Some IRON math

HealthMan

Member
I decided to take a look at how many times i have donated blood since I started TRT: total of 8 times (whole blood) during a period of 20 months (so approximately once every 10 weeks) to keep HCT in check.
Every time you donate whole blood the body loses ~ 250mg of iron. So i lost a total of 2000mg of iron donating blood. On average your body loses 1.5mg of iron a day (so during 20 months i lost an additional 900mg of iron).
In an effort to control HCT i stopped taking iron supplements and enriched foods and taking easy on red meat consumption. So lets assume i was getting the RDA of iron (18mg a day) during this period from my diet and lets assume an absorption rate of 15% (seems to be the average for an average diet). So that totals - for 20 months - 1620 mg of iron absorbed by the body

So in these 20 months:

Iron lost from blood donations: 2000mg
Iron lost due to normal excretion : 900mg
Total iron lost: 2900mg

Total iron absorbed in my diet: 1620 mg

Iron deficit: 1280mg

So my ferritin went from ~ 280 to close to zero during this period. Well now this makes a lot a sense.

The frequent donations led to low ferritin and a condition called iron avidity. Where ferritin is low but serum iron and iron saturation is high (a desperate attempt of the body to achieve homeostasis).

In an attempt to correct this i have to find a testosterone dosage that allows my body enough time replenish ferritin levels and keep HCT < 50. At my current TRT dosage my HCT was increasing way too fast and i had to donate blood way too often and that was causing an iron imbalance. In order for my body to find iron homeostasis again I need to donate less frequently so hence the decision to lower my dose. If i didnt have iron avidity i could simply keep donating to control HCT and everything was good.

So my plan is to reduce my dosage to 100mg of testosterone a week and start supplementing with 18mg iron bisglycinate 2 times a week and avoid blood donation (getting CBC checked once a month and only donate when HCT > 51-52) to give my body a change to increase ferritin. Hopefully with the reduced dosage my HCT will stabilize and I will no longer have to donate blood. And then my body will find homeostasis again.

Once that happens (and hopefully it does!!) I will stop iron supplementation. And hopefully this dosage will be enough to make me feel good.

Wish me luck!
 

ratbag

Member
It's not guaranteed of course. There is a study around here somewhere that shows why some have difficulty with low ferritin levels because of TRT. It's all about your hepecidin as I recall. I lowered my T dose from 70mg E3D to 35mg E3.5D and I still have the same problem and of course the moment you supp iron your HCT over responds. I also used to donate blood but I stopped and thought that was the end of my problem. I supped iron and vit C and got my ferritin back up only to stop all of that and later learn my ferritin still dropped below range all on it's own. Problem still there. So I supp 50mg iron daily and my HCT is at 51 but I feel ok and my hematologist says I have nothing to worry about.
 
I like your plan HealthMan. I look forward to reading about your progress.

I had my consult and the directions for my low ferritin was to supplement EOD 325mg ferrous sulfate 1g Vit C.
I am also dropping my T cyp dose from .25 to .20 M/W/F I plan to do a quicky blood test on my own in 6 weeks.
I also have permission to experiment with reducing my dose even more to try and find that point where I feel I need more. I plan to adjust or stop the AI based on how I feel.

Maybe it's because of my age but in 14 months I have reached TT steady state at 350 630 and 1175 and to be honest they all felt the same.
My original natural TT taken Dec 2016 Feb 2017 were 173 and 225. @350 I started to feel normal.
 

HealthMan

Member
I like your plan HealthMan. I look forward to reading about your progress.

I had my consult and the directions for my low ferritin was to supplement EOD 325mg ferrous sulfate 1g Vit C.
I am also dropping my T cyp dose from .25 to .20 M/W/F I plan to do a quicky blood test on my own in 6 weeks.
I also have permission to experiment with reducing my dose even more to try and find that point where I feel I need more. I plan to adjust or stop the AI based on how I feel.

Maybe it's because of my age but in 14 months I have reached TT steady state at 350 630 and 1175 and to be honest they all felt the same.
My original natural TT taken Dec 2016 Feb 2017 were 173 and 225. @350 I started to feel normal.

Keep us posted! Hopefully that works for you! I am waiting for my next consult to get the ok to reduce my dosage
 

HealthMan

Member
It's not guaranteed of course. There is a study around here somewhere that shows why some have difficulty with low ferritin levels because of TRT. It's all about your hepecidin as I recall. I lowered my T dose from 70mg E3D to 35mg E3.5D and I still have the same problem and of course the moment you supp iron your HCT over responds. I also used to donate blood but I stopped and thought that was the end of my problem. I supped iron and vit C and got my ferritin back up only to stop all of that and later learn my ferritin still dropped below range all on it's own. Problem still there. So I supp 50mg iron daily and my HCT is at 51 but I feel ok and my hematologist says I have nothing to worry about.

For sure no guarantees. So you no longer donate blood to control HCT? That is my goal. I have been on trt almost 2 years (injections) and my low ferritin seems to be because of blood donations not by testosterone messing around with hepcidin (i say this based various lab work i have done).
What are your TT and FT levels at 35mg 2x week? Feel any different than we you were at a higher dosage?
 
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ratbag

Member
I thought the same thing. Stop donating and problem solved... but that wasn't the case. My TT is now 680 and FT is at the top of range thankfully. But nothing changed when I did that. I still had the same issues. That's when I realised that TRT does something to my ferritin. That study showed that was the case. Lots of people have this issue. I do not feel any different... but if I reduce my Test to 33mg I can feel it... so clearly 35mg E3.5D is the lowest I can go without compromising myself.
 

HealthMan

Member
I thought the same thing. Stop donating and problem solved... but that wasn't the case. My TT is now 680 and FT is at the top of range thankfully. But nothing changed when I did that. I still had the same issues. That's when I realised that TRT does something to my ferritin. That study showed that was the case. Lots of people have this issue. I do not feel any different... but if I reduce my Test to 33mg I can feel it... so clearly 35mg E3.5D is the lowest I can go without compromising myself.

But are you still donating blood to control HCT? Or after reducing testosterone dosage your HCT stabilized?
I have heard of cases like you. Hopefully my ferritin is not negatively affected by TRT only by the blood donations
 

ratbag

Member
I stopped donating blood long ago and learned that low ferritin was due to me being on TRT. I never had iron issues before TRT. No my HCT did not stabilise.
 

HealthMan

Member
I stopped donating blood long ago and learned that low ferritin was due to me being on TRT. I never had iron issues before TRT. No my HCT did not stabilise.
Thanks ratbag. At least you don’t need to donate blood anymore. I am confident my issue (iron avidity) will be resolved IF i am able to either stop donating blood to control HCT or only donate a couple of times a year. Time will tell. Thanks again for answering all my questions
 

MarkM

Member
Healthman, how did this work out for you? Was supplementing with 18mg iron bisglycinate 2 times a week enough to make a difference? Thanks
 

HealthMan

Member
Healthman, how did this work out for you? Was supplementing with 18mg iron bisglycinate 2 times a week enough to make a difference? Thanks
I was supplementing daily. It did raise my ferritin to within range levels but I still had to donate blood because of my testosterone dosage. Since then i have reduced dosage , stopped iron supplementation and blood donation. My last HCT went from 53.5 to 51.6. I did bloodwork today so next week I will know where my HCT sits. Ferritin slowly creeping up and no need for iron supplementation.
 

HealthMan

Member
@HealthMan any updates from this old thread ? Thanks
Hi Nelson. My HCT iron ferritin are all normal and under control for a long time now. Apart from keeping my testosterone dosage at 100mg/week this is the supplement protocol that has been successful for me to control iron/HCT levels without donating blood:


1000mg IP6
250mg Lactoferrin

both on very empty stomach.

500mg curcumin
zinc 15mg together with 1mg copper
1 baby aspirin EOD
 
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Nelson Vergel

Founder, ExcelMale.com
Even without blood donations. 30% decrease in ferritin in this study.

 

M.J

Active Member
I am at 75mg once weekly “plus hcg 250eod and 75 fsh” everything seems under control my only problem is ferritin it’s boarder line low. Hemoglobin went to 17 although it was stabile at 16 for some time “until I decided to increase to 100mg once weekly but I went back to 75 now”

how can I increase ferritin but in the same time lower hemoglobin? I am not sure if 17 is considered high or maybe boarder line high but I will feel better if I go back to 16.

any suggestions ?
 

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