Normal Ferritin, High Transferrin Saturation: Managing Iron Overload

[Blue Water]

Hi all,

I've been doing a lot of research because my iron levels are out of whack and I have the allele for H63D which predisposes me to some iron overload risks.

My ferritin has stayed consistently low. In the past it was like 55. My health declined and ferritin actually went lower, to the 30's. However, right when ferritin dropped, transferrin––which I suspect is even more dangerous than ferritin when elevated––increased, which produced lots of gastrointestinal distress. My transferrin levels now fluctuate between 50-72% on a blood draw !! My serum iron tends to be just above the reference range, at around 205 or so.

So naturally I am trying to figure out how to manage this situation. Would it be wise to donate blood even when ferritin is in the low to mid 30's? My hemoglobin is fine as is my hematocrit, so I don't have any anemia or anything like that, but I have read that a single donation could drop ferritin somewhere between 30-50 ng/ml. That would bring my ferritin effectively to zero, if true. Given I have such a high transferrin generally, I don't know for sure if even bringing it to zero would necessarily produce anemia, but I also want to be cautious. Is there any way to donate half the normal amount during a donation, or do they always just do a one-size-fits-all amount (like a pint)?

In addition to phlebotomy, does anyone have any good recommendations for supplements to reduce my transferrin level and get free iron out of the blood? That would be very helpful for people with overload. Curcumin and milk thistle seem to be the major ones that are typically recommended online.

Thanks.

 

[Blue Water]

I should add that in previous lab tests, my ceruloplasmin has been low, along with plasma copper and red blood cell copper. This is strange to me given that my CBC ends up being normal. Another factor is that I was on finasteride which wrecked my health, and as I came off of it, that's when a lot of these mineral transport issues showed up. I wonder if finasteride somehow could cause copper deficiency? I don't know, just thoughts...

 

[Blue Water]

Body Iron Stores and the Risk of Coronary Heart Disease | NEJM

Higher transferrin-saturation levels were not associated with an increased risk of coronary heart disease or myocardial infarction. On the contrary, the results indicate that there may be an inverse association of iron stores with overall mortality and with mortality from cardiovascular causes.

And then you have studies like this which confuse the heck out of me. Basically we know that non-transferrin bound iron in the blood is toxic. If you have high levels of transferrin, as long as the iron is bound to it maybe it is not so problematic? I am skeptical of this.

 

[sunny]

I had a similar saturation % issue. I am a female. For me, after reading some ray peat quote on estrogen and iron, I *think* a high estrogen level (probably in the tissues) was the problem. Here is what I wrote on another thread.

Estrogen plays a part. As a female i had steadily increasing saturation % (which is what I was most worried about). Mine had exceeded the top of the range and I did not know why. Dr Peat recommends it to be 25%. I had mine checked just before covid hit and it was down from high 60s to 23%. I had done a blood donation the year before, and for several years have done a peaty eating style with high milk consumption, some fruit, eggs, potatoes, grass-fed beef, occasional liver and oysters. I had started cyclical progesterone to oppose estrogen during my cycle, I use a 325 mg Aspirin most nights. I am not sure but I think reducing the estrogen is what brought the saturation % back in line. I am still always investigating the subject in the event the saturation % rises again.​

 

[sunny]

As far as blood donation goes, you must donate the standard amount. You could order your own blood tests monthly or sporadically and you would lose a smaller amount each time.

 

[sunny]

From Danny Roddy clips, talking with Ray Peat:

RP: High Iron, particularly if it’s the Iron Saturation %, just like Prolactin, is a sign of high estrogen. Are you dealing with your thyroid first?

DR: “Estrogen and the hypoxia , and the low thyroid increasing the estrogen promoting the hypoxia, that is what’s making the iron accumulate and displace the copper. It’s not just a random iron overload situation right”

DR: “So the iron overload is actually hyperesteogenemia
RP: “I think so, in most cases”
Danny Roddy Clips

 

[Blue Water]

From Danny Roddy clips, talking with Ray Peat:

RP: High Iron, particularly if it’s the Iron Saturation %, just like Prolactin, is a sign of high estrogen. Are you dealing with your thyroid first?

DR: “Estrogen and the hypoxia , and the low thyroid increasing the estrogen promoting the hypoxia, that is what’s making the iron accumulate and displace the copper. It’s not just a random iron overload situation right”

DR: “So the iron overload is actually hyperesteogenemia
RP: “I think so, in most cases”
Danny Roddy Clips

Never thought about this. I did a lab test for estrogen a while back which was normal but still a bit on the high end. I am positive my thyroid is not great.

I recently did "hijama" which is where the acupuncturist makes little cuts in your back and then puts cups over your back to suction out "bad blood." I wanted to get rid of blood this way. Prior to hijama iron saturation was 52%, and after it was 44%. However, what was strange was that ferritin increased from 37 to 45 ng/dl. Maybe just because of the inflammation from the wounding?

I do need to get some lab tests for iron and other general health things like checking blood and liver/kidney numbers, etc. But I don't think these take much. Maybe 20-40ml.