Ferritin levels too low

[42daddyoopsy]

History
Hypothyroid
Low T (Started at 190)
Chasing ferritin levels but never anemic.
MCV and MCH has always been low. I do inject vitamin b12 shots and had normal levels last time.
Meds
Injecting 60 mg SubQ Mon, Wed, Fri
NP Thyroid 120 mg
Anastrozole 1mg Half Tab on Wed

So I am finally starting to fell better. First time my vitamin d has been above 40. But my ferritin is still low and I am really trying to get get that up because I am tired all the time. Sex is good if the wife would cooperate more. Did have an anxiety attack. But I am blaming my estradiol. Ran out of Anastrozole for two weeks. (only take a half of tab on Wednesdays)

So should I ignore the free T number since I feel pretty good?
What have you guys done to drive up ferritin. MCV, and MCH?
I am scheduled for a blood donation Thursday and my blood pressure is up even though my meds are the same.

Thanks in Advance

 

[Systemlord]

What have you guys done to drive up ferritin. MCV, and MCH?

Iron. Low iron binding capacity indicate low amounts of iron in the blood. Directly testing iron isn’t very useful, or is it accurate, because it can change after eating.

You’re tired because you’re iron deficient, the size of your hemoglobin is too small to carry enough oxygen in the blood.

If you get your ferritin higher, you will need to decrease your TRT dose to manage hematocrit and hemoglobin.

 

[42daddyoopsy]

Thanks, I am focused on my Iron/Ferritin now. Could be the last piece of the hormone puzzle.

 

[Systemlord]

Thanks, I am focused on my Iron/Ferritin now. Could be the last piece of the hormone puzzle.

Thyroid function is impaired with iron deficiency.

 

[42daddyoopsy]

I have read that multiple times now. But my tsh free t3 free t4 look ok. But have also always thought my thyroid meds didn't really help. Never felt any better whether on them or off them. I am kind of surprised ferritin testing and iodine levels aren't standard treatment requirements. I am also going to start adding lugols drops to some water daily.

 

[Systemlord]

I am kind of surprised ferritin testing and iodine levels aren't standard treatment requirements.

The whole iron screening guidelines are inadequate. I joined Kaiser and the first thing the endocrinologist ordered was iron saturation, and iron, scored an iron saturation of 14% (20-55%), iron 69 and nothing was said or done because hemoglobin was normal.

No way in hell I had a normal ferritin with that iron saturation level.

It’s like no doctor ever heard of iron deficiency without anemia.

 

[FDV70]

Thanks, I am focused on my Iron/Ferritin now. Could be the last piece of the hormone puzzle.

See Raising ferritin FAST (a how-to, not a question)

 

[tcmi]

your high free T indicates low SHBG; you can very likely lower your T dosage and still be at the high end of Free T range. If you’re concerned about low iron, stop donating blood. You can likely bring down hematocrit by lower T dose. Stop taking AI and let your E2 settle naturally - it will normally be higher with higher T. Give it six weeks to normalize. One other question - how much Vitamin D are you taking? Your level is super high.

 

[mcs]

This is an excerpt from a fire post. I have not been able to find who the poster was on this, but maybe somebody in this forum can help me find him. Trying to figure out why chronically low ferritin and other markers.

“In general:
Exogenous Testosterone increases EPO.
Increased EPO causes the marrow to produce more RBCs.
When more RBCs are produced, more erythroferrone is also produced.
When erythroferrone is produced, hepcidin is suppressed.
Iron binds to transferrin and goes to hepatocytes (liver) and macrophages in spleen and marrow.

PART 1, LOW FERRITIN
When hepcidin is suppressed, ferroportin in cells will allow stored iron (ferritin) to exit the liver cell very easily, re-bind to transferrin, and be used for hemoglobin. This will also prevent iron from being stored as ferritin normally in the first place.

When more iron released from ferritin is available in serum, it is channeled into hemoglobin.
Eighty percent of ferritin is stored in the liver. Retired RBCs are often stored as ferritin. Because of suppressed ferritin, the recycled iron also contributes to high hemoglobin.

PART 2, LOW IRON
Serum iron going to marrow, because that's a major stop on the circuit (liver, spleen, marrow) feeds RBCs. Which we are overproducing thanks to EPO.
RBC overproduction causes hemoglobin to be overproduced, as it's synthesized in the cytosol of immature red cells. This is proerythroblast > reticulocyte all in the marrow. Erythroferrone keeps transferrin saturation low. Everything in the body is in "put iron into hemoglobin" mode.

You can use my ferritin protocol to boost ferritin. You don't really care about "iron" which is serum iron because even in normal people not on TRT it changes hourly. Literally hourly. It also gets pulled down as explained above.

A normal transferrin saturation isn't really useful to us on TRT because iron has cellular destinations anyway. Serum Iron is just the temporary holding area. It's just going to be pulled into hemoglobin”

 

[FDV70]

It's either something I wrote or something of mine someone added to
Here is the whole protocol

Fixing High Hemoglobin or Hematocrit and Low Ferritin While on TRT

Here is the trial version of Protocol 2:

Vorck Ferritin Protocol V2 TRIAL