CSF Ferritin predicts cognitive decline in E4s

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Genesis322
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Re: CSF Ferritin predicts cognitive decline in E4s

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Very interesting discussion here. I will have to read "Dumping Iron" now.

My Keto-Mojo regularly shows me with low hematocrit (<35%) and low hemoglobin (<12 g/dL) but my iron is fairly healthy (I think?) with my most recent fasting blood panel a month ago having a total iron of 107 mcg/dL and Ferritin of 211 ng/mL, although I suppose I should try to reduce that. I am eating a lot more leafy greens since my blood panel so I can reduce my homocysteine (14.3 umol/L with 677TT MTHFR) but perhaps now I should be concerned about too much iron?

I've been rejected as a blood donor several times in the distant past and I vaguely remembered being told it was because I had too much iron but that I shouldn't be worried about it because I'm male and that's typical. I always felt there was something very dismissive about that. My blood isn't good enough to give to you for free but I shouldn't be concerned?

Well, definitely more reading to do! Thanks for this.
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Re: CSF Ferritin predicts cognitive decline in E4s

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Genesis322 wrote:Very interesting discussion here. I will have to read "Dumping Iron" now.

My Keto-Mojo regularly shows me with low hematocrit (<35%) and low hemoglobin (<12 g/dL) but my iron is fairly healthy (I think?) with my most recent fasting blood panel a month ago having a total iron of 107 mcg/dL and Ferritin of 211 ng/mL, although I suppose I should try to reduce that. I am eating a lot more leafy greens since my blood panel so I can reduce my homocysteine (14.3 umol/L with 677TT MTHFR) but perhaps now I should be concerned about too much iron?

I've been rejected as a blood donor several times in the distant past and I vaguely remembered being told it was because I had too much iron but that I shouldn't be worried about it because I'm male and that's typical. I always felt there was something very dismissive about that. My blood isn't good enough to give to you for free but I shouldn't be concerned?

Well, definitely more reading to do! Thanks for this.
You probably got declined because of your low hemoglobin and hematocrit not your iron. They check that to make sure you have adequate red blood cells to give blood. Your ferritin is slightly elevated I would still try to give blood again if you get the chance. You might make sure you have adequate b vitamin levels, especially b12 to help with red blood cell production.
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Re: CSF Ferritin predicts cognitive decline in E4s

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Genesis322 wrote:I've been rejected as a blood donor several times in the distant past and I vaguely remembered being told it was because I had too much iron
When I give blood, the phlebotomist does a hematocrit test prior to assess my reserves. S/he refers to this as "checking my iron". Presumably the misnomer comes from the common prescription of iron supplementation for anemia as evidenced by low hematocrit.

I did a quick search on "rejected blood donation high hematocrit" and found a discussion board for guys taking supplemental testosterone - apparently it's common for them to be rejected for donation due to elevated hematocrit or hemoglobin. Generally the condition is described incorrectly at the blood bank as "high iron".
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Re: CSF Ferritin predicts cognitive decline in E4s

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BTW, I have found donation to be effective. Before I began donating in late 2016 (after reading Dumping Iron), my ferritin was 123. After donations in Dec 2016 and Feb 2017 it was 33. After donations in Apr 2017, Dec 2017, and Mar 2018, my Apr 2018 ferritin is only 13! Hemoglobin and hematocrit are fine, so I'm not worried about anemia, but I think I'm going to slow to an annual donation frequency.

Here's an article with references on the topic of optimal ferritin levels:

The Normal Value for Iron and Why It Matters
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Re: CSF Ferritin predicts cognitive decline in E4s

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MarcR wrote:BTW, I have found donation to be effective. Before I began donating in late 2016 (after reading Dumping Iron), my ferritin was 123. After donations in Dec 2016 and Feb 2017 it was 33. After donations in Apr 2017, Dec 2017, and Mar 2018, my Apr 2018 ferritin is only 13! Hemoglobin and hematocrit are fine, so I'm not worried about anemia, but I think I'm going to slow to an annual donation frequency.

Here's an article with references on the topic of optimal ferritin levels:

The Normal Value for Iron and Why It Matters

This is pretty low I personally wouldn't donate again until your ferritin is above 70. You can get iron avidity if you go too low for too long.
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Re: CSF Ferritin predicts cognitive decline in E4s

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Thanks, Simon. I had not heard of iron avidity before. From a bit of searching, I think I would see my transferrin saturation percentage start to approach 50% if I were heading toward iron avidity - correct? My full recent testing history is

Mar 2014 | ferritin 186 | iron 111
Dec 2016 | ferritin 123 | iron 104 | TIBC 277 | %sat 38
Feb 2017 | ferritin 33 | iron 59 | TIBC 281 | %sat 21
Apr 2018 | ferritin 13 | iron 66 | TIBC 358 | %sat 18

Your advice to let ferritin rise a bit before donating again makes sense to me. Next year when I update my blood tests I think I'll do so before possibly making an annual donation to be sure I have a bit of headroom. I'm trying to keep levels as low as possible without creating anemia.

I imagine the whole issue is trickier for people with hereditary hemochromatosis.
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Re: CSF Ferritin predicts cognitive decline in E4s

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MarcR wrote:Thanks, Simon. I had not heard of iron avidity before. From a bit of searching, I think I would see my transferrin saturation percentage start to approach 50% if I were heading toward iron avidity - correct? My full recent testing history is

Mar 2014 | ferritin 186 | iron 111
Dec 2016 | ferritin 123 | iron 104 | TIBC 277 | %sat 38
Feb 2017 | ferritin 33 | iron 59 | TIBC 281 | %sat 21
Apr 2018 | ferritin 13 | iron 66 | TIBC 358 | %sat 18

Your advice to let ferritin rise a bit before donating again makes sense to me. Next year when I update my blood tests I think I'll do so before possibly making an annual donation to be sure I have a bit of headroom. I'm trying to keep levels as low as possible without creating anemia.

I imagine the whole issue is trickier for people with hereditary hemochromatosis.
I would classify these numbers as iron deficient. You want your sat % ideally between 30 and 40 and I would keep your ferritin over 60. I would not give any more blood and you should consider adding iron rich foods to your diet such as clams, liver and red meat. You can also supplement with Vitamin C with those meals as that will increase absorption.
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Re: CSF Ferritin predicts cognitive decline in E4s

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Is there research to support the idea that low iron is bad in the absence of hematological evidence of anemia?
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Re: CSF Ferritin predicts cognitive decline in E4s

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simonh01 wrote:You probably got declined because of your low hemoglobin and hematocrit not your iron. They check that to make sure you have adequate red blood cells to give blood. Your ferritin is slightly elevated I would still try to give blood again if you get the chance. You might make sure you have adequate b vitamin levels, especially b12 to help with red blood cell production.
I will definitely try again at the next opportunity. There is a blood drive at my work later this week.

As for B12, I have been taking a lot of that in supplemental form in the past couple months, since discovering my homozygous MTHFR, but there really hasn't been an appreciable move on my Keto-Mojo. I researched more of it recently and figured I have "sports anemia" since I am an endurance athlete and apparently some of us adapt to have fewer (but larger and more efficient) red blood cells.
MarcR wrote:When I give blood, the phlebotomist does a hematocrit test prior to assess my reserves. S/he refers to this as "checking my iron". Presumably the misnomer comes from the common prescription of iron supplementation for anemia as evidenced by low hematocrit.

I did a quick search on "rejected blood donation high hematocrit" and found a discussion board for guys taking supplemental testosterone - apparently it's common for them to be rejected for donation due to elevated hematocrit or hemoglobin. Generally the condition is described incorrectly at the blood bank as "high iron".
This would make sense since I was much younger and presumably had more testosterone, and I was no where near as much of an endurance athlete then as I am now.

Thank you both for helping elucidate this for me.

One more question: Isn't it strange for someone to have low hematocrit and low hemoglobin but slightly elevated ferritin? What could be going on there? Undermethylation?
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Re: CSF Ferritin predicts cognitive decline in E4s

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Genesis322 wrote:[
One more question: Isn't it strange for someone to have low hematocrit and low hemoglobin but slightly elevated ferritin? What could be going on there? Undermethylation?
No I don't think so, I'm not a doctor. Ferritin is iron storage. Hemoglobin is the iron-containing protein found in all red blood cells that transport oxygen. Hematocrit is just the ratio of the volume of red blood cells to the total volume of blood. Higher hematocrit is good for endurance atheletes as they can transport more oxygen in the blood. Some people just have lower hemoglobin and hematocrit they do not rise with higher levels of iron storage. They do drop some after giving blood as does your ferritin as you are removing the amount of iron in the blood, but you could still get iron overload and have lower hemoglobin and hematocrit.
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