Have you experienced iron depletion from Tirzepatide use?

[Musmadar]

I started using Tirzepatide more than 1 month ago, already lost about 6kg/13pounds...

The problem I have is that I started to feel very dizzy during workouts, especially legs workout...the same symptoms like anemia...and it has nothing to do with glucose being too low (that was the first thing I checked)

I was wondering if you have experienced the same....

 

[Musmadar]

Just a new findings on the matter.

Iron homeostasis in the body is tightly regulated by a balance between iron absorption, utilization, storage, and recycling. Key players in this process include hepcidin, a hormone produced by the liver that inhibits iron absorption and release from macrophages, and ferroportin, a protein that transports iron from cells into the bloodstream.

Medications that impact metabolic processes can influence inflammatory pathways. Increased levels of inflammation can stimulate hepcidin production, reducing intestinal iron absorption and trapping iron in macrophages and hepatocytes. If tirzepatide indirectly promotes a mild inflammatory response, this could elevate hepcidin levels, leading to lower serum iron.


Tirzepatide's ability to slow gastric emptying can affect nutrient absorption, including iron. Prolonged transit time in the stomach and intestines might alter the efficiency of iron absorption, especially non-heme iron, which requires an acidic environment for optimal solubility and uptake.


Improved insulin sensitivity may increase cellular glucose uptake and utilization. Iron is a critical cofactor for various enzymatic reactions involved in energy metabolism. Enhanced metabolic activity could increase the demand for iron, potentially depleting iron stores if dietary intake is insufficient.

Studies on tirzepatide have reported varying effects on iron parameters. Some patients may experience a decline in serum iron and ferritin levels, indicative of depleted iron stores. These findings underscore the importance of monitoring iron status in patients undergoing treatment with tirzepatide, particularly those with a history of anemia or at risk for iron deficiency.

 

[AlexDavis43]

Just a new findings on the matter.

Iron homeostasis in the body is tightly regulated by a balance between iron absorption, utilization, storage, and recycling. Key players in this process include hepcidin, a hormone produced by the liver that inhibits iron absorption and release from macrophages, and ferroportin, a protein that transports iron from cells into the bloodstream.

Medications that impact metabolic processes can influence inflammatory pathways. Increased levels of inflammation can stimulate hepcidin production, reducing intestinal iron absorption and trapping iron in macrophages and hepatocytes. If tirzepatide indirectly promotes a mild inflammatory response, this could elevate hepcidin levels, leading to lower serum iron.


Tirzepatide's ability to slow gastric emptying can affect nutrient absorption, including iron. Prolonged transit time in the stomach and intestines might alter the efficiency of iron absorption, especially non-heme iron, which requires an acidic environment for optimal solubility and uptake.


Improved insulin sensitivity may increase cellular glucose uptake and utilization. Iron is a critical cofactor for various enzymatic reactions involved in energy metabolism. Enhanced metabolic activity could increase the demand for iron, potentially depleting iron stores if dietary intake is insufficient.

Studies on tirzepatide have reported varying effects on iron parameters. Some patients may experience a decline in serum iron and ferritin levels, indicative of depleted iron stores. These findings underscore the importance of monitoring iron status in patients undergoing treatment with tirzepatide, particularly those with a history of anemia or at risk for iron deficiency.

ChatGPT has entered the conversation.

 

[Musmadar]

ChatGPT has entered the conversation.

Yes indeed...met him at the gym the other day...

 

[Ghoul]

I've read this and the previous studies that suggest GLPs are useful in managing the organ damaging effects of excess iron in patients with hemochromatosis (a problem many AAS users face).

The mechanism it does this by stops the excess accumulation of iron as a result of, basically, a malfunctioning liver, and nothing approaching iron deficiency nor some mechanism impacting normal iron levels was observed.

It's hard to believe a notable uptick in anemia would've gone unnoticed in the sickly population of diabetics using these drugs for the last decade, since they get bloodwork monitoring iron far more often than the general population.

I don't think there's anything mysterious or concerning that happens to digestion impacting iron levels. It's the same problem a lot of GLP users face....they eat less, and by not choosing foods high in protein and proper nutrients, they end up suffering the effects of deficiencies of both.

 

[sbtr12]

If that is the case it is actually helpful for me. I have hemochromatosis which causes iron overload and must get blood drained every few months. Interesting though I had not seen this anywhere as a tirz side effect.

Never seen people report low iron with tirz on the boards until this thread.

I have seen people on boards discuss their iron levels increasing with tirz use.

The ones that I saw most often were actually chronically low on iron before starting tirz and when taking tirz, their iron jumped up to normal levels.

 

[sbtr12]

Can iron be supplemented? Or just eat more red meat or what?

I have to supplement when I donate blood because it takes forever for my iron levels to come back to normal.

Ferrous bisglycinate has better absorption compared to ferrous sulfate or gluconate and it is generally gentler on the stomach for most. I add vitamin C to also help with absorption.

 

[Avies48]

@un

Never seen people report low iron with tirz on the boards until this thread.

I have seen people on boards discuss their iron levels increasing with tirz use.

The ones that I saw most often were actually chronically low on iron before starting tirz and when taking tirz, their iron jumped up to normal levels.

so iron levels would go up using Tirz? As opposed to going low iron? I’d like to see some results

 

[Ghoul]

@un

so iron levels would go up using Tirz? As opposed to going low iron? I’d like to see some results

The answer is more like this. With the exception of people with existing iron related disorders, Tirz doesn't do anything clinically significant to iron levels warranting special attention.

We have tens of millions of patient treatment years worth of experience with GLPs broadly, and several million with Tirz alone. Iron level issues weren't missed by all those clinicians and patients who closely monitor their health.

 

[Underworld]

Last time I donated blood, my iron levels were very high. Looking forward to depleting some lol

 

[sbtr12]

@un

so iron levels would go up using Tirz? As opposed to going low iron? I’d like to see some results

You mean published results? I didn't say a word about that. Don't know if they exist either way (lowering iron or increasing iron).

I just mentioned that before seeing this thread, I had only seen people online say that they had chronically low iron before taking tirz and that after being on tirz, their iron levels increased to normal levels.

 

[clearheaded]

very possible it does both depending on what u mean by iron levels..if have NAFL prob will lower.. if not super overweight maybe slowing down the gut allows for absorption..or slows excretion. (as an uneducated guess).

 

[quarter]

Adding Cagri and really got walloped with fatigue. Looked back at my last labs and the iron level was low (not colored red so I cruised right past it). Thanks for shouting this out.

 

[HB_22]

Interesting topic, I need to do some blood work on that.

 

[sbtr12]

Interesting topic, I need to do some blood work on that.

yeah if you dont get yearly or bi-yearly bloods from your doc and you track bloods yourself and results are off scale with MCV, MCH and/or MCHC in a basic cbc panel, then you would be doing yourself a favor to get an iron panel.

 

[Gigantic]

Each time you donate blood, you lose between 220-250 mg of iron. If you donate a Power Red, you lose twice that amount, about 470 mg of iron. It may take up to 24-30 weeks for your body to replace the iron lost through a blood donation. Source: Red Cross

This is why I supplement with bioavailable ferritin after donating.