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....

 

[cmK9s33]

Use of any GLP will reduce intake of all nutrients. If you were borderline on any nutrient, I'd expect it to dip into deficiency level without a concerted effort to prevent that.

I didnt notice any significant changes in the other micronutrients I routinely monitor. Granted, the fact that I seem to have an issue with iron absorption would imply that anything that might even remotely affect absorption of said nutrient could conceivably affect me to a greater degree than the average user.

 

[Mahdib]

Started Tirz 3 months ago and felt tired and weak for the first 6-8 weeks. Got my blood tested recently and everything is normal, including iron levels.
Think the fatigue was due to the huge calorie deficite during the first few weeks, now i´m able to eat a lot more and the tiredness is gone.

 

[Jin23]

Consider apolactoferrin with your iron supps. A few companies make products with it.

Seems to improve iron bioavailability but studies are limited.

Apolactoferrin is a strong iron chelator. It's seldom used for lowering iron, definitely not elevating it. If you have issues with low iron, certainly do not use apolactoferrin in hopes of elevating it.

 

[cmK9s33]

Apolactoferrin is a strong iron chelator. It's seldom used for lowering iron, definitely not elevating it. If you have issues with low iron, certainly do not use apolactoferrin in hopes of elevating it.

I’m sure he meant lactoferrin. But good catch and pointing it out.

Edit: just checked some of the lactoferrin supps I’ve seen in the past and some do indeed list apolactoferrin as an ingredient. So definitely need to read the label closely if ordering.

 

[zancek0]

I’m sure he meant lactoferrin. But good catch and pointing it out.

Edit: just checked some of the lactoferrin supps I’ve seen in the past and some do indeed list apolactoferrin as an ingredient. So definitely need to read the label closely if ordering.

Interesting ... so while lactoferrin increases iron (roughly speaking), apolactoferrin decreases it?

 

[clearheaded]

Apolactoferrin is a strong iron chelator. It's seldom used for lowering iron, definitely not elevating it. If you have issues with low iron, certainly do not use apolactoferrin in hopes of elevating it.

it seems sups labeled lactoferrin is actually apolactoferrin as far as what supplements say..

 

[Jin23]

it seems sups labeled lactoferrin is actually apolactoferrin as far as what supplements say..

Yes, presumably it's mostly apo and not holo, which is the one already bound with iron.

The picture with lactoferrin is a bit more complex then I initially alluded to/thought. Lactoferrin has a very strong affinity for iron, much stronger then the main iron transporter transferin. Apolactoferrin helps in transporting ferric iron (Fe3) from the gut to the body and it has a host of actions inside the body. The iron which gets sequestered by lactoferrin in the serum (mostly NTBI) does not get lost like it would with other chelators, but rather the body still uses it, it can even cross the BBB. This is achieved via lactoferrin receptors which are present on select tissues (mostly brain, gut, liver and immune cells). Once it enters the cells the iron can disassociate from lactoferrin due to the acidic environment and then it can get stored as ferritin. Otherwise it has a modulating effect; helps elevate iron when it is low and vice versa.

The overall modulating effect of lactoferrin is thus a bit more complex and the end result might vary individual to individual. I'd recommend using lactoferrin alongside an iron supplement which is in ferric form. This would presumably help increase iron bioavailability which in turn would mean one could take lower dosages of iron supps. In hopes of raising iron, one could also take hololactoferrin, as this is one of the most bioavailable forms of iron.

 

[clearheaded]

Yes, presumably it's mostly apo and not holo, which is the one already bound with iron.

The picture with lactoferrin is a bit more complex then I initially alluded to/thought. Lactoferrin has a very strong affinity for iron, much stronger then the main iron transporter transferin. Apolactoferrin helps in transporting ferric iron (Fe3) from the gut to the body and it has a host of actions inside the body. The iron which gets sequestered by lactoferrin in the serum (mostly NTBI) does not get lost like it would with other chelators, but rather the body still uses it, it can even cross the BBB. This is achieved via lactoferrin receptors which are present on select tissues (mostly brain, gut, liver and immune cells). Once it enters the cells the iron can disassociate from lactoferrin due to the acidic environment and then it can get stored as ferritin. Otherwise it has a modulating effect; helps elevate iron when it is low and vice versa.

The overall modulating effect of lactoferrin is thus a bit more complex and the end result might vary individual to individual. I'd recommend using lactoferrin alongside an iron supplement which is in ferric form. This would presumably help increase iron bioavailability which in turn would mean one could take lower dosages of iron supps. In hopes of raising iron, one could also take hololactoferrin, as this is one of the most bioavailable forms of iron.

yes taking iron would convert it over to hololactoferrin

 

[Jin23]

yes taking iron would convert it over to hololactoferrin

only ferric iron, it has a relatively low affinity for ferrous iron.

 

[cmK9s33]

Yes, presumably it's mostly apo and not holo, which is the one already bound with iron.

The picture with lactoferrin is a bit more complex then I initially alluded to/thought. Lactoferrin has a very strong affinity for iron, much stronger then the main iron transporter transferin. Apolactoferrin helps in transporting ferric iron (Fe3) from the gut to the body and it has a host of actions inside the body. The iron which gets sequestered by lactoferrin in the serum (mostly NTBI) does not get lost like it would with other chelators, but rather the body still uses it, it can even cross the BBB. This is achieved via lactoferrin receptors which are present on select tissues (mostly brain, gut, liver and immune cells). Once it enters the cells the iron can disassociate from lactoferrin due to the acidic environment and then it can get stored as ferritin. Otherwise it has a modulating effect; helps elevate iron when it is low and vice versa.

The overall modulating effect of lactoferrin is thus a bit more complex and the end result might vary individual to individual. I'd recommend using lactoferrin alongside an iron supplement which is in ferric form. This would presumably help increase iron bioavailability which in turn would mean one could take lower dosages of iron supps. In hopes of raising iron, one could also take hololactoferrin, as this is one of the most bioavailable forms of iron.

After noticing that so many supps list apolactoferrin, I needed to re-read all the differences and (as you say) it's not as straightforward as I had thought.

Indeed it does seem to modulate iron levels; donates or scavenges depending on need. It seems supp companies have claimed that they cannot (or will not pay to) standardize a certain amount of hololactoferrin in their lactoferrin products, but some will spell out how much theirs contains. I came across some samples showing at 15% hololactoferrin. And apparently the apolactoferrin form seems to have more data supporting immune and cardiovascular system health. That seems to be the predominant reasons apolactoferrin is actually listed on some products.

And I'd agree using lactoferrin supps along with iron would seem to be the best strategy. Can I ask where you found the data comparing its affinity for ferrous vs ferric? I only ever found it being compared to iron or along with ferrous vs ferric alone.

 

[Jin23]

After noticing that so many supps list apolactoferrin, I needed to re-read all the differences and (as you say) it's not as straightforward as I had thought.

Indeed it does seem to modulate iron levels; donates or scavenges depending on need. It seems supp companies have claimed that they cannot (or will not pay to) standardize a certain amount of hololactoferrin in their lactoferrin products, but some will spell out how much theirs contains. I came across some samples showing at 15% hololactoferrin. And apparently the apolactoferrin form seems to have more data supporting immune and cardiovascular system health. That seems to be the predominant reasons apolactoferrin is actually listed on some products.

And I'd agree using lactoferrin supps along with iron would seem to be the best strategy. Can I ask where you found the data comparing its affinity for ferrous vs ferric? I only ever found it being compared to iron or along with ferrous vs ferric alone.

It's a well known characteristic of lactoferrin. It's chemical structure is such that is best suited to "engulf" fe3 ions.

You can read about it's structure here:

Lactoferrin - Cellular and Molecular Life Sciences

Lactoferrin (Lf), a prominent protein in milk, many other secretory fluids and white blood cells, is a monomeric, 80-kDa glycoprotein, with a single polypeptide chain of about 690 amino acid residues. Amino acid sequence relationships place it in the wider transferrin family. Crystallographic...

link.springer.com

As for the exact dissociation constant for ferrous iron ions, I haven't searched deep enough to find one, I only saw mentions of it being much lower then for fe3.