Frequent Blood Donations = Iron Deficiency

[IncreaseMyT]

Dr Morgantaler (Harvard) does not suggest discontinuing TRT until you reach 55%.

Maybe this time try to go longer? Maybe test again in another month?

Thats probably what I would do if I had a problem keeping my iron up.

[Lockout888]

Now I'm seeing a catch-22...

My Ferritin level are still somewhat low. More iron is the only way to raise it, but my RBC is already high at 6.02 and hematocrit at 52.6.

If I donate blood again soon, I will lose about 250mg of iron from my blood.

Anyone use Grapefruit to lower hematocrit levels? The ingredient naringin is supposed to "lead to phagocytosis, which is a process that naturally removes red blood cells from your blood, converting them into other uses"

[Mr.BB]

Anyone use Grapefruit to lower hematocrit levels? The ingredient naringin is supposed to "lead to phagocytosis, which is a process that naturally removes red blood cells from your blood, converting them into other uses"

Yerba Mate tea also supposed to help (anedoctal evidence).

Thinking out of the box... Is everything allright with your breathing? Do you breath normally through your nose, without needing to breath through your mouth?

Pretty sure you dont smoke, right?

Hows your cardio?

[Lockout888]

Thinking out of the box... Is everything allright with your breathing? Do you breath normally through your nose, without needing to breath through your mouth?
Pretty sure you dont smoke, right?
Hows your cardio?

Yeah, breathing through my nose is fine.
I don't smoke.
Cardio was really bad before I found out about my iron deficiency. I got tired easily, a lot of sweat, no endurance etc.
Starting about 3 weeks ago, cardio got a lot better. After 30 min on the elliptical at 150 pulse rate, I'm not even tired and not sweating as much.

[Lockout888]

I too had low iron issues last year, serum Fe was 19 mcg/dl but ferritin scored normal at 80 ng/ml.
After two months of 100% RDI daily I got a serum Iron of 100 and a ferritin of 110.

You were able to do this while keeping Hematocrit under control? What were your starting and ending Hematocrit levels?

[hammerheart]

Supplementing Iron never affected CBC. In fact I believe it's the T causing low serum iron, by stimulating hematopoiesis. Pre TRT h&h were 37% and 12. Currently at 45% and 14.

Please note that my physiological readings are at the low end of range, so I'm at a kind of an "advantage" here.

[Lockout888]

Supplementing Iron never affected CBC.

Everything I'm reading is saying supplementing with iron will increase both Hematocrit and Hemoglobin.

[hammerheart]

Everything I'm reading is saying supplementing with iron will increase both Hematocrit and Hemoglobin.

That's very likely to happen with frank iron deficiency, but it really depends on circumstances.

I had low circulating Iron but stores (ferritin) were ok. CBC was also unchanged comparing to earlier readings, and no anaemia was present, but I was feeling very ill.

I think it was the T stimulating iron uptake for blood synthesis, reducing the quota available for other functions. Sluggish liver from hypothyroidism probably did the rest by preventing sustained release of stores into circulation.


As for you I suggest you continue with iron supplementation and blood donations.

If I donate blood again soon, I will lose about 250mg of iron from my blood.

No way. If your current levels are 100mcg/dl, by drawing half a liter you give away ~500mcg of Iron.

Sure there is much more stored as hemaglobin and that could be recycled once the red cells die.

[Lockout888]

No way. If your current levels are 100mcg/dl, by drawing half a liter you give away ~500mcg of Iron.

Since my Hematocrit was at 52.6% I decided to donate blood again. I wanted to see how much iron I lose from donating, so I took another blood test 36 hours later (10 days after my last test) for science

RBC (4.14-5.80) 5.71
Hemoglobin (12.6-17.7) 16.2
Hematocrit (37.5-51.0) 50.4
MCV (79-97) 88
MCH (26.6-33.0) 28.4
MCHC (31.5-35.7) 32.1
RDW (12.3-15.4) 21.9 High
UIBC (111-343) 291
Iron, Serum (38-169) 44
Iron Saturation (15-55) 13 Low
Ferritin, Serem (30-400) 20 Low

Serum Iron went from 101 to 44
Saturation from 34 to 13
Ferritin from 37 to 20

[Youthful55guy]

I discovered the low ferritin levels about a year ago during routine labs for an annual checkup. I plan to have the labs rerun in a month or two for my next annual checkup, so I can't yet answer the question as to how effective it has been.

Regarding dose, I take 1 pill of a product called Blood builder that the lady at the health food store said was popular with the women. it contains 520 mg iron plus some Vit C, Folate, and B-12. I've been doing this for about a year (since my last ferritin labs). For the first 6 months or so, I took double the dose (1 tab AM and 1 tab PM). Now I only take 1 tab PM. My thinking is that the double dose probably caught me up and now it's a matter of maintenance. I may rethink this after my next labs.

Regarding constipation as Lockout mentioned, this is definitely not a problem for me. The product does claim to be non-constipating, but I have a mild case of IBF, so any help in that regard is welcome.

Several months ago, Lockout888 asked me how iron supplementation affected my iron/ferritin levels but I couldn't answer because I hadn't done repeat labs since starting iron about a year ago. I just had them redone with my annual labs and it seems that they are a bit on the high side now. Not excessively high, but my doc wants me to cut back on the iron. Going to be hard to do, since I now just supplement one pill per day. Taking it every other day is too hard to keep track of. I'm going to try and cut the pills in half and see how that works. However, I can say for certain, that the iron supplements do work as claimed.

[testytim]

Several months ago, Lockout888 asked me how iron supplementation affected my iron/ferritin levels but I couldn't answer because I hadn't done repeat labs since starting iron about a year ago. I just had them redone with my annual labs and it seems that they are a bit on the high side now. Not excessively high, but my doc wants me to cut back on the iron. Going to be hard to do, since I now just supplement one pill per day. Taking it every other day is too hard to keep track of. I'm going to try and cut the pills in half and see how that works. However, I can say for certain, that the iron supplements do work as claimed.

Hi Youthful55 i am having some of the same issues as you with iron .Can i ask you how you were feeling??

[Youthful55guy]

I'm in a good place, but there are way too many factors involved in that to isolate to simply iron levels. Too often I see guys linking how they feel to one simple factor in their overall health program. It's much more complicated than that as I discovered on this journey. It involves getting everything balanced, the major components being: Total T, Free T, SHBG, E2, T3/T4, rT3. On top of that, there's Blood Pressure, Lipids, weight, and regular exercise.

For me iron/ferritin levels never were an issue until I was forced to donate blood regularly because I had to drive Total way up to compensate for high SHBG. It's a vicious circle. it's only recently that I started addressing the SHBG problem in hopes of reducing my T dose and making blood donation optional. That's still a work in progress...

[Lockout888]

Several months ago, Lockout888 asked me how iron supplementation affected my iron/ferritin levels but I couldn't answer because I hadn't done repeat labs since starting iron about a year ago. I just had them redone with my annual labs and it seems that they are a bit on the high side now. Not excessively high, but my doc wants me to cut back on the iron. Going to be hard to do, since I now just supplement one pill per day. Taking it every other day is too hard to keep track of. I'm going to try and cut the pills in half and see how that works. However, I can say for certain, that the iron supplements do work as claimed.

How often are you donating blood?

[Lockout888]

I've been crunching numbers of the results I have so far, to give me an estimate of what my iron levels might be 4 weeks after my last labs. Obviously this is just an estimate:
Iron, Serum = 83 (38-169)
Iron, Saturation = 27 (15-55)
Ferritin = 35 (30-400)

[Youthful55guy]

How often are you donating blood?

As often as I'm allowed. I was doing double red every 16 weeks, but then they messed up a return once and I decided it wasn't worth the added risk or discomfort of the larger needed, so now I'm back to single pint donations every 8 weeks.

[JKW]

I have been donating twice a year. I huess I will see what blood results are in about a week. I didn't know about omeprezol and iron. Been taking that for years! No wonder I am tired.

[testytim]

JKW please report back i am in the same boat been on nexium for 15 years and now have a iron defeciency and i cant go off acid reflex goes off the hook.Man does it come back with a vengence

[kelkel]

From what I've read short term PPI use has no documented effect. Long term still needs to be studied.

Association of Long-term Proton Pump Inhibitor Therapy with Bone Fractures and effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium

[Lockout888]

I have been donating twice a year. I huess I will see what blood results are in about a week.

The test I get is from Private MD labs, and is called Iron Deficiency Anemia Profile. It includes all of this for about $60 with the coupon code:

Reticulocyte count
Iron, Serum w/TIBC: Percent of saturation; serum iron; total iron binding capacity; unsaturated iron binding capacity
Ferritin
Complete Blood Count (CBC) with Differential: (Hematocrit; hemoglobin; mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration (MCHC); red cell distribution width (RDW); percentage and absolute differential counts; platelet count; red cell count; white blood cell count; immature granulocytes)

[Lockout888]

Updated Labs pulled 10/19/16. Previous ones were from 10 weeks ago.

I've been taking a Blood Builder pill every day, as well as a Multi with iron. Hematocrit was really high, so I donated blood yesterday. Now I need to find the balance of taking iron to keep my levels up, but not spike Hematocrit and Hemoglobin too high.

RBC (4.14-5.80) 5.99 High
Hemoglobin (12.6-17.7) 19.1 High
Hematocrit (37.5-51.0) 55.8 High
MCV (79-97) 93
MCH (26.6-33.0) 31.9
MCHC (31.5-35.7) 34.2
RDW (12.3-15.4) 15.3
UIBC (111-343) 206
Iron, Serum (38-169) 87
Iron Saturation (15-55) 30
Ferritin, Serum (30-400) 63

In 10 weeks:
Serum Iron went from 44 to 87
Saturation from 13 to 30
Ferritin from 20 to 63

[Lockout888]

Plan going forward.

Maybe you guys can help me with a plan going forward. My Doctor wants me to stop taking iron until my next donation, which is a minimum of 8 weeks. Even after my donation yesterday, my Hematocrit is probably still high (I'm guessing around 53%) but now my iron and ferritin are probably low.

Should I do a Double Red Cell Donation next time? Only take iron for 2 weeks after a donation?

After getting BW done before and after a donation last time, I'm guessing these are what my current numbers are now:
Iron, Serum (38-169) 40
Iron Saturation (15-55) 14
Ferritin, Serum (30-400) 35

[GSXRvi6]

I have a home tester for hemoglobin. I know it's not the same as full blown CBC but it's a pretty good marker for when I need to go donate. Amazon sells them.

I have seen similar small home style testers for hematocrit but I have yet to find a source to buy it.

[Mr.BB]

IMO you guys should not donate if your iron/ferritin is low.

Low iron is associated VTE (deep venous thrombosis) which completely beats the purpose of donating....

[Lockout888]

IMO you guys should not donate if your iron/ferritin is low.

What if your hematocrit is 55% like mine was?

[Mr.BB]

What if your hematocrit is 55% like mine was?

You need to let your iron get to normal levels before donate. Your body will try to preserve iron by elevating coagulation factor VIII, increasing the chance for clotting : Low serum iron levels are associated with elevated plasma levels of coagulation factor VIII and pulmonary emboli/deep venous thromboses in replicate cohorts of patients with hereditary haemorrhagic telangiectasia

How about reducing test dosage, at least for a few months while you cant donate?

What do you do for cardio? Increased cardio will reduce RBCs.

[Lockout888]

You need to let your iron get to normal levels before donate. How about reducing test dosage, at least for a few months while you cant donate? What do you do for cardio? Increased cardio will reduce RBCs.

Yeah, I may need to do that to reduce RBC. My protocol has been the same for almost 3 years: Test Cyp: 80mg every 3.5 days SubQ, HCG : 250iu 3x week SubQ, Anastrozole: .25mg 1x per week, day after T injection. This get my TT to about 650-750, when I do BW about 12 hours before T injection.

I also started drinking grapefruit juice and ordered some naringin pills. Hopefully that will help. I could increase cardio - currently only doing 1 day per week for about 30 min.

[Lockout888]

How about reducing test dosage, at least for a few months while you cant donate?

Reducing test dosage won't reduce RBCs correct? It may just not increase them?

What would be a good reduction dosage?

[Mr.BB]

Reducing test dosage won't reduce RBCs correct? It may just not increase them?

What would be a good reduction dosage?

Less test should reduce the production of RBCs (erythropoiesis) thus reducing the total mass of erythrocytes in circulation.

Its hard to say what "a good reduction" would be, it would just be my opinion, you need to try it yourself, maybe down to 80-100mgs weeks. It's important to split it 2x per weeks to avoid peaks which favour erythropoiesis.

Have you looked into Nebido/Aveed it is supposed to have less impact on H&H.

[The_Crawfish]

How do you even tell what your iron levels are?? My CBC through labcorp doesn't show just iron?

[Lockout888]

How do you even tell what your iron levels are?? My CBC through labcorp doesn't show just iron

You have to get labs specially for that. A few posts above I mentioned the test I order.

[Mr.BB]

You need Total Iron and Ferritin.

[The_Crawfish]

Thanks, I'll get the doc to order it next time

[Lockout888]

Well, here is my plan for now. Let me know what you guys think:

I donated whole blood on 10/19 after these labs:
Hemoglobin 19.1 HIGH (12.6-17.7)
Hematocrit 55.8 HIGH (37.5-51.0)
Iron, Serum 87 (38-169)
Iron Saturation 30 (15-55)
Ferritin, Serum 63 (30-400)

After getting BW done before and after a donation last time, I'm guessing these are what my current numbers are now:
Hemoglobin 18.1 HIGH (12.6-17.7)
Hematocrit 53 HIGH (37.5-51.0)
Iron, Serum (38-169) 40
Iron Saturation (15-55) 14 LOW
Ferritin, Serum (30-400) 35

I can't donate again for 7 more weeks. So to keep my Hematocrit down until then, I lowered my test injections from 160/week to 120/week. I started taking nattokinase (4000 fu), and drinking grapefruit juice every day until the naringin I ordered comes in. I stopped taking supplemental iron, but will continue to eat foods with iron.

When I get close to the 8 week mark, I will re-test all the above to see where I'm at. If I'm still really high in hemo/hema - I will do a double red cell donation. If not, I will do a regular whole blood donation. I will bring my test injection levels back to normal and take supplemental iron for 2 weeks only. Then do another blood test of all the above to see the results.

[Lockout888]

Update:

Just got my lab results back, 8 weeks after my last results. Looks like I won't need to do the double-red cell donation:

Hemoglobin 17.8 HIGH (12.6-17.7)
Hematocrit 51.1 HIGH (37.5-51.0)
Iron, Serum 94 (38-169)
Iron Saturation 31 (15-55)
Ferritin, Serum 37 (30-400)

Looks like the reduced Test and switching to Losartan reduced my Hematocrit quite a bit.

[Youthful55guy]

Tell me more about the Losartan. Perhaps this was discussed earlier in the thread, but I haven't read it all. I'm interested because I also have some high hemoglobin issues that I keep in check with blood donations. I am also taking Losartan for blood pressure control. Does it have an effect on hemoglobin production?

Looks like the reduced Test and switching to Losartan reduced my Hematocrit quite a bit.

[Youthful55guy]

I ended up doing a little research of my own on the topic and found that studies with type 2 diabetics does show that Losartan does lower hemoglobin. Since my doc doubled my Losartan dose from 25 mg (lowest dose available) to 50 mg a couple months ago, I'm interested to see if it has an impact on my next CBC labs and hemoglobin levels. I had no idea that it would do this. Kill two birds with one stone!

Here's an interesting read:

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers can decrease hemoglobin, causing anemia and this may be an independent risk factor for chronic kidney disease progression. We studied the relationship between a decline in hemoglobin and outcome in 1513 patients with type 2 diabetes and kidney disease by a post hoc analysis of the RENAAL Study (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan) with an average follow-up of 3.4 years. The relationship between baseline and year-1 hemoglobin and treatment on end-stage renal disease (ESRD) and ESRD or death was evaluated using multivariate Cox models (covariates: baseline hemoglobin, proteinuria, serum albumin, serum creatinine, and year-1 hemoglobin). Compared with placebo, losartan treatment was associated with a significant decrease of hemoglobin, with the largest between-group difference at 1 year. After adjustment, there were significant relative risk reductions for losartan compared with placebo for ESRD and for ESRD or death regardless of the baseline hemoglobin even in those patients with a baseline hemoglobin below 120 g l(-1). Hence, the renoprotective properties of losartan were maintained despite a significant lowering of the hemoglobin concentration.

From <https://www.ncbi.nlm.nih.gov/pubmed/18094675>

Full text of the article available at: https://www.google.com/url?sa=t&rct=...LUmj0ReCq1IiNw

[Bonaparte]

Seems like we've already covered all this, but to reiterate: if your iron stores are low, but H&H is high, then you need to increase your iron intake and lose more blood. Just do it yourself at home if donating isn't cutting it.

[Mr.BB]

Seems like we've already covered all this, but to reiterate: if your iron stores are low, but H&H is high, then you need to increase your iron intake and lose more blood. Just do it yourself at home if donating isn't cutting it.

Just adding that lowering test dose is also advisable, and IMO changing protocol to x2 a week injection can also help.

Its interesting that with nebido I dont have any problems with H&H.