High hematocrit, low iron?

**Beethoven** · 07-24-2014, 07:47 PM

Been looking at my past BW along with the latest. Dr is puzzled by the following:

RBC 7.56 range 4.20-5.80 H
Hematocrit 50.1 range 38.5-50.0 H
MCV 66.3 range 80.0-100.0 L
MCH 21.5 range 27.0-33.0 L
RDW 20.8 range 11.0-15.0 H

Basically I'm anemic with a high volume of blood. It's been this way since I started hrt but not before. Is this only me or has anyone else experienced similar findings. He doesn't know how this can be and wants me to see a specialist. Your input always appreciated.

**Beethoven** · 07-25-2014, 01:58 PM

Bump

**MuscleInk** · 07-25-2014, 02:10 PM

Originally Posted by Beethoven

Been looking at my past BW along with the latest. Dr is puzzled by the following:

RBC 7.56 range 4.20-5.80 H
Hematocrit 50.1 range 38.5-50.0 H
MCV 66.3 range 80.0-100.0 L
MCH 21.5 range 27.0-33.0 L
RDW 20.8 range 11.0-15.0 H

Basically I'm anemic with a high volume of blood. It's been this way since I started hrt but not before. Is this only me or has anyone else experienced similar findings. He doesn't know how this can be and wants me to see a specialist. Your input always appreciated.

Not uncommon even at TRT doses. The hematocrit is high but slightly and I would expect the same of RBC with your a higher hematocrit.

Did he check your platelet count and hemoglobin?

What dose of TRT are you taking? Are you using an AI at all?

**Spartans09** · 07-25-2014, 05:34 PM

I am having the same issue. I donate blood 3-4 times a year to keep rbc and hematocrit at close to low normal. I have low iron and am borderline anemic. I have not figured it out yet either. I can take an iron supplement but that will quickly jack the benefits of the blood donations on rbc and hematocrit. Catch 22.

**highpsi** · 07-25-2014, 05:35 PM

Mine is similar, iron bottom of the range, can't get a answer either.

**Spartans09** · 07-25-2014, 05:35 PM

I've been quite lethargic in the morning the last couple of months and assume that is the low iron.

**SEOINAGE** · 07-25-2014, 11:24 PM

Doctor has me on 45 mg of iron a day, but my rbc and hematocrit is within range, and haven't donated for a quite a while. I hope he does a CBC soon, now that I have been supplementing for so long, had another round of iron panels today, it was moving in right direction as in last bloods it was finally in the range but at the bottom of the range. Hoping for better now. Kind of funny I noticed this week my blood finally tastes like it is supposed to instead of like sweat.

**2Sox** · 07-26-2014, 09:30 AM

Interesting discussion. I recently found that my iron and ferritin were considerably below range and I started to supplement two tabs of iron/day. I'm in the mid range now. Was time for a colonoscopy and endoscopy and my doctor looked for possible causes of this in these areas. Getting results next week.

Then my hematocrit came in at 53 and I didn't make the connection with the iron supplementation until reading this thread. Thanks for the insight. I donated blood 2 weeks ago. Taking my next BW in two weeks but I anticipate a drop of a few points. And if keeping everything in balance is as simple as donating every two months, I won't mind it at all.

**Beethoven** · 07-26-2014, 10:34 AM

I'm guessing that is part of the sides to hrt. My dose isn't very high. I pin 50 mg twice a week and 500 iu HCG . I feel good though, strength in the gym is very good. I also take .5 mg of Anastrozole once a week. Thanks for the feedback. My Dr is puzzled by this. I have often thought this was due hrt since it only began after hrt. I will see the specialist just to cover my bases.

**spacemon** · 07-26-2014, 11:14 AM

I have elevated hematocrit as well so I am interested in this discussion. So what is measured to tell if you have low iron or not? I'm not sure what all the abbreviations in the first post mean exactly.

**Beethoven** · 07-26-2014, 12:55 PM

Originally Posted by spacemon

I have elevated hematocrit as well so I am interested in this discussion. So what is measured to tell if you have low iron or not? I'm not sure what all the abbreviations in the first post mean exactly.

Check my bw above.

**spacemon** · 07-26-2014, 01:18 PM

Yes I did but I'm not sure which one is iron?

**spacemon** · 07-26-2014, 04:41 PM

OK a bit of Google helped me out...

Red cell distribution width (RDW): Low & High Levels - MedFriendly.com

If RDW is high and MCV is low it could be from low iron.

**Beethoven** · 07-26-2014, 05:02 PM

Originally Posted by spacemon

OK a bit of Google helped me out...

Red cell distribution width (RDW): Low & High Levels - MedFriendly.com

If RDW is high and MCV is low it could be from low iron.

Good research. Nice read.

**Beethoven** · 07-26-2014, 05:26 PM

Doing some more research. So before hrt mcv, mch and rdw as well as hematocrit levels normal. Between then and now have had six theraputic phlebotomies. Where testosterone does increase hematocrit and rdw, mcv and mch just can't keep up.

**spacemon** · 07-26-2014, 07:10 PM

I'm gonna add iron to my vitamin regimen now. Just started taking baby aspirin too. I am doing bloods again in a few weeks so I am curious if it will help.

**Beethoven** · 07-26-2014, 07:29 PM

Originally Posted by spacemon

I'm gonna add iron to my vitamin regimen now. Just started taking baby aspirin too. I am doing bloods again in a few weeks so I am curious if it will help.

Will be interesting to see. Check back and let us know. Probably take a little laxative or something as iron does make you constipated.

**SEOINAGE** · 07-27-2014, 08:37 PM

My panels indicate poor iron absorption, and my doctor is convinced it is because I am hypothyroid and wants me on armor thyroid. After this blood work, if things are still bad likely will jump on it. Just another thing to keep in mind.

**Beethoven** · 07-27-2014, 09:57 PM

Originally Posted by SEOINAGE

My panels indicate poor iron absorption, and my doctor is convinced it is because I am hypothyroid and wants me on armor thyroid. After this blood work, if things are still bad likely will jump on it. Just another thing to keep in mind.

Good to know. My Dr had done a thyroid work up that was ok. But will keep it in mind. The previous Dr wanted me to take a thyroid pill after a blood work up. That was right before hrt and my levels were good back then. I'm about to go round up all my previous BW and do some more checking.

**SEOINAGE** · 07-28-2014, 09:45 AM

Originally Posted by Beethoven

Good to know. My Dr had done a thyroid work up that was ok. But will keep it in mind. The previous Dr wanted me to take a thyroid pill after a blood work up. That was right before hrt and my levels were good back then. I'm about to go round up all my previous BW and do some more checking.

Yeah, I've been mostly borderline, one point went on synthroid and came off, another time were able to modify my diet and get enough improvements in free t3 and reduction in thyroid antibodies, but this last panel was pretty bad. Worth another look over I would think.

**Lockout888** · 06-09-2016, 11:34 AM

Originally Posted by spacemon

I'm gonna add iron to my vitamin regimen now. Just started taking baby aspirin too. I am doing bloods again in a few weeks so I am curious if it will help.

Any update on this?

How much iron is everyone taking and how has it effected your labs?

**yettibecsuse** · 10-07-2016, 01:16 AM

Originally Posted by Lockout888

Any update on this?

How much iron is everyone taking and how has it effected your labs?

I have the opposite problem; my iron is normal, my crit levels are fine but my feritin levels were 900; so I had to give blood four times in the last two weeks to get it down

**yettibecsuse** · 10-07-2016, 01:17 AM

Originally Posted by yettibecsuse

I have the opposite problem; my iron is normal, my crit levels are fine but my feritin levels were 900; so I had to give blood four times in the last two weeks to get it down

I take no iron sups get it all in my protein

**hammerheart** · 10-07-2016, 01:25 AM

Originally Posted by yettibecsuse

I have the opposite problem; my iron is normal, my crit levels are fine but my feritin levels were 900; so I had to give blood four times in the last two weeks to get it down

You what? Ferritin is a protein released by the liver and a marker of acute inflammation other than an index of Iron stores; giving blood won't serve the purpose intended, unless Iron overload is present but you'd get high serum Fe then.

You seriously need to take a look at your liver.

**TjmAble** · 10-07-2016, 02:02 AM

Originally Posted by MuscleInk

Not uncommon even at TRT doses. The hematocrit is high but slightly and I would expect the same of RBC with your a higher hematocrit.

Did he check your platelet count and hemoglobin?

What dose of TRT are you taking? Are you using an AI at all?

First of all he's indeed anemic, second you should also do blood test for Hemogonlin to see if you hematocrit is for real or just plasmatic from the TRT cause as you know testosterone has the effect to elevate the hematocrit numbers, BUT you must count your hemoglobin and when you take the results calculate the number of hemo x3 to see your real hematocrit, third of all Iron and hematocrit doesn't always depend on each other, purpose your doctor to give you some Folic Acid (Brand name: Filicine).

**yettibecsuse** · 10-07-2016, 02:56 AM

Originally Posted by bizzarro

You what? Ferritin is a protein released by the liver and a marker of acute inflammation other than an index of Iron stores; giving blood won't serve the purpose intended, unless Iron overload is present but you'd get high serum Fe then.

You seriously need to take a look at your liver.

feritin is your stored iron levels can be high as you said inflammatory disorders, consuming too much alcohol or haemocromatosis genetic disorder; every blood donation drops ferritin levels but 50 to 150 varies in different people the normal prescribed procedure is 2-4 500 ml donations for four weeks; you will find high ferritin levels in people in the US Australia and Europe quiet common; most men don't check it that's all

**yettibecsuse** · 10-07-2016, 03:03 AM

Originally Posted by bizzarro

You what? Ferritin is a protein released by the liver and a marker of acute inflammation other than an index of Iron stores; giving blood won't serve the purpose intended, unless Iron overload is present but you'd get high serum Fe then.

You seriously need to take a look at your liver.

Approximately 75% of the body's 3-4 g total iron is found within haemoglobin in red blood cells, 10-20% is stored in the protein ferritin and the remainder is found in the iron transport protein transferrin, as well as in myoglobin, cytochromes and as unbound serum iron.

serum ferritin involves identifying alcohol consumption, metabolic syndrome, obesity, diabetes, liver disease, malignancy, infection or inflammation as causative factors.

4. Venesection schedule
Iron unloading phase, target serum ferritin ~50 ?g/L
Weekly venesection of ~7 mL/kg (maximum 550 mL) whole blood
Ensure pre-venesection haemoglobin >120 g/L
Monitor Hb and SF
Hb: is it safe to remove more blood? Delay for 1 week if pre-venesection Hb <120 g/L
SF: is it safe to remove more iron? Monitor SF every 4-6 venesections, more often as SF approaches
100 ?g/L
It may take many months or even years to unload excess iron
Oral vitamin B12 and folate supplements support erythropoiesis during frequent venesections

25% of Australian Americans have high ferritin levels

**hammerheart** · 10-07-2016, 04:46 AM

My point was there is no need for phlebotomy if high ferritin isn't related to iron overload. You are just exposing yourself to becoming anemic.

**yettibecsuse** · 10-07-2016, 11:41 PM

Originally Posted by bizzarro

My point was there is no need for phlebotomy if high ferritin isn't related to iron overload. You are just exposing yourself to becoming anemic.

that's the treatment 2 twice a week is what I am trying to explain and your iron leves does not drop because if stored ferritin

You need to look up the pathway most of the iron is stored in the gastro tract. Good discussion but I have attached the production pathway. It's a very interesting process, good discussionsection Biszarro