Anemic with very low BP's since starting trt gel

[Systemlord]

MCV, MCH

If either of these are at the bottom of the ranges, this would indicate a problem. I experienced the symptoms of iron deficiency long before MCV dropped below range.

Iron deficiency can be the most difficult medical condition to diagnose.

 

[ratt57]

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

One of several sources on the web re: anemia/low BP:

Other symptoms of iron deficiency anemias may include:

• 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

Only experiencing the shortness of breath when I stand up and am active, some weakness and the low BP.

 

[ratt57]

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 - PMC

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 ...

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

Thanks for the link! So were you taking 9 of these 28mg tablets a day with no side effects at all?

 

[Systemlord]

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

I’m taking five and a half capsules. The only side effects are positive, increased energy, strong muscles, better erections and better sleep.

My ferritin levels are healthy.

 

[ratt57]

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.

 

[Vince]

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

Low blood pressure (hypotension) - Symptoms and causes

www.mayoclinic.org

 

[Systemlord]

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

This sounds similar to symptoms of long Covid.

 

[ratt57]

This sounds similar to symptoms of long Covid.

Luckily, I've never had covid yet, even though everybody else I know has.

 

[Wilson7]

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.

It's not the gel and drinking more water will drive it lower, not higher. I'd follow up with your doc and make sure nothing else is going on (occult blood loss or anemia of other origin). Gels have the least effect on Hb/HCT, inj esters the greatest.

 

[ratt57]

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.

My ferritin levels came back perfectly normal at 286. However, RBC, hemoglobin, hematocrit, transferrin and abs lymphocytes are even a slight bit lower than they were before. Iron is right on the border of low. Strange. because today I'm not experiencing any dizziness or weakness and had a great workout at the gym!

 

[Systemlord]

My ferritin levels came back perfectly normal at 286.

I wouldn't say perfectly normal, because normal doesn't translate into healthy. According to multiple studies, people with ferritin between 20-100 have increased life expectancy.

Decreased life expectancy with ferritin above 100, the average life expectancy with ferritin at 200 is 79 years old, above 500, 50 years old.

Ferritin is a marker of inflammation rather than iron status in overweight and obese individuals.

 

[magnus68]

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.

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

 

[ratt57]

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

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

 

[Systemlord]

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

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.

 

[ratt57]

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.

 

[magnus68]

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.

I would check ferritin, MCV, MCH, MCHC and iron saturation. If this is ok and Ferrit is 40 is that ok?. How can I increase without raising Iron too high

 

[ratt57]

Something to take note of:

Serum Ferritin and Death from all Causes and Cardiovascular Disease: The NHANES II Mortality Study

PURPOSE: The purpose of this study was to assess the association between serum ferritin and death from all causes, cardiovascular diseases (CVD), CHD …

www.sciencedirect.com