T Nation



Ever since the start of my TRT my iron levels have been off the charts. Is there anything other than donating blood to help me keep these in check. Today before donation I was told my level was 19.2. Which they said was extremely high. I have been fighting constant fatigue and after my donation I felt lots better. Could my iron levels contribute to the fatigue?


Not much here to go on. Are you checking your BP and is it lower after donating? Is your BP elevated?

Serum iron, ferritin or RBC?

Are you eating prepared breakfast cereals? Many are highly iron fortified which is not appropriate for older males. Great for kits and cycling women. Look at packages for iron %DV.

What you are probably feeling when donating is hematocrit changes and better blood flow. You can take mini aspirin every day which will reduce flow resistance. It makes red blood cells slide past each other easier by modifying the surface of the cells.

Take things that lower BP, such as fish oil and ....


Have not BP after donation, but before donation both have been in the mid normal range. Breakfast usually consists of either Egg whites or oatmeal and a piece of fruit. I take krill oil daily but will give the aspirin a shot. Thanks for the tip.


losing a pint of blood will drop ferritin levels by 60-100 points.
If your blood is thick it will starve oxygen from getting to the tissues. Sleep apnea can cause elevations in RBC and hemocrit as well as dehydration.


I'm very well hydrated,use melatonin for sleeping and I sleep very well I don't snore. I'm just trying to resolve my fatigue issues (I'm grasping at straws here). It used to be that just my TRT was enough and would make me feel perfect, but the last nine months something else has to be out of sink with my system. I have been on Cortef now for about 5wks (5mg morning and 5mg afternoon). I'm really hoping that Hardasnails will take a look at my FT3 vs my RT3 (as it shows Most of my FT3 is being canceled out) in 3wks when we retest and we can make some adjustments to see if it helps at all. I shouldn't have to take a stimulant everyday to get going or to just keep from falling asleep at work.


from what little I know - most people on Cortisol need to take 20-30 mg daily before there is any effect. then stay on it for several months to let their system in shape before trying to slowly wean off of it.


I have just been through this too. Been on TRT for almost 3 years. My hemoglobin got to 19 and I was very tired, joints hurt, brain fog. Donating dropped it a point or 2 but it was right back up in 2 months. Finally had to get a doctors order to donate every month to get it down. Now that it's finally lower I can go longer without giving blood. Keep a close eye on it, my doctor had a guy stroke at 20. Different places will get different results. The doctors office and hospital were 2 points apart! You should feel better but have to watch that serum iron levels (check through an iron panel) don't get too low and you get anemic. Stay hydrated, very important.


So maybe my cortisol should be rechecked and adjustments made if needed. This will be up to Hardasnails as I have been seeking his support.


I like HANS and the advice he gives, but you should never 100% rely on someone else to run your life or make decisions for you.

yes, you should seek out informed medical opinions, but they don't have to live with the consequences of those decisions - you do.

do your own research, form your own opinions, ask why they want to do someone or not do something, push for answers that you understand. you are the customer, this is your body, your life. there are no do overs. sitting in passenger seat is just not an option.


when you start cortisol you start slow and work your way up and then address thyroid issues along the way. Again one needs to identify the issue then treatments then remeasure from symptoms and using labs as guide tools. if RT is increasing then more cortef may need to be given because some time we see a rise in tsh with people on too low of cortisol as it as just like t gel where it just teases the system. So we keep close monitore on that. RT3 affects every one different some it bothers other it does not, But e2 and thyroid issues are very similar related which makes it even more challenging. We look for rt3 and t3 ratio and keep these factors in mind, but we have also seen people with perfect adrenals with high rt3 then start using alittle bit of t3 that cause their adrenals to crash to truely reveal a hidden issue. So we get accused of making things worse but in reality we are finding the real underltying issue that was just hiding for all this time. We also want you to research and present ideas to us because dr O and I do not know everything but are willing to learn from even the patients. Dr and patients need to work as a team not have mentality "i am the dr you the patient" other wise there will not be a good relationship which will not help recovery.


Do you have lab work also showing hematocrit?


I don't have lab work only the #'s they tell me when I donate blood. It seems to be impossible for me to get any updated lab work though my consultant. I get the feeling I'm going to have to find another Dr. again.


Some times patients just have to learn to have patience.


Have you been checked by a doc for Hemochromatosis? This condition causes iron to be retained by the body, and I've heard can also cause T issues, and testes to shut down....


I have been on TRT for approximately six months now..when i started my hemoglobin was 11.2...since being on trt my levels are raising..right now 17.7...was experiencing the fatigue some of you talk about but got put on arimidex and the fatigue and fogginess went away...doc said they might have to supplemental draw me every month which is fine..this treatment is for my hypo but in addition it is actually helping my RA...so yeah i will stay on the TRT and get monthly blood draws if thats what it takes..cause guys...night and day..and yes polycythemia is something i look out for...always check the numbers...donating blood right now and they take you until your level reaches 20 here..after that point will do the monthly...actually doing the weekly injections of test here...which is cool..tremendous changes in feeling good all the time..not moody any more..dont stress out....night and day


you only donate if your hemoglobin is above 20?

I thought the general recommendation was that 16+ was unhealthy?


This is not the test for sleep apnea.

Sleep apnea comes in three primary forms: central sleep apneas, obstructive sleep apneas, and hypopneas. Central sleep apneas are incidences where there is an issue in your nervous system that is causing you to stop breathing. Obstructive sleep apneas are incidences where there is something in your airway (e.g. your soft palate) that is preventing you from breathing. Hypopneas are incidences of shallow breathing that cause the O2 levels in your blood to drop significantly, despite the fact that you are still breathing.

Obstructive sleep apnea and hypopnea are sometimes linked to snoring, but not even close to always.

Having a sleep study would be worthwhile.


Mine was 18.5 --- Yikes.... How dangerous is this? How might it effect my health?

I found out when I went to give blood - I was doing so because my BP was a bit elevated.

I gave 2 units of Red Blood Cells in one sitting; however, this means that they won't allow me to give for another 16 weeks.

So - I may do a full blood donation at the 8 week mark to try to dump more iron and reduce volume a bit.

Does this make sense? Obviously I'm going to have to go to a different donation center.

Happy new year guys!



or, I'll do another double red blood cell donation in 8 weeks - as long as my hemoglobin is still on the high side, there's no danger in this right? Even if I were doing another in, say, 4 weeks?

I'm kinda talkin' to myself ain't I? Sure is quiet round these parts.



I have anudder question: if my Hemoglobin was 18.5 - and I donated 2 units of red blood cell, how much have I effected that number? Presumably it would depend a bit on many things, but there must be a rough rule of thumb?