Iron on TRT? - No libido

[bvictor]

26m who has struggled on TRT for a long time.

In summer 2021 was prescribed test cypionate which immediately causes complete loss of libido, which only returned about 6 weeks after cessation of treatment.

Testosterone did not naturally recover (although libido did), and resumed treatment this time with scrotal cream through Defy in Jan 2022. Libido was mostly alright (on and off), but completely died again in August. I can't figure out what changed, besides possibly the use of anavar, 25mg/day, which crushed my shbg. However, my libido was mostly fine on the drug for 9 weeks prior, and only died in August.

Also supplement 100mcg T4 and 35mcg T3 in the morning, and 100mg pregnenolone, and 4mg Naltrexone at night.

My frequent blood tests have mostly been normal, although after crushing shbg it seems total testosterone is much lower than at the beginning of treatment, despite remaining on 4 clicks of the 200mg/ml cream in the morning.

My dhea is ~150 (138-275), but has been around this level for a long time, including when my libido was good.

Recently tested Iron, which has come down a lot since it was last tested in April:

Iron Bind.Cap.(TIBC) 326 Prior (285) 04/12/2022 ug/dL 250-450
UIBC01 278 Prior(203) 04/12/2022 ug/dL 111-343
Iron01 48 Prior(82) 04/12/2022 ug/dL 38-169
Iron Saturation 15 Prior(29) 04/12/2022 % 15-55

Could low iron explain my symptoms? Would it be appropriate to supplement? Tad surprising given I eat a good amount of fish, meat, shellfish, and even liver.

Also trialed hcg without success, and really at my wits end with respect to libido here. Unfortunately lack of libido seems to correlate with a general anhedonia for me, and I'm contemplating coming off trt entirely again.

Has anybody else lost libido over time on cream or after a long trial of dht derivatives (anavar)? I speculate that if I can get my SHBG to return from 17 atm back to 30 or 40 where it sat prior it could fix my issue?

 

[Systemlord]

Could low iron explain my symptoms?

TRT doesn't work very well for me when my iron is low. Pre-TRT my ferritin was 128 and started TRT and two months later ferritin is 24, iron low, so I stopped TRT and ferritin recovers, the second attempt had the same result, ferritin back to 24.

My iron saturation was 14 and 12%, range 20-55%.

The symptoms started within the second week of starting TRT both times even though my iron tested fine, but I think a snapshot in time doesn't really show what's going on inside your body in real-time.

I have to supplement 140 mg of iron daily or it drops fast and all the benefits to TRT are gone!

If your iron levels were higher pre-treatment and now they're lower on TRT, then that's a clear sign you need to supplement iron.

 

[bvictor]

Thanks! Don't have my ferretin levels back quite yet (will soon). Basis my numbers above is it safe to supplement iron (based on the iron total and saturation being low?)

 

[Systemlord]

Thanks! Don't have my ferretin levels back quite yet (will soon). Basis my numbers above is it safe to supplement iron (based on the iron total and saturation being low?)

Considering your iron saturation was 29 a couple of months ago, and if this was pre-treatment, you have enough information to start supplementing iron.

 

[savefoxes]

Considering your iron saturation was 29 a couple of months ago, and if this was pre-treatment, you have enough information to start supplementing iron.

How long did it take to get the levels to normal?

 

[Systemlord]

How long did it take to get the levels to normal?

It took my 3 months to get my ferritin, iron levels up and feel good on a consistent basis.

I doubt it will take you as long as me to get your iron levels up, because your iron saturation is boaderline and other markers aren't nearly as low as mine were, plus I have absorption issues.

I would supplement 50 mg of the iron cheated and then retest in 2 months.

 

[bvictor]

Thanks. Did you notice libido issues? I do struggle with fatigue but thats existed for a long time (even when iron levels were normal).

Have really been struggling with lack of libido recently and considering coming off trt again as a result.

Only other things I'm considering are maybe progesterone, kisspeptin 10, or other such "complex" additions. Not my preference frankly.

 

[bvictor]

Just got my ferretin back at 34 (although other iron numbers higher?).
I suppose this is low enough to cause symptoms? Also tested for H Pylori on a whim, as had heard this could cause low iron? Strangely came back positive, do you know anything about this?

Ferritin01 34 prior(94) 10/04/2021 ng/mL 30-400


H. pylori, IgG Abs01 1.31 High Index Value 0.00-0.79

Negative <0.80
Equivocal 0.80 - 0.89
Positive >0.89

 

[Systemlord]

Also tested for H Pylori on a whim, as had heard this could cause low iron? Strangely came back positive, do you know anything about this?

H Pylori impairs iron absorption.

 

[themadhatter]

TRT doesn't work very well for me when my iron is low. Pre-TRT my ferritin was 128 and started TRT and two months later ferritin is 24, iron low, so I stopped TRT and ferritin recovers, the second attempt had the same result, ferritin back to 24.

My iron saturation was 14 and 12%, range 20-55%.

The symptoms started within the second week of starting TRT both times even though my iron tested fine, but I think a snapshot in time doesn't really show what's going on inside your body in real-time.

I have to supplement 140 mg of iron daily or it drops fast and all the benefits to TRT are gone!

If your iron levels were higher pre-treatment and now they're lower on TRT, then that's a clear sign you need to supplement iron.

140 mg of iron daily with TRT, doesn't your RBC, Hemoglobin and hematocrit levels go up out of range?

 

[themadhatter]

26m who has struggled on TRT for a long time.

In summer 2021 was prescribed test cypionate which immediately causes complete loss of libido, which only returned about 6 weeks after cessation of treatment.

Testosterone did not naturally recover (although libido did), and resumed treatment this time with scrotal cream through Defy in Jan 2022. Libido was mostly alright (on and off), but completely died again in August. I can't figure out what changed, besides possibly the use of anavar, 25mg/day, which crushed my shbg. However, my libido was mostly fine on the drug for 9 weeks prior, and only died in August.

Also supplement 100mcg T4 and 35mcg T3 in the morning, and 100mg pregnenolone, and 4mg Naltrexone at night.

My frequent blood tests have mostly been normal, although after crushing shbg it seems total testosterone is much lower than at the beginning of treatment, despite remaining on 4 clicks of the 200mg/ml cream in the morning.

My dhea is ~150 (138-275), but has been around this level for a long time, including when my libido was good.

Recently tested Iron, which has come down a lot since it was last tested in April:

Iron Bind.Cap.(TIBC) 326 Prior (285) 04/12/2022 ug/dL 250-450
UIBC01 278 Prior(203) 04/12/2022 ug/dL 111-343
Iron01 48 Prior(82) 04/12/2022 ug/dL 38-169
Iron Saturation 15 Prior(29) 04/12/2022 % 15-55

Could low iron explain my symptoms? Would it be appropriate to supplement? Tad surprising given I eat a good amount of fish, meat, shellfish, and even liver.

Also trialed hcg without success, and really at my wits end with respect to libido here. Unfortunately lack of libido seems to correlate with a general anhedonia for me, and I'm contemplating coming off trt entirely again.

Has anybody else lost libido over time on cream or after a long trial of dht derivatives (anavar)? I speculate that if I can get my SHBG to return from 17 atm back to 30 or 40 where it sat prior it could fix my issue?

I have the same issues, add something new, libido get slightly better but then everything turns back to shit and on top of that other side effects from the extra stuff added. I had a really good libido when I was injecting once-a-week (but everything else [mood, energy, anxiety] was bad). When I went to EOD, it made everything else better but the libido went away. Maybe the Ferritin is the cause, mine is low now too.

 

[Systemlord]

140 mg of iron daily with TRT, doesn't your RBC, Hemoglobin and hematocrit levels go up out of range?

My hemoglobin and hematocrit are declining as my vitamin D levels increase which makes me less dehydrated.

My hemoglobin last week was 18.5.

 

[Systemlord]

When I went to EOD, it made everything else better but the libido went away.

That's probably because the milligram release is higher on an every other day protocol, so you're probably using more iron.

Men on TRT will use more iron than someone not on replacement therapy, since testosterone influences hemoglobin levels and uses up iron.

 

[FDV70]

Might be of help on ferritin. For the ED, I can't say.

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

Hi all, I started TRT in 2001 and have been giving blood over the years and have always had issues with recovering my ferritin. Long story short, I got tired of waiting for others to do the research, so I did it myself, created a protocol, hired a hematologist in May 2021 who thought it could...

www.excelmale.com