Frequent Blood Donations = Iron Deficiency

[Lockout888]

Since being on TRT, I have been donating blood every 8 weeks or so for 2 years now. Recently, I have been feeling fatigued and started to tire easily when working out or during sex. My quarterly labs have been OK, except my last one in April - where my MCH & MCHC were low and my RDW was high. RBC, Hemoglobin and Hemocrit were fine.

I researched it more and found that is normally caused by low iron. All my symptoms pointed to the same thing.

I found recent studies show that frequent blood donors are prone to developing iron deficiency. I had always heard that men don't need iron supplements because only Women menstruate, Men absorb iron better than Women and we get enough in our diet. This is why Men's multivitamins don't contain any iron.

This pisses me off, because the place I donate blood never mentioned anything about frequent donors taking iron. Nothing on their website about it either.

But on the Red Cross website: "The American Red Cross now recommends that frequent blood donors take a multivitamin with iron or an iron-only supplement to replace the iron lost through each blood donation. You should consult with your health-care provider before taking an multivitamin with iron or an iron-only supplement."

I decided to get labs done and have my iron tested. It confirmed what I thought:

RBC 5.18 4.14-5.80 x10E6/uL
Hemoglobin 11.8 LOW 12.6-17.7 g/dL
Hematocrit 39.5 37.5-51.0 %
MCV 76 LOW 79-97 fL
MCH 22.8 LOW 26.6-33.0 pg
MCHC 29.9 LOW 31.5-35.7 g/dL
RDW 17.3 HIGH 12.3-15.4 %
Iron Bind.Cap.(TIBC) 373 250-450 ug/dL 01
UIBC 351 HIGH 111-343 ug/dL 01
Iron, Serum 22 LOW 38-169 ug/dL 01
Iron Saturation 6 ALERT LOW 15-55 %
Ferritin, Serum 8 LOW 30-400 ng/mL
Reticulocyte Count 1.9 0.6-2.6 %

What sucks is getting my iron levels back to normal will take at least 2 months. We can only absorb a small amount of iron each day.

Lesson learned - anyone who donates frequently needs to be taking an iron supplement

[AR's King Silabolin]

HCT 39?....i have not studied trt and donation alot, but i thougth donation was something you had to do to stay safe on hct. With 54% as a donation deadline. Is it really necessary to donate every 8 weeks?. Your hct could easily stay around 49.

[Lockout888]

HCT 39?....i have not studied trt and donation alot, but i thougth donation was something you had to do to stay safe on hct. With 54% as a donation deadline. Is it really necessary to donate every 8 weeks?. Your hct could easily stay around 49.

My last donation was about 3 weeks ago. I had been donating regularly about every 8 weeks without looking at my HCT. Looking now, my labs on 3/30 - HCT was 43.4. On 12/30 - HCT was 46.8

[AR's King Silabolin]

But did your trt-doctor advice this donation-protocol and talk to you abouth hematocrit?

[hammerheart]

I had always heard that men don't need iron supplements because only Women menstruate, Men absorb iron better than Women and we get enough in our diet.

That's retarded, as simple as that.

[marcus300]

8 weeks ?? I really think your giving blood way to soon. Lengthen it to 12-16 weeks see how your bloods run then.

[Lockout888]

But did your trt-doctor advice this donation-protocol and talk to you abouth hematocrit?

Yes, we discussed high Hematocrit from TRT and he recommended giving blood regularly to keep it in check. But even if I had waited 12-16 weeks, my iron stores would have still depleted:

"Without iron supplementation, two thirds of the donors did not recover the iron lost from donating blood after 24 weeks"

https://www.nih.gov/news-events/news...-recovery-time

[hammerheart]

Yes, we discussed high Hematocrit from TRT and he recommended giving blood regularly to keep it in check.

Yeah but how was your HCT back then. I mean, did you start donating without knowing it was high in first place? Your doc just advised to proceed, while no bloodwork was made?

[bass]

i only donate as needed.

[Lockout888]

Yeah but how was your HCT back then. I mean, did you start donating without knowing it was high in first place? Your doc just advised to proceed, while no bloodwork was made?

I started donating when it was up to 52.3%

[kelkel]

Donate when and if needed based on BW. To automatically donate just because you're on TRT is not necessary and internet dogma. In many cases simply titrating your dose down can alleviate the issue and provide more stability over the long term.

[Mr.BB]

In europe you can only donate every 12 weeks, and if arrive at donation centre with 11.8 hemoglobin you will be refused.

Seems you overdone it quite a bit. I would not donate if my hemoglobin was below 16.

[Lockout888]

The point I was trying to get across, was that if you donate blood - you should take an iron supplement. You lose about 220-250mg of iron each time you donate, and can take months to replenish your iron without supplementing.

[Mr.BB]

The point I was trying to get across, was that if you donate blood - you should take an iron supplement. You lose about 220-250mg of iron each time you donate, and can take months to replenish your iron without supplementing.

Yes, but ppl here donate to lower hemoglobin and hemotocrit. No need to supplement if you only donate when your hematocrit is high

[Lockout888]

No need to supplement if you only donate when your hematocrit is high

You can have high Hematocrit and low iron.

http://forums.steroid.com/hormone-re...-low-iron.html

[hammerheart]

You can have high Hematocrit and low iron.

http://forums.steroid.com/hormone-re...-low-iron.html

Wow, that totally looks like microcytic erytrocytosis from beta thalassemia (minor), which do I have. Note that low MCV (microcytosis) doesn't imply being low in iron, although that obv occurs in overt iron deficiency anaemia. Remember that nutritional deficiencies needs to be severe and chronic to show up as hematological abnormalities.

[AR's King Silabolin]

In europe you can only donate every 12 weeks, and if arrive at donation centre with 11.8 hemoglobin you will be refused.

Seems you overdone it quite a bit. I would not donate if my hemoglobin was below 16.

Yes, you will be refused. But i guess thats is not because you dont need it, its because they will not have your blood then. And then you should get a request from your doc, or cut your self. Hct 55+ is dangerous wheter or not your hb is low or high.
I would also say whether or not your Ferritin is high/low. My doc said Ferritin should be the donationcause, not hct..but i dont trust him. He really doesnt know a shit about these things. Blood should be able to clot, whether your ironstore is full or not.

[Youthful55guy]

I think it's an excellent point. Frequent donations may be necessary to control hemoglobin/hematoctit but while under the influence of high androgens, your body will immediately try to replace it. To do this, it steels the iron it needs from storage (ferritin) and that can cause a cascade of problems (e.g. thyroid) elsewhere in the body.

After about 2 years of regular donations, my doc threw in ferritin labs in the annual check up and (like you) I was low. I've been supplementing with iron daily for about a year now. I plan to ask her to recheck ferritin in the upcoming labs.

Thanks for bringing this to our attention. It's an important reminder.

[Lockout888]

I think it's an excellent point. Frequent donations may be necessary to control hemoglobin/hematoctit but while under the influence of high androgens, your body will immediately try to replace it. To do this, it steels the iron it needs from storage (ferritin) and that can cause a cascade of problems (e.g. thyroid) elsewhere in the body.

After about 2 years of regular donations, my doc threw in ferritin labs in the annual check up and (like you) I was low. I've been supplementing with iron daily for about a year now. I plan to ask her to recheck ferritin in the upcoming labs.

Thanks for bringing this to our attention. It's an important reminder.

How much iron are you taking, and how has it effected your labs?

[hammerheart]

How much iron are you taking, and how has it effected your labs?

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.

[Lockout888]

In doing more research on my issue, I just found that taking Omeprazole (Prilosec) for acid reflux can reduce iron absorption. I have been taking Omeprazole for almost a year now, which probably compounded the problem of losing iron through donating blood.

The only reason I'm taking Omeprazole, was that I started taking Cialis (for the non-ED benefits) and started to get GERD. FML

[hammerheart]

Omeprazole is a PPI (proton pump inhibitor). It reduces stomach acid, which is needed for proper nutrients absorption, not just Iron, but any vitamin and mineral from food.

[Youthful55guy]

How much iron are you taking, and how has it effected your labs?

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.

[hammerheart]

When it comes to constipation the worst iron supplement is ferrous sulphate, the most bioavailable are the chelates (gluconate, glycinate) but the organic salts like ferrous fumarate are OK at RDI dosage (10-15mg).

Beware what's reported on the label. The amount of iron explicited usually is the salt form, not the elemental one.

[Lockout888]

Regarding dose, I take 1 pill of a product called Blood builder

Yes, in my research I have found that product is very popular, gets very good reviews and works for people when regular iron supplements did not.

I initially bought some iron from Vitamin Shoppe, which contains ferrous fumarate, amino acid chelate and citrate. But the other day, I bought the Blood Builder product and have switched to that. I also plan on taking 1 pill in the AM and 1 pill in the PM until my levels are back to normal.

[Lockout888]

Just wanted to give you guys an update. I started using Blood Builder twice a day, and making sure to eat beef at least once a day. I got my blood tested 3 weeks later to see my progress:

Hemoglobin (12.6-17.7) 14.6
Hematocrit (37.5-51.0) 47.8
MCV (79-97) 82
MCH (26.6-33.0) Low 25.0
MCHC (31.5-35.7) Low 30.5
RDW (12.3-15.4) High 23.3
UIBC (111-343) 282
Iron, Serum (38-169) Low 34
Iron Saturation (15-55) Low 11
Ferritin, Serem (30-400) Low 27

Not out of the woods yet, but happy with how well Blood Builder is working.

[kelkel]

The only reason I'm taking Omeprazole, was that I started taking Cialis (for the non-ED benefits) and started to get GERD. FML

Omeprazole is a PPI (proton pump inhibitor). It reduces stomach acid, which is needed for proper nutrients absorption, not just Iron, but any vitamin and mineral from food.

Been on Omeprazole for years due to Barretts Syndrome. Couldn't live without it. Low dose daily Cialis as well (5 + 5) with no issues as yet...

[oldnsedentary]

Since being on TRT, I have been donating blood every 8 weeks or so for 2 years now. Recently, I have been feeling fatigued and started to tire easily when working out or during sex. My quarterly labs have been OK, except my last one in April - where my MCH & MCHC were low and my RDW was high. RBC, Hemoglobin and Hemocrit were fine.

Why do you say iron is low but your hemoglobin and hematocrit were fine? You are not paying attention to your own labs, Lockout888. Wake up! This is your health. You should be looking at your own labs.

[hammerheart]

Why do you say iron is low but your hemoglobin and hematocrit were fine? You are not paying attention to your own labs, Lockout888. Wake up! This is your health. You should be looking at your own labs.

Iron status is not a synonym for Hgb, or hematocrit.

[Lockout888]

Why do you say iron is low but your hemoglobin and hematocrit were fine? You are not paying attention to your own labs, Lockout888. Wake up! This is your health. You should be looking at your own labs.

I was referring to my labs from April, but I should have said "within normal ranges". My iron was not tested in April.

[IncreaseMyT]

I just saw a lab yesterday that raised the range of HCT up to 53.

[hammerheart]

I just saw a lab yesterday that raised the range of HCT up to 53.

With a MCV of 70 I'd need RBC to be more than 7.30 in order go over 50%. Have you ever seen a rbc this high?

[IncreaseMyT]

Hard for me to remember. I will try to check today.

Have guys go over 50 with RBC being out of range though.

[IncreaseMyT]

Found another lab range, access, where HCT goes up to 54.

I guess my point is I think its very common for guys to OCD about HCT and draw too much. 51 is not a terrible number at all.

[almostgone]

Found another lab range, access, where HCT goes up to 54.

I guess my point is I think its very common for guys to OCD about HCT and draw too much. 51 is not a terrible number at all.

51% is a totally acceptable value, IMHO. I was 52.8% pre-TRT and it has gotten as high as 57% after TRT. Right now I monitor by pulling CBCs regularly (have a standing order in my file), and donate or phlebotomize as needed. As of 2 weeks ago, I'm @ 49.8% Hct, although Hgb is still slightly out of range (using a range of 13.7 - 16.7 g/dL, my hemoglobin was 17.3 g/dL).
Donating blood is a great thing; a gift actually to those that need it, however donating at every chance just because you are on TRT w/o the blood work to indicate that you need to lower Hct is reckless.
On the flip side of the coin, if any of you guys have a coagulopathy/clotting disorder like myself and are on TRT, check with your Dr. about pulling a CBC on a regular basis. If you're prone to throwing clots, always play it safe.


Edit: Just because I let my hematocrit get away from me once and climb to 57%, I'm defo not endorsing it, LOL. I try to keep mine under ~ 53% . Anything over that and I get winded, stay ultra tired, and for some people I don't think it is an acceptable risk.

[IncreaseMyT]

Great post!!!!

I totally agree. I think you should definitely monitor and control your blood cell mass, but I just see these guys posting like "as soon as I get to 50 I draw" then I see they have iron problems.

Its a tough balance and wire walk, I just think you can donate too often as you mentioned.

I think the guidelines you mentioned are much more reasonable and would help ward off potential iron deficiency.

[< <Samson> >]

I only donate this often when hitting high doses of juice that typically causes a higher RBC.

As mentioned above - donate as frequent as necessary

[Lockout888]

Update:

Its been 8 weeks since I started taking supplemental iron. All the research I did indicated it would take about 2 months to get levels back to normal. Looks like its almost time to donate again.

RBC (4.14-5.80) 6.02 High
Hemoglobin (12.6-17.7) 17.2
Hematocrit (37.5-51.0) 52.6 High
MCV (79-97) 87
MCH (26.6-33.0) 28.6
MCHC (31.5-35.7) 32.7
RDW (12.3-15.4) 23.5 High
UIBC (111-343) 197
Iron, Serum (38-169) 101
Iron Saturation (15-55) 34
Ferritin, Serem (30-400) 37

[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"