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Blood Donation, Low Ferritin. Help Needed

Please help me taking a decision

I donate blood every 6 months due to high Red blood cell( RBC) production. I am due for my next donation. But my Serum Ferritin is low normal at 64 ng/ml normal range is 25-336. When we donate blood we loose about 30-50 ng/ml of ferritin in one session. So it means that after my next donation my Ferritin reserves will get about 14 to 34 which is really low.
But i have to donate blood with in this week as my RBC and hematocrit is very high. So my question is how i can compensate my low Ferratin problem. After how many weeks my Ferritin will be ok after taking Iron supplement…or should i take injectable Iron? Any one else encountered this problem? Any other tips or advise?

What does your hematocrit test at?

51%. Any advise regarding low ferritin?

That is a normal reading. I do not have an ferritin info.
" The normal hematocrit for men is 40 to 54%"

Someone had posted a podcast where they discuss that its somewhat normal for someone’s HCT and RBC to be higher on TRT. They compared it to people living at high altitude in Colorado, and how those people are not dropping like flies, or going for phlebotomy.

Didn’t they mention not needing bloodletting until 55%?

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What are your labs looking like? Do you have room to lower dose to maybe mitigate this problem?

As I understand it, low ferritin virtually ensures you’ll never get cancer.

Ferritin’s job is to carry O2 to your brain first and foremost but also all your muscles and organs. If you crash your ferritin too low the worst side effect is you will gasp for breath. When you inhale you never get that AH I can exhale. You might have to go into the hospital and be put on O2 and they will also put you on an IV to get your ferritin back up so you can breath on your own again.

Google it. You can die from ultra low ferritin and if your TRT doc finds out you are done getting a script for T he/she will drop you like a hot rock.

As for folks saying heah it can go to 55. Well, my TRT doc has always insisted anything over 51.5 I have to donate a pint of whole blood or he cuts my dose to 80mg/wk and puts me on iron and Vit-C for 6 months. Ask me how I know all this and what my protocol has looked like for the last 8 months. My July TT was 485 SHGB 29
But goddammit my ferritin is back up over 100 so I am back in the saddle again. this time I will really watch my Free T and adjust my protocol so its at the top of the range but not over.

Why your Dr. Cut your dosade to 80 mg and start Iron supplementation. Is the reason behind that Iron supplementation increases RBC and T does too. So he cuts your T dosage to restrict your RBC production ?? Is this True That Iron supplementation increases RBC too? And how quickly?

With all due respect none of the modern TRT doc believe in phlebotomies for slightly raised HCT anymore. As @anon10035199 mentioned for people living above 4000 ft (6000+ in CO), “The range of normal values was 45% to 61% for hematocrit”

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Yes Yes and Yes.
My ferritin took 6 months to go from 14 to 109 I was taking a script iron pill and 1g Vit-C a day.
So ferritin increases much slower the HCT increases if T dose is too high. I feel the best when my Free T is between 33-39 labcorp ranges 6.6-18.2 and my doc was ok with this as long as my HCT stayed in check and I could donate blood to help. But over time it is a losing game your HCT goes higher way faster than your ferritin can go up. So you have to cut your dose or end up in the hospital with heart issues HCT super high or put on O2 and IV for crash ferritin.

I live in the foot hills of the continental divide (8000ft) and my TRT doc is Defy.

Dude we’re practically neighbors! Lol!

Is Defy aware of your locations above sea level?

They have my mailing addy I buy all my drugs from them. Altitude has been talked about during consults. Alt or not if/when my HCT hits >52 my daily morning blood pressure goes up 10 points on top and bottom numbers. All I had to do was donate a pint and my pressure would drop.
If my memory serves me right I believe Defy does not like your BP to go over 135/85 my normal pressure is 120/70 with a resting HR of 58

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Ah, well that def adds to the situation. Thanks for the clarification.

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I can not Thank you enough for your Answer. It has cleared all of my confusion.

One thing that is still bothering me is that my RBC count is higher than normal on a very high Free T( High T dosage). But my HCT and HB is fine. Important point is i am “Feeling” that my blood needs a dump. I can always feel it when my RBC goes higher. So should i ignore or consider this point> high RBC but normal HCT and HB.

@hrdlvn
I can not Thank you enough for your Answer. It has cleared all of my confusion.

One thing that is still bothering me is that my RBC count is higher than normal on a very high Free T( High T dosage). But my HCT and HB is fine. Important point is i am “Feeling” that my blood needs a dump. I can always feel it when my RBC goes higher. So should i ignore or consider this point> high RBC but normal HCT and HB.

So now your Ferratin is over 100 after 6 months of Iron supplementation and you have also reduced the T dosage. I would like to know what is the status of your HCT at this stage?

Whats is your protocol during previous 6 months? And what was your protocol when your Free T were very high?

My free T is at 55 right now and i think its the main culprit. I am going to cut down my T dosage. I have low SHBG and i am on EOD protocol at 17.5 mg. Now i am planning to go on daily injection with a T dosage that will just keep my Free T top of the range but not any higher. I think thats the way to go.

But one heavy question. I am exactly at your stage 6 months back. My ferratin is at 64. And RBC too high although HCT is in check. Should i donate a pint of blood?? And start iron supplemenation, like you did.

One quick fix that comes to my mind is "IV iron " . Why havent you tried IV Iron for a quick fix of low ferratin along with your reduction in T dosage??

Please i know its too much of questions but please try to answer all one by one. I am in a mess right now, mate.

What is your shbg?