I didn’t change the point, I clarified the wording. The issue is still the same.
This is not about insulting you. I’m pointing to a standard of reasoning.
In this case, you presented a mechanism as an explanation without establishing that it is actually a meaningful driver of the outcome.
If you don’t want to engage on that, that’s fine. I’ll leave it there.
You changed the wording. That changed the meaning of the phrase. I had proven your original meaning false. I can prove your changed meaning false. However, I am not going to waste my time. My view is that you disagree with me.
You tend to wish to play the man rather than play the ball. I prefer to stick to rational evidence based arguments about the science.
You obviously don’t recognise that you are insulting me. That may be a subtle point relating to my native language.
After this response I will not waste anyone elses time by engaging with you.
In this discussion of not too much and not too little iron (which I personally wrestle with), I wonder how much activity level matters. I would think (and I am acting on) that I need more iron than a sedentary person to perform well to provide the signal to my body to move well, be vigorous and resilient, be strong, heal fast, etc. An active body uses more iron: needs more, loses more. I aim for cycles of hard and easy, break down and rebuild. I also donate whole blood regularly (dump “old factors”) but struggle to keep my iron levels from falling (donate less often now). I’m struggling to establish of a proper level of iron (or how to measure). I’m in the weird place of donating blood and supplementing iron. Any useful thoughts?
I am not sure why someone who is active would consume more iron. Menstruating women have a good reason. I lose iron with blood tests.
What are your values?
I don’t think your activity changes what is the optimal level of iron in the body for you. What it does change however is how much iron you need to ingest through foods or supplements to maintain that optimal level. E.g. if two people want to maintain a certain ferritin level, the one who is exercising a lot or donating blood will need to ingest more iron to maintain that level.
One could argue though that someone that donates blood regularly might want to aim for slightly higher iron stores, because his iron will fluctuate more from slightly lower right after each donation and then rising until the next one. So to not go too low you might want to aim for a little bit higher level than someone that doesn’t donate blood.
My understanding is that athletes have higher iron needs (higher hemoglobin ie more iron) and the greater iron losses: sweat, GI micro bleeding, foot strike, and can have more hepcidin which interferes with iron absorption.
Anyway, my last test results were:
Iron Binding Capacity: 370
Iron: 140
Iron Saturation: 38
Ferritin: 26
Yes. That is sensible. I was imagining that perhaps a person who is trying to slow aging without being active could have a different relationship with iron. Perhaps not. Extreme CR is often touted as a way to extend lifespan but the body adapts to far lower calorie intake making an active lifestyle more difficult…. but if a person is not active perhaps much lower calories is another way to get some of the benefits of exercise. This is the model I was imagining. But not for me. No way.
The compounding effect of hard exercise and frequent blood donation is tough to overcome with diet (intake of iron). I’ve tried. I had to slow down my whole blood donations and increase iron supplementation. I’m still on the low end.
What is your Hb?
Checking with chatGPT as a starter it is true that endurance athletes particularly can lose more iron “The main reasons are exercise-related hemolysis, small gastrointestinal blood losses, hematuria, sweat losses, and transient exercise-induced rises in hepcidin that can reduce iron absorption.”
There seems to be an argument that Hb should be higher yes, but to a great extent that iron is recycled. Hence there is a question as to whether the normal age linked increase in iron levels is counterbalanced by some activity. It seems clear that endurance exercise does cause iron loss.
I would think your frequent blood donation is far more significant than activity even if it is endurance exercise.
What is a “memory disorder” in menstruating women, and why did the iron-deficient with 8 ug/L ferritin have “30 % lower”?
I’m not surprised but it’s wild that Greger highlighted this. It was data dredging and confounding from a 2003 study. They barely adjusted for any confounding factors.
Hemoglobin: 16.2
That’s quite high. Do you know why?
It can be testosterone linked. Do you supplement?
TRT plus exercise. I have to donate whole blood periodically to keep my Hemocrit down (otherwise I would have quit due to impact on iron). That last reading was after a blood donation (a few days earlier). Since you’ll wonder, on that same blood test my testosterone was
Total testosterone- 759 ng/dl
Free testosterone- 114 pg/ml
PS — I may have a genetic leaning to high hemoglobin. I have always been good at high altitude and fast adaptation to altitude.
Are there arguments against the fact that iron loss/chelation directly induces mitophagy while iron overload strongly impairs autophagic flux, making mitophagy ineffective?
Then, even though I think the above is true, it doesn’t mean one should lower iron (and if so, how low). But I don’t understand your point @Olafurpall (and the “in this context” bit). Could you please explain?
I don’t know enough of the effects of TRT, but it strikes me it is skewing your iron metabolism some distance. The majority of the body’s iron is stored in blood so you clearly have quite a bit of iron. The TRT is probably pushing more into Hb from ferritin. You may also have more myoglobin, but this is not being measured.
Obviously there is the question as to whether you are causing dopamine problems. Symptoms such as RLS would indicate that.
It may be that titrating TRT would be sensible, but what seems to be the case is that you are not overall short of iron, but materially more is in Hb (and possibly myoglobin as well) and hence less in ferritin.
That may not be a bad thing, but it depends on broader issues.
Another interesting question is MCV. A shortage of iron can be seen in lower MCV.
I wish my nephrologists could read this thread. By even the most conservative standards, I have a case of anemia in need of immediate treatment. And yet the nephs insist that it should be only monitored. My PCP finally referred me to hematology, which gave me an appoint for a month later. Aside from weakness and fatigue, I am bothered by extreme mental lassitude, which I’ve never had before. Even worse, I am subject to near-fainting and dizzy spells, a dangerous condition for anyone but especially for the elderly. As you can see from my numbers, I have ample reason to be furious with some of my caregivers.
Iron 50
HGB 10
Ferritin 10
Iron Sat 11
TIBC 491
Why do you have nephrologists? What are their reasons for not wanting Iron in a better environmment.
Incidentally what is MCV?
And what is your urinary pH?
I have nephrologists for the same reason I have anemia–chronic kidney disease. I don’t know why the nephs are so recalcitrant, but this isn’t the first time that I’ve had to go around them. The first time was when they wouldn’t or couldn’t recommend a treatment for metabolic acidosis, which I have learned can be much improved with sodium bicarbonate. Incidentally, I am reading your papers on citrate, which is a better buffer than sodium bicarb, because it has more cations to work with. Citrate and an alkaline diet are proving to be a good combination.
Which is why the question as to urinary pH is important. Anions such as urate (uric acid) are more soluble in neutral urine than acidic urine. Hence if kidney function is constrained you really need to make sure your urine is not too acidic as otherwise you will get gout.
I go completely bonkers on urinary pH and at times are around 9 or even higher.
Still I would think if the forum awarded a prize for the most anaemic forum member you probably would win it.
I am bothered by extreme mental lassitude
Strikes me as a dopamine issue. Neurologists like ferritin at 70.
I do have gout, which has been ameliorated by febuxostat, obtained from India, not from an Rx. I have to do my own research, which is why I place a superlative value on sites such as this.
Is an xanthine oxidase inhibitor which reduces the production of urate. You also need to excrete it.
If you buy pH strips off Amazon you will be able to monitor your urinary pH. Don’t use the generic urine strips you need to have a good idea of pH.
If you increase the pH of your urine then you will with the same volume of urine excrete more urate.
If you have a really big problem with urate you could also have kidney stones.
There is an argument to keep the pH below 6.8 to avoid calcium phospate stones, but if you use citrate that acts to inhibit the formation of those stones.
I have been reading up on this issue (not least because my own urine is manically alkaline) and I have not really found much to substantiate the argument that citrate supplementation causes a problem with Ca-P stone formation.
It is something to monitor. There is a cautious position you could take which is to vary the urinary pH so most of the time it is 7 or higher, but part of the week (say the weekend) is say around 6.