Low ferritin doesn't matter as long as hemoglobin and hematocrit are good?
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Systemlord
Member
I need my ferritin level 80 or higher to feel consistently good.I get it checked monthly. Levels bounce around between 15-77. Last level was 66 but felt horrible. 
That's what I've been seeing from cruising the forums. I guess it's like T levels, everyone has their own level.
Systemlord
Member
In my case, TRT absolutely crushes my ferritin levels unbelievably fast! If I take my Jatenzo, oral testosterone, without taking my iron supplements, within two hours, I start to feel the effects of low iron, IBS, excessive yawning, tiredness, sleepiness, fatigue, doesn’t matter if ferritin is 98 or 198.
TRT really fu*** up my iron metabolism.
I am the extreme outlier, an uncommon case.
I also happen to respond vigorously to TRT!
Very curious about this. My ferritin dropped since I started TRT. Ferritin was 93 (38 - 330) Pre-TRT and has been between 37 and 41 since being on TRT the last 1.5 years.
My TIBC has been normal all that time, but my total Iron and Saturation have been slightly elevated. I've felt good, to great, to sometimes fatigued all that time, so hard to say if it's low ferritin related vs. just going through life.
My TIBC has been normal all that time, but my total Iron and Saturation have been slightly elevated. I've felt good, to great, to sometimes fatigued all that time, so hard to say if it's low ferritin related vs. just going through life.
Have you been seen by gastroenterology?
Systemlord
Member
Yes, I ate a sandwich with radioactive iodine and they watched my digestive system, breakdown the food, and found out that my G.I. moves the food too quickly through my G.I. due to the type 2 diabetes.
This is less of an issue now, as I have very little to no bloating at all after eating.
I had a colonoscopy, nothing of note.
If I stop TRT, and my iron supplements, ferritin levels will rise higher than they are now eating iron rich foods.
Did they put you on Reglan (metoclopramide) for the motility issues?
Systemlord
Member
Yes, but I no longer need it.
FunkOdyssey
Seeker of Wisdom
I think this is typical and that many or even most guys on TRT are walking around with ferritin levels like this if they were to check. I've heard some argue it is not a real iron deficiency because there is still plenty of iron in the body -- it is basically being stored in hemoglobin instead of ferritin, and the body does recycle iron from aged red blood cells. This camp argues low ferritin is just a normal condition of being on TRT and is not cause for concern. Then there are some like Systemlord where TRT does seem to create a symptomatic deficiency. That seems less common though.
What does for sure create a real iron deficiency is frequent blood donations.
Guided_by_Voices
Well-Known Member
The other important pieces of this POV are that 1) most men are far more likely to have iron overload rather than low iron, so blood donation (at least for a while) would not necessarily cause a deficiency but rather bring levels down to a healthier point. If someone was truly deficient without a lot of blood donation, the question would be "where did the iron go?" since" donation, chelation, and endurance sports are AFAIK the only ways to remove iron from the body. This is the obvious question for people who believe that low ferritin alone is indicative of low iron. And 2) copper plays a large role in iron metabolism so what could appear to be an iron issue could really be a low-copper issue.
Slightly offtopic but where are your levels sitting with less than 5mg? Daily prop-enan blend or what?
Iron overload on TRT, really?
It is a propionate/enanthate blend, 2.4 mg/3.2 mg, 4.4 mg T/day. It leads to peak total testosterone of around 700 ng/dL and a trough in the low-400s. SHBG is in the 30s nMol/L. @tareload demonstrated that this response to dose is actually fairly close to average.
Guided_by_Voices
Well-Known Member
"Iron overload on TRT, really?"
I'm not sure what your question is. I've never heard of a mechanism by which T would cause iron excretion. It may reduce ferritin but the iron could be reabsorbed by tissue or other ferritin. Ferritin AFAIK is a carrier for iron in the blood, but the actual amount of iron it carries at any one time can vary dramatically, hence why it is a fairly poor marker of iron status compared to TIBC, for example. Iron overload is, from what I understand, due to iron in the tissues which creates a highly oxidative, pro-aging state and lowering ferritin without actually getting iron out of the tissues does not address iron overload. The book Dumping Iron covers this as do various videos from Morley Robbins. There was a prolific blogger on the topic that preceded both of them but I don't remember who that was, but they have all come to similar conclusions which is that almost everyone (men and possibly older women) who does not give blood consistently, likely has too much iron in their tissues, especially given the amount of "iron fortified" foods in the modern diet.
Yes i am familiar with this school of thought, and yes the exogenous testosterone suppressing effect on hepcidin(could lead to iron overload) is more significant in aging males and higher dosages, still you hear a lot of guys telling how they need to supplement iron on trt, go figure.
Nice, at one point i was doing enanthate 7.5mg daily, i guess around 5.5mg test, got a through of 15nmol/l so around 430ng/dl
So how do you get your Ferritin up while on TRT WITHOUT raising Hemo?
Systemlord
Member
Not possible to have your cake and eat it too. The reason why hematocrit and hemoglobin decrease after blood donations is due to ferritin dropping.
When Did Bloodletting Start? Egyptians were among the first to perform bloodletting more than 3000 years ago. From there, the practice spread to the Greeks and Romans, then Asia, and beyond. By the Middle Ages, bloodletting was widely practiced in Europe and barbers served as pseudo-medical providers.
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