“Low hemoglobin?”
I am a 35 year old Caucasian male. I have had a sleeve gastrectomy in 2017. I take multivitamins daily. I also have chronic depression, anxiety, and ADD. I have been diagnosed with low T and began TRT in June 2021. My current medications:
Fluoxetine 60mg daily
Wellbutrin XR 300mg qd
Klonopin 1mg BID
Vyvanse 70mg qd
Testosterone Cypionate 100mg BIW
Ambien 10mg prn insomnia
Primidone 50mg qhs - essential tremors
Since beginning TRT, I have been donating blood about every 3 months to help keep hematocrit in check. However, I have noticed when giving blood, my hemoglobin levels have been borderline low (around 13-13.5). Yesterday, I went to donate blood again and my hemoglobin was 12.9 so we waited a few minutes and tried collecting blood from my other hand hoping it would be 13 or higher so I could give. My other hand turned up 11.3. So, I was not able to donate blood as the minimum level for a male is 13.
Would TRT be affecting the iron in my blood or would it most likely be because of my sleeve gastrectomy? I haven't had any trouble in the past donating blood after my sleeve so I wouldn't think that would be the issue. However, my hemoglobin levels hasn't dropped till I began TRT. So, what could be the likely possible reason and why? Thank you in advance!
Fluoxetine 60mg daily
Wellbutrin XR 300mg qd
Klonopin 1mg BID
Vyvanse 70mg qd
Testosterone Cypionate 100mg BIW
Ambien 10mg prn insomnia
Primidone 50mg qhs - essential tremors
Since beginning TRT, I have been donating blood about every 3 months to help keep hematocrit in check. However, I have noticed when giving blood, my hemoglobin levels have been borderline low (around 13-13.5). Yesterday, I went to donate blood again and my hemoglobin was 12.9 so we waited a few minutes and tried collecting blood from my other hand hoping it would be 13 or higher so I could give. My other hand turned up 11.3. So, I was not able to donate blood as the minimum level for a male is 13.
Would TRT be affecting the iron in my blood or would it most likely be because of my sleeve gastrectomy? I haven't had any trouble in the past donating blood after my sleeve so I wouldn't think that would be the issue. However, my hemoglobin levels hasn't dropped till I began TRT. So, what could be the likely possible reason and why? Thank you in advance!
Male | 35 years old
Complaint duration: 7 Months
Conditions: Low Hemoglobin
2 Answers
Not my area of expertise. That said, take a look at...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154071/
and
https://prescriptionhope.com/blog-testosterone-and-high-iron-levels/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154071/
and
https://prescriptionhope.com/blog-testosterone-and-high-iron-levels/
As a gastroenterologist, I don't have the expertise to comment on the low T therapy and its effects. But I can say that the sleeve surgery would not be a likely source for anemia. Any anemia requires a formal work up so appropriate testing to determine the nature of the anemia should be performed. This would include looking at a full CBC, the red blood cell indices, possible iron studies and a blood smear. The type of anemia will then dictate further work up.
