New study below [1].
But why?
It is well known that that as testosterone [T] drops in men, so does the red blood cell count. RBCs contain hemoglobin, which carries oxygen from lungs to the rest of the body. Dr. Myers has said that almost all of his patients on ADT are "mildly" anemic [3].
Wiki [2]: "Anemia ... is usually defined as a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood. It can also be defined as a lowered ability of the blood to carry oxygen."
I have been rapidly switching between castrate & high-T for a number of years. RBC sinks to the bottom of the reference range (or below) when I am castrate & quickly becomes normal following T supplementation.
Dr. Myers has an old vblog post on iron supplements [3]. A number of his patients were using iron supplements on the advice of their GPs. Hemoglobin is an iron-containing protein. With an iron deficiency, there might not be enough hemoglobin for optimum oxygen transport.
However, as Myers points out - men don't bleed the way that women do. At medical school, he was taught to look for internal bleeding if a man was anemic for no obvious reason.
{It is possible for vegans to be lacking in iron, although some sites say the this is a myth. Animal protein contains heme iron, which is easily absorbed. Vegetables contain only non-heme iron, which is poorly absorbed.}
For a man to be taking iron without having had a blood test for deficiency is stupid. Iron overload is extremely dangerous.
[4] (2008 - Mayo)
"ADT results in a significant drop in haemoglobin levels into the anaemic range. A number of patients become symptomatic from this change. Practitioners should monitor haemoglobin levels, and treat symptomatic patients."
How does one treat a low RBC? Transfusion?
[5] (2006 - U.S.)
"In a sample of men with newly diagnosed, metastatic prostate cancer, a decline in HGB {hemoglobin} level after 3 months of ADT was associated with shorter survival and progression-free survival after adjusting for disease status and other baseline covariates."
So, while a hemoglobin decline is normal, it is clearly something to be concerned by.
My own feeling is that lower levels result in hypoxia-inducible factor 1alpha [HIF-1alpha] which makes PCa cells more aggressive & difficult to kill.
I have come to the view that men on ADT should use a low-dose nitroglycerine patch. It releases nitric oxide, which dilates blood vessels - improving the blood supply to the cancer & forestalling HIF production. My alternative doc wrote me a prescription when I explained why I wanted it. But I doubt that many doctors know much about HIF.
[6] (2009 - U.S.)
"Consider transfusion if severe anemia or symptomatic".
That's the only option? Gus & Nalakrats (& others) are going to jump all over this, but this adds to my belief that a unit of blood from a healthy young person each month would vastly improve survival.
New study [1]:
"The use of androgen deprivation therapy is associated with increased risk of anemia, which reverses upon treatment discontinuation."
Very useful. LOL
-Patrick
[1] ncbi.nlm.nih.gov/pubmed/287...
[2] en.wikipedia.org/wiki/Anemia
[3] askdrmyers.wordpress.com/20...
[4] ncbi.nlm.nih.gov/pubmed/189...
Iron deficiency anemia
Keytruda effects on anemia
Surgery+radiation+ADT orRadiation + ADT
Anemia from radiation.
