FT, and estradiol level will be much higher.

With a trough TT 900-1000 ng/dL it is a given that your trough FT will be high-end/high even if you have highish/high SHBG and you can rest assured that your peak TT, FT, and estradiol will be absurdly high.

Your peak TT/FT levels will be absurdly high post-injection (8-12 hrs)/during the first few days (2-3) only to be followed by lower levels come weeks end and in many cases, most men are still hitting a high-end trough TT upper 900s/low 1000s which would still have your trough FT level high.

You are always going to struggle with elevated hematocrit due to running too high an FT level and to make matters worse your protocol is not helping any as the downfall of running a once-weekly injection using high doses of T is that there will be an extreme difference between peak--->trough on such protocol which can also have a significant impact on driving up your hemoglobin/hematocrit/RBCs.

To make matters worse you have crashed your ferritin/iron from donating too frequently trying to manage your elevated blood markers.

Never-ending merry-go-round.

Low ferritin/iron can lead to numerous issues




thread #1 Test E sub Q?

thread #2 High Free Test. Normal Total


Take a close look where your almost true trough (6 days post-injection) TT/FT levels sat injecting 150 mg T once weekly!
Screenshot (14238).png


Thread #1 you were running a whopping 210 mg T once weekly.

Now you are running 200 mg T/week and again you stated you are hitting a TT 900-1000 ng/dL which is most likely your trough so it is a given that your trough FT level will be high and peak levels will be much higher!

Not sure why you seem to be caught up on this more T is better mentality.
 

madman

Super Moderator

You have been a member of the forum since 2016.

Hard to believe you would not know this.

Regarding elevated hematocrit.


My reply from a previous thread:

As you can see your RBCs/hemoglobin/hematocrit is elevated which is a common side-effect when using exogenous T, especially when running higher FT levels let alone peak--->trough levels can have a significant impact.

Keep in mind smoking/sleep apnea can also drive up hematocrit.


Regarding those struggling with high hematocrit here is my reply from another thread:

When using exogenous T RBCs/hemoglobin/hematocrit will increase within the 1st month and can take up to 9-12 months to reach peak levels.

T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).

Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.

Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.

3–18% with transdermal administration and up to 44% with injection.

In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.

Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.

As again running very high TT/FT levels will have a stronger impact on driving up HCT.

Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.

Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.

How high an FT level you are running is critical.

It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.

Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.

If you are struggling with such blood markers then in most cases finding the lowest FT level you can run while still maintaining the beneficial effects may very well be the solution.

Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.

Mind you some are lucky and never have an issue or levels tend to stabilize over time.

Others will continue to struggle until the cows come home.

Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!
 

magnus68

Member
You have been a member of the forum since 2016.

Hard to believe you would not know this.

Regarding elevated hematocrit.


My reply from a previous thread:

As you can see your RBCs/hemoglobin/hematocrit is elevated which is a common side-effect when using exogenous T, especially when running higher FT levels let alone peak--->trough levels can have a significant impact.

Keep in mind smoking/sleep apnea can also drive up hematocrit.


Regarding those struggling with high hematocrit here is my reply from another thread:

When using exogenous T RBCs/hemoglobin/hematocrit will increase within the 1st month and can take up to 9-12 months to reach peak levels.

T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).

Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.

Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.

3–18% with transdermal administration and up to 44% with injection.

In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.

Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.

As again running very high TT/FT levels will have a stronger impact on driving up HCT.

Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.

Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.

How high an FT level you are running is critical.

It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.

Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.

If you are struggling with such blood markers then in most cases finding the lowest FT level you can run while still maintaining the beneficial effects may very well be the solution.

Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.

Mind you some are lucky and never have an issue or levels tend to stabilize over time.

Others will continue to struggle until the cows come home.

Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!
I appreciate the feedback. I will dial it down and redo labs in six weeks. Ive added Iron glycinate and Beef Liver supplement . lets see if I can straighten this out. Thanks again
 

Systemlord

Member
I do get phlebotomy s and last time did a double red. My HCT climbs rather fast so I have to get them.
I'm in the same boat as you, I get phlebotomies every month and hematocrit and hemoglobin only take a month to go from 16.6->18. I do have to consume 140mg iron daily.

The vitamin D supplementation has lowered my hemoglobin .5 points, because when I become deficient or over supplement either one makes me dehydrated.
 

magnus68

Member
I'm in the same boat as you, I get phlebotomies every month and hematocrit and hemoglobin only take a month to go from 16.6->18. I do have to consume 140mg iron daily.

The vitamin D supplementation has lowered my hemoglobin .5 points, because when I become deficient or over supplement either one makes me dehydrated.
Are you on TRT? how much? What type of Iron do you take ? does it help?
 

Systemlord

Member
Are you on TRT?
Yes, Jatenzo 237 mg twice daily. Peaks are 980 ng/dL within 2 hours, trough 12 hours later 287 ng/dL.
What type of Iron do you take ?
The Vitamin Shoppe brand, ferrous fumarate, amino acid chelate and citrate. I don't need iron supplementation at all when not on TRT.

The TRT brings it down even without phlebotomies.

does it help?
Without the iron, ferritin would plummet quickly. I can't take all my iron at once though, I have to split it up 3x times daily.
 
Last edited:

Match

Member
Fractionating iron dosage or even liver in small portion increases Hepcidine to increase Ferritin without increasing HCT? Is that the way it works?
 
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