I experience this same problem. Ferritin drops like a rock almost instantly. Joined this forum because I've been searching for answers to my symptoms. Can't stay on TRT for more than a month or two because I end up feeling horrible.
Warning for Men on TRT: Low Ferritin is Bad
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Vince
Super Moderator
Have you ever had your magnesium levels checked. I keep my in the high range.
Magnesium is known to play a role in iron metabolism, including the absorption, transport, and utilization of iron. Studies have shown that magnesium deficiency can lead to impaired iron absorption and utilization, potentially affecting ferritin levels.
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Does Magnesium Affect Ferritin Levels? Exploring the Relationship - Statcare
Ferritin levels do fluctuate, and it is an acute phase reactant, meaning it can also spike due to things like infection, inflammation, etc. However, ferritin is the most specific lab for assessing iron stores.
You're right that most men do not experience iron deficiency, but it is common to men on testosterone therapy. Again, ferritin levels indicate iron status, not serum iron. What us TRT users experience is depletion of stored iron due to activation of EPO secondary to exogenous testosterone supplementation. So, you'll have enough iron-bound to hemoglobin but your iron stores can be deficient.
No, but that's an excellent point and I'll request it. I think my personal experience is a combination of two things: overdonating blood, due to the online TRT company that I was using urging me to donate frequently even though I never had elevated h&h levels AND now possible inflammatory bowel disease, which can hinder vitamin and mineral uptake. It's extremely frustrating to have good numbers on paper but feel like absolute dog shit.
Can you please tell me how often you ran the Vorck protocol to get from 15 to 200? I've tried it a couple times with a moderate increase but my levels don't stay long. Thanks in advance.hey @FDV70
Any thoughts on my results in
Iron/Ferritin Issues - Excel Male Health Forum
Hi all, for the last year or so ive been having issues related to iron. THis started by me having 4 phlebotomies over the space of a few months to reduce my haemocrit down from 56% Since then Id been getting symptons of low ferritin like brain fog, extreme fatigue, shortness of breath and in...www.excelmale.com
I’ve been following your protocol on and off over the last year and often for runs longer than a week . Sometimes a couple of weeks at a time.
As you can see my ferritin level is great (200+)
(It was 15 in September 2022 when I first had a blood test) . It’s my other results I don’t know what to make of.
Thanks
Systemlord
Member
TRT increases EPO which increased erythroferrone, lowering hepcidin and ferroportin lets iron release from hepatocytes and therefore ferritin doesn't rise.
Vince
Super Moderator
Effect of Testosterone on Hepcidin, Ferroportin, Ferritin and Iron Binding Capacity in Patients with Hypogonadotropic Hypogonadism and Type 2 Diabetes
Since the syndrome of hypogonadotropic hypogonadism (HH) is associated with anemia and the administration of testosterone restores hematocrit to normal, we investigated the potential underlying mechanisms.Randomized, double blind, placebo controlled trialWe ...
www.ncbi.nlm.nih.gov
Systemlord
Member
Maybe, maybe not, no way to know the thresholds for a particular individual.
good thing is those issues have extremely simple solutions. Stop donating blood, and try to eat as close to carnivore as u can. Full carnivore will clear that bowel inflammation within a week, but getting close to that should also clear it up in a relatively short amount of time
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
Found this in another post here. Thoughts?
Wich Type of MAG is best?
Vince
Super Moderator
I use source naturals magnesium malate. I believe liquid magnesium is better absorbed. I know a few men that use liquid magnesium and usually their levels go above range and they have to cut back.
Same thing happened to my 90-year-old mother when she used liquid magnesium. Her levels went over range and her doctor made her cut back.
So, I went down a massive ferritin wormhole today and ended up here. I have been thumbing through the discussion only to learn we don't have a lot of definitive guidance here!
I have been battling fatigue for about a year. Have been working on systematically eliminating various medications I thought could be causing it (beta blockers, migraine prevention meds, etc). TRT numbers are perfectly in range. I did a bunch of labs, including some iron studies. My TRT doc didn't say much, because everything was "normal", including HGB and HCT. But, I just looked back at them and my ferritin of 30 (very low end of "normal") caught my eye, thus leading me to the wormhole.
I literally have many of the classic symptoms of iron deficiency without anemia (fatigue, poor mood, restless leg - rarely, some pain, etc) and I really wonder if my ferritin is the issue.
So far, it seems like there is some consensus on a few things. I'd love for others to help me summarize what we know, what we think we know and what we don't know.
Off the top of my head:
I have been battling fatigue for about a year. Have been working on systematically eliminating various medications I thought could be causing it (beta blockers, migraine prevention meds, etc). TRT numbers are perfectly in range. I did a bunch of labs, including some iron studies. My TRT doc didn't say much, because everything was "normal", including HGB and HCT. But, I just looked back at them and my ferritin of 30 (very low end of "normal") caught my eye, thus leading me to the wormhole.
I literally have many of the classic symptoms of iron deficiency without anemia (fatigue, poor mood, restless leg - rarely, some pain, etc) and I really wonder if my ferritin is the issue.
So far, it seems like there is some consensus on a few things. I'd love for others to help me summarize what we know, what we think we know and what we don't know.
Off the top of my head:
- There are a few theories on why testosterone treatment lowers ferritin, but the connection is pretty clear and well recognized
- Quitting TRT will raise your ferritin
- Lowering your dose might raise your ferritin
- There is debate about whether the form of TRT matters (ie injecting vs. cream)
- Why would the form of TRT matter? Is the mechanism for dropping ferritin related to your levels, regardless of how you get there? Or, are sustained high levels more important than absolute numbers?
- @Systemlord feels strongly that Jatenzo won't drop your ferritin. Why is that? Periodic drops in levels versus sustained high levels? If this is true, shouldn't cream be ferritin friendly? Seems like some here have low ferritin on cream, too. I never checked ferritin while on Natesto, but I would venture to guess it was normal. That said, I think Natesto left my testosterone levels a bit low, which also leads to fatigue
- Why would the form of TRT matter? Is the mechanism for dropping ferritin related to your levels, regardless of how you get there? Or, are sustained high levels more important than absolute numbers?
- It's really hard to balance raising ferritin without raising Hct
- Taking vitamin C may or may not help raise ferritin
- What seems pretty consistent is that guys who check ferritin and notice it's low tend to feel shitty. Seems like some guys drop TRT doses, or entirely drop TRT, ferritin goes up and they actually feel better than when on TRT
- if I'm wrong, please chime in
Guided_by_Voices
Well-Known Member
You may want to watch/listen to Morley Robbins who has written a lot on the Iron/fatigue issue. He has a book called CU-re your Fatigue. The book Dumping Iron is also informative. If Chris Masterjohn has had something to say on the issue, his views are always valuable. There is way more to fatigue than Iron/Ferritin. Have you had a good work-up from a holistic Doc specifically focused on infections and micro-nutrient status? Ferritin is a carrier for Iron in the blood, but the Iron bound to the ferritin can vary dramatically. Also, note that excess Iron in the tissues can cause fatigue. Iron overload is likely more of a risk for most men than too little iron since there is no mechanism for removing iron from the body except blood loss, chelation, and IIRC extreme endurance activities.
Mike Wriley
New Member
Mike Wriley
New Member
Ditto that,
Found that the PPI pantaprozole will interfere with iron adsorption and drop ferritin into the 9-10 range, so don’t ad insult to injury.
Found that the PPI pantaprozole will interfere with iron adsorption and drop ferritin into the 9-10 range, so don’t ad insult to injury.
Considering it's been in use for several years in various FB groups and some reps at Matrix and Defy use it, I would consider my existing protocol to be definitive actually.
Did you not get good results on it?
Edit to add in case someone still hasn't heard of it
Belekas
nobody
Agree on all points here and actually I'm surprised everyone is just talking about it being too low. Currently reading the RCP and got the CU-re book, so lots of reading ahead. Ferritin is an acute-phase reactant that can be elevated from a lot of things. I've chatted with Fred Vorck a bit in his FB "Iron Disorder" group as he seems really good at this as well and also Kyle Van. Anyone on TRT/androgens that has Ferritin > 120 is suspect for Iron Disorder and should be investigated. Last year I had Ferritin 124 while on 100mg/week TRT. Came off 6 months ago and now a month ago my Ferritin came back sub 400, above the NHS lab range and also TS above range at 52%. That's straight up red flag and exactly as you wrote about excess Iron in the tissues possibly causing fatigue and other issues. Also Ferritin tends to rise slowly as we age and once we hit 40-50 it spikes IF we have issues. But then the damage IMHO can be already done because we haven't been on top of this our all lifes checking just Ferritin, popping some Iron pills maybe as a lot of Docs say a lot of people are deficient, eating foods that pretty much all contain Iron, meats, etc. My test was done after me being sick for 4 weeks and still feeling the effects of this so maybe thats why it was sub 400, because as we get sick body shuffles Iron into Ferritin to starve the bacteria/virus, temp goes up to cook it and removing serum iron helps inhibit replication. Viruses and bacteria need iron to replicate. Inflammation also can raise ferritin fwiw. So thats a possibility but what about above range TS%? I'm not sure it can be elevated that much from being sick but who knows. I will have another Iron panel blood test done next week since I've had 500g blood let and been taking IP6 and Curcumin with meals for close to 2 weeks now. Then will need 23andMe genetic test done and since I'm from Eastern Europe and have Celtic ancestry traits theres a bigger possibility for me to have hereditary hemochromatosis. Just hope nothing more serious as this Iron overload thing is dangerous and hope no organs have been damaged while this issue was persistent.
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