How many of you who blasted EQ now have low ferritin?

[RockyP]

Sorry I don't use EQ (will in the future) so I can't give input on the specific question, but generally as my cycle progresses my ferritin goes low, RBC count up but size of the blood cells down. This repeats itself over and over after maany cycles. I am using up the iron I have until I have too many red blood cells to which there is not enough iron to make them grow in size, and end up with a lower hematocrit at the end of the cycle vs start. Then during the health phase iron stores build up again as does the size of the blood cells so hematocrit goes up while RBC slowly goes down, it takes time for red blood cells to die. Seems with many replies in this thread that this is common with EQ too, probably due to the same mechanism.

A friend of mine with different heritage and genetic traits, specifically the type who has excess iron and excess blood regardless of AAS, has not the same pattern on/off cycle as me.

Is your friend Northern European?

 

[Tbaz192]

Absolutely the general medical community (including endocrinology) is totally clueless about

As an aside, and I don’t really believe this to be the smoking gun at all since guys are supplementing with iron and still having issues, how many of you guys are eating red meat regularly? I eat it a few times per week only, lean angus steak. For no other reason than it’s just expensive and i am not talented at cooking it well.

facts.

Yeah, gotta be something else happening.

Perhaps a reaction or a combo effect within the body causing
low HCT/HBG with EQ but low iron, or the drastic drop in ferritin in my body.
(Above my pay grade & knowledge)
Or maybe its the GLPs and mixing certain compounds. But we’d never know.

I eat red meat multiple times a week & consume cereals full of iron. Still no effect or improvement lol

Time to turn into a little piggy and shoot up some iron. Oink oink.

 

[cousinmuscles]

Is your friend Northern European?

Yes Viking type lol. You can tell by these guys from their looks and how red they get when they do heavy lifts.

 

[OldGHGuy]

My Ferritin is super low just running test at 160mg per week. On 5mg of Reta. Had run some Var around the time of my most recent Iron panel.

Total Iron 53 mcg/dL. Range 50-180

Iron Binding Capacity 457 (high). Range 250-425

% saturation 12 (low). Range 20-48%

Ferritin 4 (low). Range 38-380

Quest panel.

started Iron Bisglycinate 25mg
Elemental Iron (liquid) 125mg

I shouldn’t be as fatigued as I am. Side effect of low Iron?

You have similar labs to mine. ANy improvement in your situation?

 

[dinfaralt]

2 bloodworks in row now my hematocrit trt 47, 2nd bloodwork on eq 46, now its down to 44. ferritin and iron ok

sørry i just wanted to flex on yall

 

[k710]

I actually got my Ferritin results back today at 28 (38-380 range). Ive done some iron + vitamin C supplementation before for slightly lower normal levels, but first time its actually come back LOW. Is iron bisglycinate + vitamin C the first step in correcting? Im reading through the protocol mentioned earlier in the thread now

 

[Barney67]

My theory would be that the constant erythropoiesis induced by AAS (some more than others) caused ferritin to be depleted. We see something similar in CKD patients who are started on EPO but have relatively low ferritin. At first the EPO resolves their normocytic anemia that’s causes by CKD, but then the surge of erythropoiesis causes the ferritin to be used up, pushing them into microcytic iron deficiency anemia.

 

[Beach19]

You have similar labs to mine. ANy improvement in your situation?

I’ve been taking Iron Bisglycinate and Liquid Elemental Iron. I’ve seen both Iron and Ferritin levels increase at the expense of increased Hematocrit and Hemoglobin rising above ref range.

 

[RockyP]

My theory would be that the constant erythropoiesis induced by AAS (some more than others) caused ferritin to be depleted. We see something similar in CKD patients who are started on EPO but have relatively low ferritin. At first the EPO resolves their normocytic anemia that’s causes by CKD, but then the surge of erythropoiesis causes the ferritin to be used up, pushing them into microcytic iron deficiency anemia.

This makes the most sense of anything I’ve seen / can think of. And also would explain why serial phlebotomy makes this situation much worse.

 

[Tbaz192]

Seeming like Reta can play a factor as well.
Changes timing on nutrient absorption possibly enough to effect iron.

I noticed when taking Reta. I took my multivitamin & the typical b complex ( change in urine color) wouldn’t flush out till mid day.
Where as not on Reta it was pretty quick to flush thru my system.
Very significant time difference. And that’s a liquid multi vitamin. Not solid food.

 

[k710]

Seeming like Reta can play a factor as well.
Changes timing on nutrient absorption possibly enough to effect iron.

I noticed when taking Reta. I took my multivitamin & the typical b complex ( change in urine color) wouldn’t flush out till mid day.
Where as not on Reta it was pretty quick to flush thru my system.
Very significant time difference. And that’s a liquid multi vitamin. Not solid food.

Now that you mention this, I have noticed sometimes the bcomplex comes out first/second pee after taking it but sometimes it doesnt show up till the latter part of the day and in the morning. I am taking Reta, <1g/week.

Im taking 20mg iron bisglycinate daily as of today. Was told 20-30mg but my supp is 20mg and didnt want to cut tablets lol Ill try and remember to update on my next labs.

 

[RockyP]

I will have to check the clinical trial data but off the top of my head I dont recall iron deficiency / ferritin issues being listed as common side effects with reta or other GLP's but I could totally be off. Need to consult the literature.

 

[Barney67]

This makes the most sense of anything I’ve seen / can think of. And also would explain why serial phlebotomy makes this situation much worse.

If your MCV is low and RDW is high, get a simple ferritin test to check. No need for serum iron or TIBC. If low, then you can either do daily oral iron or IV iron. I personally don’t have much patience for daily oral because 1) it takes a long time 2) it restricts your daily meal plans because you need to take it on an empty stomach and wait 1-2 hours. For IV dosing you can use an online calculator like the one on MDCalc.

 

[OldGHGuy]

I asked Groc why a person would have low ferritin with high RBC. The #3 answer:

Testosterone Therapy or Anabolic
Steroid Use

• Testosterone strongly stimulates erythropoiesis → high RBCs/ hematocrit.
• Many men on TRT become iron-deficient because the increased red cell production consumes iron faster than it's replaced (especially if they donate blood frequently to lower hematocrit).
• Ferritin often <30 ng/mL while hematocrit >50-54%.

 

[k710]

If your MCV is low and RDW is high, get a simple ferritin test to check. No need for serum iron or TIBC. If low, then you can either do daily oral iron or IV iron. I personally don’t have much patience for daily oral because 1) it takes a long time 2) it restricts your daily meal plans because you need to take it on an empty stomach and wait 1-2 hours. For IV dosing you can use an online calculator like the one on MDCalc.

Oof idk if I would IV myself just yet, not that comfortable lol. Although I am sure I would do a hell of a better job than the angry vampire at quest. Bruised half my arm and left a legit ball at injection site...

 

[Barney67]

Oof idk if I would IV myself just yet, not that comfortable lol. Although I am sure I would do a hell of a better job than the angry vampire at quest. Bruised half my arm and left a legit ball at injection site...

Don’t IV yourself. Iron infusions are supposed to be given at medical centers that are equipped to handle emergencies. This is because, although low, there is a chance of anaphylaxis. It’s high when compared to other meds and infusions but very low overall.

 

[Barney67]

This makes the most sense of anything I’ve seen / can think of. And also would explain why serial phlebotomy makes this situation much worse.

Yup, so not only is the constant erythropoiesis consuming your iron stores, the phlebotomy makes removes iron, which is normally recycled to a degree.

 

[Beach19]

I asked Groc why a person would have low ferritin with high RBC. The #3 answer:

Testosterone Therapy or Anabolic
Steroid Use

• Testosterone strongly stimulates erythropoiesis → high RBCs/ hematocrit.
• Many men on TRT become iron-deficient because the increased red cell production consumes iron faster than it's replaced (especially if they donate blood frequently to lower hematocrit).
• Ferritin often <30 ng/mL while hematocrit >50-54%.

My urologist confirmed the same thing.

 

[RockyP]

Like all things the propensity to develop this and its severity must be genetically determined.

I suppose my next question is, if you have low ferritin and high-ish HCT (say ferritin < 30 and hct 54+) do you start to add iron in? Would that just make the hct higher and the additional iron would eventually be depleted?

 

[Tbaz192]

Like all things the propensity to develop this and its severity must be genetically determined.

I suppose my next question is, if you have low ferritin and high-ish HCT (say ferritin < 30 and hct 54+) do you start to add iron in? Would that just make the hct higher and the additional iron would eventually be depleted?

Posting my results here. Hopefully the lay out Doesn’t get messed up lol

I’ve had consistent high HCT on regular TRT and normal labs all around. Always 52-54 HCT no matter what. RBC/Hemo always close to elevated.

Added iron biglycinate when my ferritin got low (18) July to almost October, had zero effect on my ferritin. Not sure why. So I dropped it.

Did this to my labs.


End of October was dropping iron & lowering TRT dose.

August was almost the worst of it with terms of iron issues. I was taking 250mg test cyp at 2iu HGH daily that time, with 1-2mg Reta a week.
Dropped the HGH & test cyp.
I think my issue was long term use of androgens never let my ferritin re build. The constant demand to create new red blood cells. Pulled all my ferritin to make them. For a long time.

And fast forward to November 2025 - I’m now on 150mg test cyp 1mg Reta a week. but I have to drop the Reta. Think it’s messing with my thyroid nodes. Have an ultrasound in December. Will also keep an eye on my ferritin and see if it rises even more with no Reta.
NOT TAKING IRON SUPPLEMENT. SINCE EARLY OCTOBER ISH.

Do I feel better now? No. But my ferritin and iron are staying normal now.