Low iron levels and starting strength?

[Domjo54]

Would the board agree that iron pills should provide a positive effect on general health / training for a male who is not grossly underweight or undertrained (210 lbs, been training for 7 years) and who eats an iron-heavy diet but for whom iron levels have remained stable throughout life? I have thalassemia (Mediterranean anemia, runs in my family), diagnosed with it before puberty, and my levels have not changed much since at least high school. It does not appear to affect my day-to-day.

After not taking it in many years, I began taking daily iron supplements last summer and have found no obvious health benefits and only minimal increases in hemoglobin levels (which could also just be regular fluctuation). The only observable changes have been in my stool, in terms of color, volume reduction, and difficulty producing, the latter of which is quite unpleasant.

What he said.

Also, I find it inconceivable that you were diagnosed with a genetic, iron refractory anemia and that you didn't receive any treatment recommendations. If this is really true, you need to see a hematologist. This should be highly treatable (sometimes with IV iron) and shouldn't interfere with your strength training or your ability to gain weight.

You should not find this inconceivable, nor should you expect that, even if OP did see a hematologist, that the doc would provide much advice. See ^^. There is remarkably little consensus about the proper way to treat someone with a recessive iron disorder, or if treatment should occur at all.

[Mark Rippetoe]

The most commonly prescribed iron supplement, Feosol -- ferrous sulfate -- is very poorly absorbed and will darken your doodoo long before it does much of anything else. Ferrous gluconate or fumarate is a better choice, and it is OTC.

[Karl Schudt]

Inspired by this thread, I smoothed out a crappy Lodge cast iron skillet with my drill and some sanding discs, and now it's glorious.

Thanks for the idea, omaniphil.

[Austin Baraki]

Would the board agree that iron pills should provide a positive effect on general health / training for a male who is not grossly underweight or undertrained (210 lbs, been training for 7 years) and who eats an iron-heavy diet but for whom iron levels have remained stable throughout life?

I would absolutely not agree with this. In fact, it is more likely to cause harm than benefit.

I have thalassemia (Mediterranean anemia, runs in my family), diagnosed with it before puberty, and my levels have not changed much since at least high school. It does not appear to affect my day-to-day.

After not taking it in many years, I began taking daily iron supplements last summer and have found no obvious health benefits and only minimal increases in hemoglobin levels (which could also just be regular fluctuation). The only observable changes have been in my stool, in terms of color, volume reduction, and difficulty producing, the latter of which is quite unpleasant.

Thalassemias result from mutations in the genes coding for one of the globin chains in your hemoglobin molecules, not from iron deficiency. Hence your observation that iron supplementation has provided no benefit. In fact, patients with thalassemia are frequently prone to iron overload. Unless you have lab-proven iron deficiency, you should really not be taking supplemental iron.

You should not find this inconceivable, nor should you expect that, even if OP did see a hematologist, that the doc would provide much advice. See ^^. There is remarkably little consensus about the proper way to treat someone with a recessive iron disorder, or if treatment should occur at all.

What are you talking about?

[Domjo54]

The most commonly prescribed iron supplement, Feosol -- ferrous sulfate -- is very poorly absorbed and will darken your doodoo long before it does much of anything else. Ferrous gluconate or fumarate is a better choice, and it is OTC.

I checked it out, and I am taking ferrous sulfate. Good to know!

I would absolutely not agree with this. In fact, it is more likely to cause harm than benefit.

Would the harm be because I naturally have low hemoglobin/blood iron, or because of too much iron in general? And am I tying the two (hemoglobin and iron) together too much?

Thalassemias result from mutations in the genes coding for one of the globin chains in your hemoglobin molecules, not from iron deficiency. Hence your observation that iron supplementation has provided no benefit. In fact, patients with thalassemia are frequently prone to iron overload. Unless you have lab-proven iron deficiency, you should really not be taking supplemental iron.

My questions above apply here as well, I suppose. My hemoglobin seems to float between 12.5 and 13.2 g/dL, so just outside of the "normal" male range (13.5-17.5).

The reason that I know the normal "range" is because 13.0 is the minimum threshold to donate blood, so I get tested every 2-3 mths when I attempt to donate (success rate of probably 50/50). Do you think that donating blood is foolish in my case?

What are you talking about?

Some doctors I've talked to have said a supplement should be taken, others have said it should not, and I'd say the majority have said that it could go either way. Same has been the case for what I've read online, as well as what I was told when I got that bloodwork done 10-12 years ago.

[Mark Rippetoe]

The reason that I know the normal "range" is because 13.0 is the minimum threshold to donate blood, so I get tested every 2-3 mths when I attempt to donate (success rate of probably 50/50). Do you think that donating blood is foolish in my case?

This is like an unemployed man going to the Casino. Well, not exactly, but you're still a dumb guy.

[Austin Baraki]

Would the harm be because I naturally have low hemoglobin/blood iron, or because of too much iron in general? And am I tying the two (hemoglobin and iron) together too much?

Yes, you are inappropriately conflating hemoglobin and blood iron levels. They are not the same thing.

Hemoglobin is a complex molecule consisting of various protein ("globin") chains complexed with a "heme" molecule, which itself consists of a porphyrin ring and one single iron atom. Problems with any one of these components can cause it's own unique type of anemia. If you have one of the Thalassemias, you have a genetic defect affecting a globin protein. This can result in an anemia despite completely normal iron levels, because the other (non-heme) part of the Hemoglobin molecule is defective. So this has nothing to do with iron deficiency.

Taking supplemental iron in the absence of iron deficiency (especially as a male who presumably does not experience regular menstrual periods) runs the risk of iron overload and its significant complications.

The reason that I know the normal "range" is because 13.0 is the minimum threshold to donate blood, so I get tested every 2-3 mths when I attempt to donate (success rate of probably 50/50). Do you think that donating blood is foolish in my case?

Eh, if you maintain a normal or low-normal hemoglobin concentration, you likely have a very mild, asymptomatic form of thalassemia (i.e., a genetic defect that does not significantly impair globin synthesis & function) and it's probably not harming you to donate. With that said, I probably wouldn't if it was me.

Some doctors I've talked to have said a supplement should be taken, others have said it should not, and I'd say the majority have said that it could go either way. Same has been the case for what I've read online, as well as what I was told when I got that bloodwork done 10-12 years ago.

I am skeptical about the contents of what you've been reading online, especially since you seem to be under the impression that you have a "recessive iron disorder" (which you do not).

[Walter Palmer]

I'm late to the thread but must say that most teflon pans suck when used for driving in tent stakes but I have had great success with cast iron.

[Will Morris]

What are you talking about?

Maybe we should just get rid of all medical providers in the country and just set up Internet kiosks to allow the "patients who have done their research" to diagnose and treat themselves.

[Mark Rippetoe]

Maybe we could just get rid of the medical providers that don't have any idea about what the fuck they are doing. A more measured approach.