Iron Supplementation and Iron Testing Questions?

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Systemlord

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A world doesn't exist where I'm on TRT and not supplementing iron, 6 weeks ago my ferritin was 24, iron 42 and started supplementing iron. Today my ferritin was measured at 88 and yesterday was forced to increase the daily dosage of iron do to symptoms of iron deficiency returning after reaching a stable state (exactly 6 weeks) on my new protocol.

Hours after increasing the dosage of iron, a ferritin lab was run in the urgent care do to my symptoms, lightheadedness, dizziness, fatigue, cold hands, feet and body chills all day long forcing me to cover up when it's 72 outside. The increase in iron snuffed out these symptoms within several hours and have felt warm all day today and feel better.

I'm one of those guys that will experience symptoms of iron deficiency with normal blood parameters including hemoglobin, MCV, MCH, MCHC when iron and ferritin are below ranges.

How is it that I can still be experiencing symptoms of iron deficiency with a ferritin of 88?

Did taking the iron so close to the ferritin testing skew the results?
 
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A world doesn't exist where I'm on TRT and not supplementing iron, 6 weeks ago my ferritin was 24, iron 42 and started supplementing iron. Today my ferritin was measured at 88 and yesterday was forced to increase the daily dosage of iron do to symptoms of iron deficiency returning after reaching a stable state (exactly 6 weeks) on my new protocol.

Hours after increasing the dosage of iron, a ferritin lab was run in the urgent care do to my symptoms, lightheadedness, dizziness, fatigue, cold hands, feet and body chills all day long forcing me to cover up when it's 72 outside. The increase in iron snuffed out these symptoms within several hours and have felt warm all day today and feel better.

I'm one of those guys that will experience symptoms of iron deficiency with normal blood parameters including hemoglobin, MCV, MCH, MCHC when iron and ferritin are below ranges.

How is it that I can still be experiencing symptoms of iron deficiency with a ferritin of 88?

Did taking the iron so close to the ferritin testing skew the
B12? You know I've tried thyroid, testosterone, many vitamins and minerals, including high dose vitamin D. Nothing. I returned to my research on B12 because my wife is exhibiting symptoms of dementia, which afflicted all of her sisters. It got me interested in trying B12, again, in order to try to normalize my sleep.

I had two expired vials of cyanocobalamin which I purchased from Thailand. (Now I have 10 vials) After some experimenting and observing how I feel, I decided to take my injection(1000 mcg) at noon. Paydirt! My sleep normalized and my body temp runs 98 or slightly above most of the day,including upon awakening. I won't say I'm now totally okay, but my depression has greatly diminished, as has my OCD, brain fog and irritability. B12 accomplished what all the psych meds I was prescribed never did.
 
I have also been taking vitamin B12 injections (1000 mcg, cyanocobalamin) and my temp rose from 97.6 to 98.3 so far. No other changes.

My B12 levels were within the normal range before starting so I go by symptom improvement rather than targeting a lab number.
 
I don't go by labs, either. The last lab I had was 389, when I saw my urologist last December. But I'm now finding my sleep quality has declined. Last night went to bed at 9:30, up at 1:30. Took 2 grains of desiccated thyroid, sublingual, ate a little, read and was back asleep at 3, sleeping until 7. Looks like I'll be resuming thyroid at night.
 
B12? You know I've tried thyroid, testosterone, many vitamins and minerals, including high dose vitamin D. Nothing. I returned to my research on B12 because my wife is exhibiting symptoms of dementia, which afflicted all of her sisters. It got me interested in trying B12, again, in order to try to normalize my sleep.

I had two expired vials of cyanocobalamin which I purchased from Thailand. (Now I have 10 vials) After some experimenting and observing how I feel, I decided to take my injection(1000 mcg) at noon. Paydirt! My sleep normalized and my body temp runs 98 or slightly above most of the day,including upon awakening. I won't say I'm now totally okay, but my depression has greatly diminished, as has my OCD, brain fog and irritability. B12 accomplished what all the psych meds I was prescribed never did.
The injection of 1000mcg of methylcobalamin is subq and how many times a week? For those who have problems with the MTHFR gene it is good to supplement with methyl cobalamin + methyl folate. Here I do sublingual.
 
@Systemlord Those symptoms (besides the fatigue) don't sound like iron deficiency. When will they give you the results from the urgent care place?

Have you checked your thyroid? Is there any chance that you were sick with something? (COVID, STI, etc)
 
The injection of 1000mcg of methylcobalamin is subq and how many times a week? For those who have problems with the MTHFR gene it is good to supplement with methyl cobalamin + methyl folate. Here I do sublingual.
Cyancobalamin, IM. I've tried oral methylcobalamin. Don't feel good when I take it. Now taking 2000 mcg, daily because sleep quality was returning to baseline poor. My urologist gave me an rx with 12 refills. He's a believer in B12.
 
@Systemlord Those symptoms (besides the fatigue) don't sound like iron deficiency. When will they give you the results from the urgent care place?
Yes I have the results, not at home and will update post later tonight. When I take my iron in the morning and eat, I feel unwell, but eating after my second iron dosage is a non-issue.

I agree it's more than likely I've got more things going on than just iron deficiency. When I eat, my ring finger on my left hand hurts within 10 minutes, turns red around the finger nail, swells and eventually needs draining of puss buildup.

The swelling builds up (peaks) into the evening.

I took a course of antibiotics for 10 days which got rid of it but is now coming back days after running out of antibiotics.


Have you checked your thyroid?
TSH is 0.45, fT4 1.0, T3 101 and was checked in the evening at 7 p.m. Testing during the morning hours sees a slightly high TSH (.68-.89). I did try NDT and after only two doses started experiencing hyperthyroidism.
 
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Ferritin level 88 is excellent, ideal
For who? A person recently iron deficient the goal is to get the ferritin 100> as per guidelines because someone who has been chronically low in iron for prolonged periods of time has a higher requirement for iron than someone who has never had iron deficiency.
 
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yes, if not iron deficient, really. But I think there's room for iron augmenting and still having good ferritin.
 
A world doesn't exist where I'm on TRT and not supplementing iron, 6 weeks ago my ferritin was 24, iron 42 and started supplementing iron. Today my ferritin was measured at 88 and yesterday was forced to increase the daily dosage of iron do to symptoms of iron deficiency returning after reaching a stable state (exactly 6 weeks) on my new protocol.

Hours after increasing the dosage of iron, a ferritin lab was run in the urgent care do to my symptoms, lightheadedness, dizziness, fatigue, cold hands, feet and body chills all day long forcing me to cover up when it's 72 outside. The increase in iron snuffed out these symptoms within several hours and have felt warm all day today and feel better.

I'm one of those guys that will experience symptoms of iron deficiency with normal blood parameters including hemoglobin, MCV, MCH, MCHC when iron and ferritin are below ranges.

How is it that I can still be experiencing symptoms of iron deficiency with a ferritin of 88?

Did taking the iron so close to the ferritin testing skew the results?
My bloodwork always looks fine but my ferritin’s always been super low despite taking iron before the test that would be skewing it even higher (starting TRT it was around 13-30, after it was 9, iron pills before the test had it at 20-50 depending on the test and time). Low iron can have a cascading affect on all your other hormones, particularly thyroid conversion and uptake and cortisol, which I’ve had issues with over the years and odd reactions to when trying to supplement. I also personally have odd allergic reactions to nearly all foods if things are bad, seemingly the worst with histamine containing or promoting foods. I even feel allergic to water if things are at their worst and get itchy from it. If I have a bunch of salt all at once that’ll do it too eventually. I personally have an odd rash thing on my face that’ll even start bleeding during it, which sounds similar to your finger pus thing.

My physician advised me to not take any iron supplements for 5-6 days before a test to really see what my body’s holding onto. My current goal’s getting my ferritin to 115 or a little higher, and am on higher-potency iron supplements advised around here with absorption aids (Ferrits Iron + Vit C + L-Lysine + Transferritin twice a day on an empty stomach), in addition to eating more iron-rich foods that are well absorbed like red meat and liver with vitamin C and L-Lysine while avoiding things that inhibit iron absorption around them (egg whites, magneium and calcium, etc). Having looked into things a lot regarding this, ferritin itself is necessary and in higher demand on TRT, sometimes independent of current serum iron. Anyone that’s historically had low ferritin while on TRT and isn’t feeling the best probably owes it to themselves to see how they feel when they get their ferritin up to at least 115, after having verified their ferritin wasn’t already high due to infection or something.

Since you also seem to have similarly odd issues as I do, one odd thing I have also found is that if I try something that gives me a certain sort of diarrhea or intestinal motility, I’ll usually feel a lot better and my hormones all seemingly work and click for a peroid of time after that until something ‘builds up’ again and I start having allergic reactions and other weird symptoms like yours. Whatever’s building up isn’t feces as I‘m always regular. In my case with my history it’s possible I have something that builds up in there that inhibits iron absorption that I’m ridding myself of when I do that. If you haven’t already, looking into your gut health as a potential source may be relevant to you as well.
 
I have always struggled with ferritin on the low side (under 60) even though I have only donated blood 3 times in 30+ years. We are now seeing data that TRT decreases ferritin as it adjusts to the higher need for iron due to erythrocytosis. I think that is the reason why some of us may not feel our best. Low ferritin has also been linked to restless leg syndrome, body aches and low mood. I think many of us could use iron plus Vitamin C supplementation not only once but twice per day to bring ferritin up closer to 100 even in the presence of "normal" serum iron.

 
I wish everyone measured their ferritin and not only their hematocrit before donating blood, as this study suggests. The US only uses hemoglobin since they can do it from a hand-held meter. If everyone on TRT knew their ferritin values before blood donations, many would find out that they should not do it. You lose about 30 ferritin points per donation.


First results of a ferritin-based blood donor deferral policy in the Netherlands​


BACKGROUND​

Whole blood donors are at risk of becoming iron deficient. To monitor iron stores, Sanquin implemented a new deferral policy based on ferritin levels, in addition to the traditional hemoglobin measurements.

METHODS​

Ferritin levels are determined in every fifth donation, as well as in all first-time donors. Donors with ferritin levels <15 ng/mL (WHO threshold) are deferred for 12 months; those ≥15 and ≤30 ng/mL for 6 months. The first results were analyzed and are presented here.

RESULTS​

The results show that 25% of women (N = 20151, 95% CI 24%-25%) and 1.6% of men (N = 10391, 95% CI 1.4%-1.8%) have ferritin levels ≤30 ng/mL at their first blood center visit. For repeat (non-first-time) donors, these proportions are higher: 53% of women (N = 28329, 95% CI 52%-54%) and 42% of men (N = 31089, 95% CI 41%-43%). After a 6-month deferral, in 88% of returning women (N = 3059, 95% CI 87%-89%) and 99% of returning men (N = 3736, 95% CI 98%-99%) ferritin levels were ≥15 ng/mL. After a 12-month deferral, in 74% of returning women (N = 486, 95% CI 70%-78%) and 95% of returning men (N = 479, 95% CI 94%-97%) ferritin levels increased to ≥15 ng/mL.

CONCLUSION​

Deferral of donors whose pre-donation ferritin levels were ≤30 ng/mL might prevent donors from returning with ferritin levels <15 ng/mL. This policy is promising to mitigate effects of repeated donations on iron stores.

https://onlinelibrary.wiley.com/doi/full/10.1111/trf.15906
 
I have been experiencing strange symptoms lately after taking iron, if I take 115-125mg> iron, I breifly get shoulder blade pain shortly after taking it, but if I take about 100mg iron I can barely get out of bed the next day and I feel run down.

I feel better when taking more than 100mg. If I split it up into 2x daily dosing I don't feel good until I take my second dose.

I checked my ferritin a month ago and it was 88. I wonder if my diabetes can affect my body of the utilization of iron.

I've been taking iron supplements for more than three months now originally 200-300 initially.
 
I have been experiencing strange symptoms lately after taking iron, if I take 115-125mg> iron, I breifly get shoulder blade pain shortly after taking it, but if I take about 100mg iron I can barely get out of bed the next day and I feel run down.

I feel better when taking more than 100mg. If I split it up into 2x daily dosing I don't feel good until I take my second dose.

I've been taking iron supplements for more than three months now originally 200-300 initially.
Shoulder blade pain that soon after taking it can often by referred pain from your GI track somewhere. I’ve tried many different kinds of iron supplements. Some made me feel nauseous and odd, others did not. Even took too much one time and seemingly had very mild iron toxicity.

What kind are you taking? Might need some doing to find a kind you best tolerate at an amount you benefit from.
 
Shoulder blade pain that soon after taking it can often by referred pain from your GI track somewhere. I’ve tried many different kinds of iron supplements. Some made me feel nauseous and odd, others did not. Even took too much one time and seemingly had very mild iron toxicity.

What kind are you taking? Might need some doing to find a kind you best tolerate at an amount you benefit from.
I'm currently taking Iron chelate and have been on Bisglycinate with the same symptoms.

You might be right about the GI causing the back pain, after eating lunch today (chicken which has iron in it) shortly after eating I experienced a couple of things, minor shoulder blade pain but on the left side and my muscles from my workout the day prior suddenly became sore and stiff upon leaving the restaurant, muscle soreness normally occurs the very next morning upon waking up when I have sufficient iron intake the day prior.

The problem I faced 3 months ago is my iron and ferritin both super low was I couldn't get sore from a workout until I started downing 200-300mg of iron. If tomorrow morning I take more than 100mg of iron and I workout, the next morning I wake with muscle soreness, but if I take less than 100mg of iron, the time it takes for my muscles to get sore increases and is delayed sometimes by 2-3 days.
 
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@madman

I was wondering if you can provide an iron dosing conversion chart so that I can dose (1:1) various forms of iron such as ferrous sulfate, ferrous fumarate, ferrous gluconate do to side effects.

Much appreciated.
 
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The problem I faced 3 months ago is my iron and ferritin both super low was I couldn't get sore from a workout until I started downing 200-300mg of iron. If tomorrow morning I take more than 100mg of iron and I workout, the next morning I wake with muscle soreness, but if I take less than 100mg of iron, the time it takes for my muscles to get sore increases and is delayed sometimes by 2-3 days.
This is very interesting. Were you able to confirm these symptoms with this dose of chelated iron? You go to the gym and you will only feel sore muscles after 2-3 days. That's interesting.
 
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