All of my red variables were just below the normal range. The Dr. said she wasn't worried, not low enough. Would taking iron help bring my reds up? I am thinking higher reds would mean more energy.
My Reds variables were low: All of my... - Advanced Prostate...
My Reds variables were low
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arete1105
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Not unless your blood iron is low. There are many causes of anemia - taking iron while blood iron is high can be toxic.
RBC, AUTO 4.31 Mill/mcL
4.70 - 6.10 Mill/mcL
HGB 13.7 g/dL
14.0 - 18.0 g/dL
HCT, AUTO 40.9 %
42.0 - 52.0 %
Would iron help me?
As I said, only if your blood iron is low.
Some supplements pull iron out of the blood- chelators like curcumin do that especially
I read that you are using supplements. You might try eliminating them to see if your anemia gets better.
Dude, half the members here would gladly trade their numbers with you, myself included! My Hgb is currently 11.5, up from a low of 9.1. Turns out I was iron deficient, which an IV supplement corrected. That said, even 9.1 wasn't particularly worrying to my MO.
Those numbers are within the acceptable range at Sloan these days.
I think Sloan changed their ranges last year. I was never sure why they did that.
Sloan Ranges as of today:
WBC
[4.0 K/mcL - 11.0 K/mcL]
RBC
[3.95 M/mcL - 5.54 M/mcL]
HGB
[12.5 g/dL - 16.2 g/dL]
HCT
[37.5 % - 49.3 %]
I tried iron for awhile no change, been on B12 for awhile and no change. My reds have been low but stayed relatively stable.
Carbamazepine, Amlodipine, Hydralazine, Lupron shot, PSA 4.6. Plus enough supplements to "fire me through the pearly gates".
Careful, you can OD on iron supplements.
What is your blood test MCV? If below 70 it is iron deficiency if above 100 then it is B12 deficiency. You can't take iron without knowing your blood level. Also I read that high iron intake is bad for people with PCa.
WBC'S AUTO 3.6 x1000/mcL
(4.0 - 11.0 x1000/mcL
)
RBC, AUTO 4.31 Mill/mcL (4.70 - 6.10 Mill/mcL
)
HGB 13.7 g/dL (
14.0 - 18.0 g/dL)
HCT, AUTO 40.9 % (
42.0 - 52.0 %
)
MCV 94.9 fL (
80.0 - 94.0 fL
)
MCH 31.8 pg/cell
(27.0 - 35.0 pg/cell
)
MCHC 33.5 g/dL (
32.0 - 37.0 g/dL)
RDW, BLOOD 11.9 % (
11.5 - 14.5 %
)
PLATELETS, AUTOMATED COUNT 236 x1000/mcL
(130 - 400 x1000/mcL)
It may be the carbamazepine and or amlodipine:
1) Bone marrow suppression secondary to carbamazepine:
pubmed.ncbi.nlm.nih.gov/262...
As you know RBCs are produced in the BM so the suppression may also include the WBCs (you have WBC 3.6 x1000/mcL)
2) Decreased Red blood cell count is found among people who take Amlodipine besylate, especially for people who are male, 60+ old, have been taking the drug for 1 - 6 months.
I started out with Lupron + Casodex, but dropped Casodex with Lupron only. I will ask my Onc about Casodex since Lupron might be the cause of swelling of legs.
Your MCV is 94.9 fL (normal is 80.0 - 94.0 fL) so you dont have Microcytic anemia (iron deficiency MCV< 70.0) also it is not a Macrocytic anemia B 12 deficiency MCV > 100 )Check with a hematologist for possible bone marrow suppressing medications that you are currently taking.
I have RBC bellow the lower normal range (4.2-4.4<4.5) and iron at the highs of the normal range, some times well over the latter (110-220 NR 50-160). Doctor says that the diurnal variance of iron is significant. I have read an article which divides blood anemia into 4 or 5 categories. Iron deficiency is one of them, quite common, but not the only one. Chronic inflammation due to cancer is another, more pertinent to our cases.
Just cancer and Bp
Are you eating mostly plant diet? If so, then an rad level cheated iron a couple times a week is warranted. If you are eating red meat a few times a week then that would give you iron I. I have more red cells too when I’m on adt but on adt break they improve.
My reds have been like yours for nearly two years, hanging just below the reference range. My docs have also said not to worry. Mild anemia can be "the norm" for many with cancer, for a variety of possible reasons. Unless you truly KNOW the reason, you probably don't want to attempt to address it with a potentially incorrect solution (that may or may not have potentially negative impacts on PC remission or progression).
Here is an interesting observation: every time my PSA has dropped, my red counts have also dropped, and vice versa. The initial occurrence in Spring 2019 made sense to me, because the PSA drop from 20 to 13 (and ALP from 74 to 39) appeared to result from a rather strict diet where I dropped my excess 20% of body weight. I had reduced my intake of foods with B12, folate, etc. My PCP said that with a normal iron level, I might try B12 and folate supplementation to reverse the anemia.
Well, I did that (in the fall of 2019), and my next labs indeed showed better red counts. They also showed my PSA had doubled from 13 to 26 (with ALP doubling, as well). Then in the summer of 2020, bicalutamide dropped my PSA to 3.8, even as my red numbers fell again, to their lowest levels. They have all since slightly risen again... along with my PSA, as the bicalutamide failed!
What does this all mean? I have no idea, except it appears I should be rooting for my mild anemia to get slightly worse with my next labs, since that appears to inversely correlate with disease progression?
Thanks noahware,
I checked my spreadsheet and can confirm that a stable PSA count, or a low increase of it bounded within the 0.01 reported granularity, was coincident with a decline in the RBC. The inverse was also true: When RBC came higher with regards to the previously tested, PSA showed a 0.01 or 0.02 advancement. Theory was tested on 11 pairs the results of which are: 9 true, 1 false and 1 equivocal.
See: askdrmyers.wordpress.com/20...
I feel like it should be common knowledge among both docs and patients that low T can cause anemia, but I don't recall reading that in all the many lists and articles discussing "possible side effects of ADT." Did I just miss it, a hundred times? [I don't feel too bad, because nobody else bluntly mentioned it as a simple and obvious cause in their replies above, LOL.)
But then after a quick google search I see I only missed it some of the time, because on many lists (especially the government cancer sites) the mention of "anemia" is indeed not present at all. (We see "fatigue" on those lists, of course.) I do see it listed in many scientific papers but some times, I guess, it is briefly mentioned but not highlighted as a MAJOR side effect of ADT, and easier to miss among the biggies like bone density, etc.
Then also, I read this: "androgen deficiency is typically overlooked in guidelines on the investigation of anemia." What gives? Shouldn't it be on TOP of the list, with docs caring for men doing ADT?
A reduced red blood cell count is not a side-effect of ADT - it is a consequence & predictable.
Oddly, those with a bias against testosterone replacement are quick to point out that TRT can cause the opposite effect - too many red blood cells - but this is not at all inevitable, & Denmeade's BAT therapy involves a massive injection to T cypionate. I have never seen mention in his studies that hematocrit is monitored, but presumably it is.
From an Italian paper [1] (2006):
"Anemia is a frequent feature of male hypogonadism and anti-androgenic treatment. We hypothesized that the presence of low testosterone levels in older persons is a risk factor for anemia."
"We found that older persons with low testosterone levels tend to have lower hemoglobin levels, are more likely to have anemia, and have a higher risk of developing anemia over a 3-year follow-up period. The risk of anemia associated with a low testosterone level and anemia was similar in the whole study population and in participants with normal serum iron levels and no deficiencies of iron, vitamin B12, or folate. Both the cross-sectional and the longitudinal associations of testosterone level with anemia were stronger for bioavailable than for total testosterone level."
i.e. elevated SHBG increases risk.
"To our knowledge, this is the first study that directly addresses the hypothesis that a low testosterone level is a risk factor for anemia in older persons." !!! Unbelievable.
-Patrick
You do not actually have anemia. Taken as a whole your labs are fine. 2% more “reds” will not give you more perceptible energy unless you are competing at your MVO2 max such as sprinting to win a Tour de France Stage. If you want to confirm you have normal iron reserves then ask for a ferritin test. And stop worrying. That will sap your energy reserves. Be happy.
Sprinting uses primarily the anaerobic pathway (glycolysis) so increased VO2 max is not primarily involved; but if he's climbing the Tourmalet then yeah, he'll want his VO2 max raised.
When I had my hematocrit and Hb on the low side, my doc immediately said I should get a colonoscopy. That's next up.
You are correct and the Tourmalet is an awesome beast. Rode it back in the day. Great memory.
Lucky you. I've ridden in the Alps, not the Pyranees though.
No worries is right. But that’s good you’re watching it! What I don’t understand is that I’ve been “critically low” for about 6 months..and they’re still giving me chemo. Unreal. And turning the Dose up.
Unfortunately so were Trumps votes........
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 02/22/2021 6:48 PM EST
Almost 40 years ago I wasn't feeling well. I took wife's pregnancy vitamins. Felt worse so took some more. Did not know they have way more iron than a man needs. Was a zombie for a month. Now I'm just a zombie during a full moon. (I do have anemia, caused by ADT.)
I am guessing that you are at the start of your journey. Almost everyone experiences what you describe but, as your MO has said, it is not a big concern within the larger context. You could try a good plant-based diet and exercise to get your energy up. Also, if you are retired, you might try some sort of volunteering that gives you joy.
There is nothing that replaces the feeling of helping others while we are sick ourselves. Good luck!
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