T Nation

Anemia and Low T

I’ve been anemic my whole life with Hemolytic Anemia.

For the past several years I’ve been super whitdrawn, exhausted all the time, poor concentration, as well as like every symptom of low t.

So I made an appointment and got my test levels checked. I’m 36 years old.

330 total
76.3 free
Sbhg 25

They didn’t check anything else.

My hemoglobin which has always been super low was 12.1. Normal for me.

Hematocrit 33% which is also normal for me.

I was wondering if there’s any connection between anemic diseases and low t and if TRT is an option?

I have a follow up scheduled within the next few days and was also looking to see if anyone had suggestions on questions to ask.


If have Hemolytic Anemia, your doctors should have prescribed TRT years ago. I was anemic when I was diagnosed with a testosterone deficiency at 225 ng/dL, no longer. My hematocrit was 41% and is 50% when Total T is 500 ng/dL and hemoglobin is 17.0, closer to the top of the ranges. You deserve better care than you are receiving.

Correcting the testosterone deficiency is associated with increased hemoglobin levels and tends to correct hemolytic anemia! Studies are showing a cardiovascular disease is associated with testosterone levels below 440, you are scoring lower than healthy 70 year old men including our current president (446 ng/dL).

Do not let your doctor to tell you that you’re levels are normal, a common tactic sick care doctors use to deny TRT because the organisations behind these reference ranges and the endocrine society have a bias toward TRT and will make it difficult to get approved for treatment even though the clinical studies show the cut off point for experiencing low testosterone to be much higher than what the Endocrine Society states in the guidelines that all doctors follow.

We see a lot of men complaining of low testosterone symptoms when dropping below 500 ng/dL, I myself am on TRT and recently scored a Total T of 406 and Free T 16.0 (ranges 6.8-21.5) had every symptoms of low testosterone, poor sleep, weak infrequent erections, low energy. A simple dosage increase fix that little problem.

According to the average 36 year old healthy male, you are significantly lower than the average male your age. Your Free T is at the bottom of the ranges where most would have symptoms, some men have symptoms with Free T midrange, everyone is different.

You will find little to no help going through insurance as they are very few doctors who specializes in this area of medicine, most of the experts in this field of medicine can be found privately in anti-aging or sports medicine.

TRT will lower SHBG a little, low SHBG guys tend to do better on multiple injections per week using insulin syringes in the shoulders and quads. If your doctor prescribes 200mg every two weeks, suffering will continue or get worse.

I would like to see thyroid panel, ferritin and cortisol levels.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction.

Thank you. I’m going in tomorrow for follow up to discuss those results. Are there any questions I should ask the doc? Also to get blood work for the cortisol and thyroid what should I ask for? Thanks!

Respectfully more likely any doctor you have access to will be inadequate in their knowledge about TRT, most skip the optional education in hormone therapies after graduating medical school unless they plan on specializing in TRT.

Arm yourself with a couple of studies because more than likely you will be asking questions may be above the doctors expertise. These studies should help.

Testosterone alters iron metabolism and stimulates red blood cell production

Association of Testosterone Levels With Anemia in Older Men

Low Testosterone Levels and the Risk of Anemia in Older Men

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Saw PCP today and she referred me to both an Endo and Hematologist.

She said I was in the “low normal” range and that ranges vary during time of day, etc. Bunch of nonsense about ranges.

She told me she wasn’t comfortable treating Low T with test at her office but an endo would know more. Told me to take a multi, iron, etc.

Said my anemia is most likely “normal” for my body as I’ve grown with it and my body knows how to function as it is.

Told me there isn’t a good hormone blood test to check everything and my insurance wouldn’t cover another test, to go to Amazon and get a saliva test.

She also to be careful reading the studies online and just because they’re on pubmed doesn’t mean they are done well.

Exactly what I expected but glad to get referrals.

Waiting for appointments to get scheduled to Endo and Hema docs.

Sick care doctors have no choice but to follow narrow insurance guidelines or get blacklisted.

This is nonsense, your symptomatic and still argue that you are normal even after all the studies I provided. Men grow up with all kinds of hormonal deficiencies and suffer for it, but it’s not normal. Makes you wonder why in the hell they became doctors.

This is sick care, you must fight to get treatment in a system that has low standards for getting approved for treatment. You may have to seek private care for TRT, insurance will refuse TRT unless <300 ng/dL on two separate occasions.

Let me remind you of the cardiovascular disease study and it’s cut off point of 440 ng/dL, the 300 cut off point was chosen to save insurance companies money on healthcare.