Chronic Low ferritin. Need advice from those who have fixed low ferritin.

[Sera]

View attachment 361976View attachment 361977
Fresh labs. Only things abnormal are listed.
Hmm not really sure what’s going on here CBC wise. Maybe very dehydrated. I have been lacking on my water

Guess the lack of Test cyp allowed my Ferritin to rise. Good to see that.
But still on the lower side.

I’m taking no supplements other than glutamine, multi vitamin (iron free) and a sleep aid.

Roughly 125mg test cyp a week on these labs.

Won’t be taking any iron till CBC levels back down.

This is just my thoughts, obviously only you know the right answer:

Possibly those symptoms you recently had were due to high HCT.

When’s the last time you donated?

If it were me I’d want to:
1) hydrate aggressively
2) donate (seems like even dehydration shouldn’t increase hct that much)
3) keep taking the iron

Possibly your androgen signalling was still too high pushing the RBC production up. So try and reduce it if that’s something you are open to. Maybe split doses further, or switch to a test cyp in cottonseed oil (thicker) or similar to avoid spikes.

 

[Ateam2023]

Everyone always says donate blood, that is such a temporary fix , and likely not the right one ,

 

[Sera]

Everyone always says donate blood, that is such a temporary fix , and likely not the right one ,

If you are committed to not reducing your dose you are probably right, (it will just go right back to what it was) but if you are open to decreasing the dose then that should avoid a rebound.

I have heard anecdotally that some people on moderate TRT doses manage to do regular donations without an issue but that’s a bit of an extreme option anyway, I don’t think anyone wants to be forced to regularly donate blood to stay healthy.

Note: I’m pretty new to all this but recently had success by donating 500ml blood and reducing my dose substantially, and taking iron to keep my ferritin up.

 

[Tbaz192]

Looks like you may have fixed it.
Pull hsCRP too. If it's elevated then ferritin will be overstated.

Exactly my thoughts!

 

[Tbaz192]

This is just my thoughts, obviously only you know the right answer:

Possibly those symptoms you recently had were due to high HCT.

When’s the last time you donated?

If it were me I’d want to:
1) hydrate aggressively
2) donate (seems like even dehydration shouldn’t increase hct that much)
3) keep taking the iron

Possibly your androgen signalling was still too high pushing the RBC production up. So try and reduce it if that’s something you are open to. Maybe split doses further, or switch to a test cyp in cottonseed oil (thicker) or similar to avoid spikes.

Donating would crash my ferritin again, absolutely avoiding donating. It’s a driving factor to my issues.
Iron supplement have no effect on me. So that’s also why.

 

[Sera]

Donating would crash my ferritin again, absolutely avoiding donating. It’s a driving factor to my issues.
Iron supplement have no effect on me. So that’s also why.

The iron supplements are clearly having an effect considering your RBC count and ferritin have both increased.

The reason so much has gone to your RBC count vs your ferritin is because androgen signalling is pushing it towards RBC production rather than storage.

 

[Tbaz192]

The iron supplements are clearly having an effect considering your RBC count and ferritin have both increased.

The reason so much has gone to your RBC count vs your ferritin is because androgen signalling is pushing it towards RBC production rather than storage.

you misread. I’m not taking iron supplements. Haven’t for months.

 

[Sera]

you misread. I’m not taking iron supplements. Haven’t for months.

Oh ok, my bad.

 

[Tbaz192]

No worries.

Seems the androgen load of higher testosterone (200 a week) was effecting me enough to keep my ferritin from building. Dropping down to half my normal dose was enough to raise my ferritin after awhile.

Unless CRP/inflammation is elevated from whatever. That could cause a false read on my ferritin.
And I’ve been out of the gym since October 22nd. So we’ll see if my numbers change once I’m back in on a routine.

I’ll pull labs again in a week or two. And a little after being back on a gym routine.

I’m still getting some gnarly weak/dizzy spells, and vision issues.
So I haven’t been in the gym at all.
Could be elevated CBC.
I have an appointment with an ENT to see if I have ear issues & or if it’s something else.

Also getting my thyroid looked at again.
Make sure my thyroid nodes haven’t increased or become cancerous. One side was inconclusive on the higher % time back in spring time.

 

[OldGHGuy]

Damn. Now I'm in this 'low ferritin' mix. Never had this problem previously. Mid 50 years old. Finished up my old man blast of 300 Test/175 Primo/2.4IU in September and now TRT on 150 only since. Feeling good except for some stomach discomfort. Went for periodic bloods with Nephrologist:





My guess is a combination of the cycle plus my PPI use for GERD causing a lack of absorption of Iron (although it is "in range" technically" is causing this. Funny thing is I don't have any typical symptoms of low iron so not sure. Have to wait a week+ to get back into the doc to discuss. Not dehydrated and was fasted on blood draw. Never low ferritin before.

Thoughts?

 

[Photon]

Feeling good except for some stomach discomfort.

You might want to do an at home FIT stool test to check for bleeding.
Also at that age, routine scopes can be considered..

Are you on a GLP?
That can prevent iron absorption.

You'll probably start getting symptoms if your iron sat drops even lower.

Try supplementing iron, then retest bloods.
Also get hsCRP labs pulled the next round.

 

[Sera]

Damn. Now I'm in this 'low ferritin' mix. Never had this problem previously. Mid 50 years old. Finished up my old man blast of 300 Test/175 Primo/2.4IU in September and now TRT on 150 only since. Feeling good except for some stomach discomfort. Went for periodic bloods with Nephrologist:

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View attachment 362446
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My guess is a combination of the cycle plus my PPI use for GERD causing a lack of absorption of Iron (although it is "in range" technically" is causing this. Funny thing is I don't have any typical symptoms of low iron so not sure. Have to wait a week+ to get back into the doc to discuss. Not dehydrated and was fasted on blood draw. Never low ferritin before.

Thoughts?

I’m not a doctor of course, but if it were me I’d be starting on 36mg iron bisglycinate daily.

Something to consider also: PPIs can decrease absorption of vitamin B12 from food (like from meats) but B12 from supplements is unaffected.

 

[OldGHGuy]

You might want to do an at home FIT stool test to check for bleeding.
Also at that age, routine scopes can be considered..

Are you on a GLP?
That can prevent iron absorption.

You'll probably start getting symptoms if your iron sat drops even lower.

Try supplementing iron, then retest bloods.
Also get hsCRP labs pulled the next round.

Thanks brother. I recently had upper endoscopy and colonoscopy scopes. A few benign polyps removed but all good. No bleeding that I know of but that was one of the first things I thought of, too.

I was on Tirz for roughly 8 months but got off about 2 months ago because I felt like it was aggravating my GERD (I later found out the slowing of digestive movement from GLPs does, in fact, increase stomach acid. Not good for someone already with GERD). I didnt really need it for weight loss but wanted to try for other benefits. I probably wont use it again.

 

[OldGHGuy]

I’m not a doctor of course, but if it were me I’d be starting on 36mg iron bisglycinate daily.

Something to consider also: PPIs can decrease absorption of vitamin B12 from food (like from meats) but B12 from supplements is unaffected.

Ya PPIs do a number on absorption. One of the reasons I take extra Magnesium and now it looks like I can add iron and possibly should add B-12/

 

[Tbaz192]

@OldGHGuy
We have similar labs sorta
Mine corrected itself after lowering my
dose.
( don’t pay attention to my new labs lol. I was very dehydrated on the CBC)

My body was creating red blood cells too fast due to the elevated doses of Test / cycles.
The elevated MPV is newer young platelets I believe. And mine has been consistently elevated. All that combined
my ferritin never had a chance to rebuild at all.

Definitely keep an eye on the GI things.
My doctors blamed GI issues for my low ferritin but normal iron sat / % labs

Low dose and some extra iron, should hopefully help. Worst case there’s plenty of other ideas in this thread including piggy iron as the last resort.

 

[OldGHGuy]

@OldGHGuy
We have similar labs sorta
Mine corrected itself after lowering my
dose.
( don’t pay attention to my new labs lol. I was very dehydrated on the CBC)

My body was creating red blood cells too fast due to the elevated doses of Test / cycles.
The elevated MPV is newer young platelets I believe. And mine has been consistently elevated. All that combined
my ferritin never had a chance to rebuild at all.

Definitely keep an eye on the GI things.
My doctors blamed GI issues for my low ferritin but normal iron sat / % labs

Low dose and some extra iron, should hopefully help. Worst case there’s plenty of other ideas in this thread including piggy iron as the last resort.

Thanks. I bought some Iron Glycinate with Vitamin C so I'm going to try that, probably every other day at first. Gonna ramp up the red meat, nuts, cereal etc too to try to get more dietary Iron.

I've been on PPI for 25 years so its really doing a number on some of my absorption. That + age + summer blast (and TRT) I think is the culprit but I am going to stay on it until its fixed.

 

[OldGHGuy]

@OldGHGuy
We have similar labs sorta
Mine corrected itself after lowering my
dose.
( don’t pay attention to my new labs lol. I was very dehydrated on the CBC)

My body was creating red blood cells too fast due to the elevated doses of Test / cycles.
The elevated MPV is newer young platelets I believe. And mine has been consistently elevated. All that combined
my ferritin never had a chance to rebuild at all.

Definitely keep an eye on the GI things.
My doctors blamed GI issues for my low ferritin but normal iron sat / % labs

Low dose and some extra iron, should hopefully help. Worst case there’s plenty of other ideas in this thread including piggy iron as the last resort.

I'm using 150 per week Test C. Was this low enough to see improvement or did I read you went as low as 100 per week in order to see results?

 

[Tbaz192]

I'm using 150 per week Test C. Was this low enough to see improvement or did I read you went as low as 100 per week in order to see results?

I’d say everyone is different?

I was bouncing between 150 and 100.

Avoiding foods that my stomach didn’t agree with. And added glutamine 10g a day. Plus 5-6 other supplements.
Did those help? No clue at all lol but I was also crossing off the gut being an issue.

I definitely have to have higher levels of ferritin & more regular iron.
I feel better physically & mentally. The gym doesn’t feel terrible. I’m still not as strong but it’s okay.
And my libido/drive is back. Hasn’t been this high since I noticed these issues ages ago.