Very low iron level - Advice regarding supplementation.

[MsBoBo]

My father is dealing with 2nd BCR. His recent blood test shows extremely low iron levels which is putting his heart at great risk of giving out. He has not had low iron levels before at all. The cardiologist has prescribed supplementation, if that proves insufficient, the cardiologist will administer injections. I am very concerned about this knowing that cancer hoards iron. I am wondering if this is a common side effect of radiation, or indicative of an aggressive growing cancer? Does supplementation fuel the growth of the cancer? Any advice at all is greatly appreciated. 🙏

[JohnInTheMiddle]

Ms BoBo - I am metastatic and being treated on an ongoing basis with ADT and Abiraterone. I have an ongoing situation of low-ish iron - but not the very very low risky iron that you have reported concerning your Dad.

I looked into questions of supplementation. And what I learned may be useful for you to follow up with with your doctor's possibly. Apparently there is a circumstance whereby low iron is an artifact of they changed biochemistry of one's body in our circumstances.

I also had my ferritin done and it was paradoxically high.

In my case supplementation would not have been a good idea. Because my low iron is not because of insufficient ingestion of iron. I still suffer fatigue and I do not know if this is related to my low-ish iron. And no one has said anything about doing anything about it.

I don't have any references that I saved but maybe this is worth investigating. Maybe a medical oncologist would be more knowledgeable about these deep processes. And of course my notes here could be completely irrelevant in your situation.

[NanoMRI]

(edited per Justfor_- a correct call out on my comment). Do you know why the iron (ferritin?) is low? I ask because I wanted my ferritin lower. A new to me internist first wanted to know why my results were at very top standard range, ferritin over 300ng/mL. Turns out, I have hemochromatosis. Treatment of this is to lower iron - so a two for one for me

[Justfor_ in reply to NanoMRI]

Cancer, must be breaking some physiological control loop. I have permanently high serum iron (within normal range ~150 - 175 μg/dL ) that occasionally surges to 200, while my ferritin is flat down just above the lowest normal value and on top of that low RBC which is the well known "cancer anemia". For a while, I was taking vitamin C that I stopped when read that it facilitates iron absorption. Haven't found any way to bring balance back.

PS: You are probably quoting your ferritin value which is measured in ng/mL, but doesn't look that much high. My lab acknowledges 21.8 - 274.7 as the ferritin normal range.

[NanoMRI in reply to Justfor_]

yep, you got me. Wrote too fast, focused on my thought as to why and left a convoluted mess - so have edited.

[SpencerBoy11 in reply to NanoMRI]

Same with me. I also have myelodysplastic syndromes with ring sideroblasts and am approaching the need for transfusions. Anemic with low red blood cells, hemoglobin and platelets . Also have prostate cancer which is still responding to ADT and various types of skin cancers. But, I am already past my expiration date.😎

[NanoMRI in reply to SpencerBoy11]

Well done making it past expiration date! I had not heard of "myelodysplastic syndromes with ring sideroblasts" - sounds far more ominous than hemochromatosis - which was new to me too. All the best!

[Tall_Allen]

Why is iron low? There may be reasons for his low serum iron that have nothing to do with his iron intake.

[MsBoBo in reply to Tall_Allen]

My apologies, it is Ferritin that is very low. It dropped from being in the 80s ug/L to 30ug/L in 3 months. He is currently not on ADT. He had lupron for 1 year after late salvage RT, and it has stopped for over 1 year now. No changes to diet. Only thing is PSA progression. What may this be indicative of?? His doctor only said to supplement iron as he is in the danger zone with his heart health. We are very concerned about the risk of fuelling the cancer.

[Tall_Allen in reply to MsBoBo]

It may be a liver problem. But whatever you do, do not feed him extra iron. It is quite toxic.

[MsBoBo]

My apologies, you are correct that it is Ferritin levels and not serum iron. RBC is on the low side also. Ferritin is only 30ug/L and he has been prescribed iron supplements. 3 months ago it was in the 80s. What could have caused this sudden drop with no other changes to his diet? Is there correlation between this and cancer growth rate/aggressiveness. Will supplementation fuel cancer growth?

[Justfor_ in reply to MsBoBo]

"Is there correlation between this and cancer growth rate/aggressiveness?"

I checked for a correlation between my PSA vs serum iron and alternatively PSA vs ferritin. Didn't find any, although with only 5 sample pairs that I have the conclusion is statistically weak.

"Will supplementation fuel cancer growth?"

IMO, generaly no, but as you wrote cancer hoards iron. If he has serum iron deficiency (i.e. bellow the mean value of the normal range) I would take the supplement. But, in my case I take curcumin and milk thistle just for the opposite reason, that is to lower it.

Iron Deficiency: In iron deficiency anemia, serum iron levels are typically low, and ferritin levels are also low, indicating depleted iron stores.

Iron Absorption and Storage: When body iron stores (ferritin) are low, the body increases iron absorption from the diet, which can increase serum iron. Conversely, when iron stores are high, iron absorption is reduced.

[NanoMRI in reply to Justfor_]

many things to read and many expert opinions - I find this interesting - ncbi.nlm.nih.gov/pmc/articl...

[Teacherdude72]

nutritionfacts.org/blog/wha...

[EdBar]

My oncologist recommended that I take iron to help with anemia, and it has . I take an iron supplement daily in the evening with food and have my levels checked every few months to make sure that they’re not too high which can be bad. I haven’t had that issue and my iron remains in normal range. It took a couple of months to reach normal. BTW I’ve never heard of cancer hoarding iron.

Ed

[Explorer08]

It might be time to engage with a hematologist at a blood disorder clinic, preferably in a university medical center setting.

[Grandpa4]

low iron levels almost always mean bleeding. Usually occult blood loss from the colon. Maybe radiation caused bleeding. When I was a physician I always looked for a bleeding source when this happened. I save many lives picking up colon cancer early. Not saying I think this is colon cancer. The current recommendations is to take iron every other day. That improves absorbtion

[God_Loves_Me]

I had low iron last year. my MO started Iron infusion after 6 months, My Iron and hemoglobin increase.

[MateoBeach]

Don't overthink it: If the Cardiologist advises supplemental iron the that is presumably correct. Iron is best estimated by Ferritin in most circumstances. Especially if it is resulting in anemia consistent with iron deficiency. Taking care of the body and keeping at the best possible functioning is always the top priority. Theoretical considerations because cancer uses iron does not alter that. Thank you for your best support of him.