i want to be clear about what i said about testosterone and ferritin. my rbc counts are a little low - my ferritin counts are very low. so, i ought to be more concerned about low ferritin than low rbc.

what modulating testosterone does is increase or decrease the rate at which the ferritin converts to red blood cells. so, if you give your body more testosterone, it should create more red blood cells and leave less ferritin behind; if you reduce testosterone, it should slow the rate of red blood cell production, thereby incresing your iron stores.

it follows that my low ferritin count cannot be explained as a consequence of low testosterone - that i would rather expect the opposite from low testosterone, namely an excess of ferritin.

so, i've got some sleep and need to catchup, after i make some fruit.

conversely, if i do another test with iron levels right after i eat and it's still exceedingly low, then i'm going to need to react differently.

what about testosterone suppression? could that affect iron levels?

again - i don't think that's the primary cause because there's so much evidence pointing to the genetics, but testosterone suppression should actually increase ferritin levels, from what i can see. the mechanism seems to be that taking the testosterone out of the process would limit the conversion of ferritin into red blood cells. that is, the ferritin is a precursor to the red blood cells, so what you end up with is more ferritin and less red blood cells. that's the opposite of what i'm seeing.

if anything, the fact that my rbc count was a little bit deficient and my ferritin count was extremely deficient seems to point to the idea that my ferritin got used up making red blood cells and what the test really suggests is that i was hungry. that might be over-simplifying, but i think it makes sense of it.

and, if that's the case, it would suggest that it was just a function of the distance between eating.

so, while fasting is good for testing glucose, it seems to be bad for testing ferritin - or, at least, bad for testing it once and drawing conclusions from it. i need a post-meal test...

yeah.

the more i look into this, the less concerned i am about it. 

this is a different reference range:

The normal range for ferritin in your blood serum is:

20 to 250 ng/mL for adult males

10 to 120 ng/mL for adult females, 18 to 39 years

12 to 263 ng/mL for females, 40 years and older 

25 to 200 ng/mL for newborns

200 to 600 ng/mL at 1 month old

50 to 200 ng/mL at 2 to 5 months old

7 to 140 ng/mL for children 6 months to 15 years

https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=ferritin_blood

i'm at 12 ng/ml - or 12 ug/l, same thing. i don't menstruate, so the 12 is a more appropriate lower bound than the 10.

see - it's the very lower limit, regardless. but, i was fasting.

if my body doesn't know what to do with the iron, it doesn't know what to do with the iron - and i need more warmth, not supplements.

but, i need to make sure i'm not bleeding.

and, how much does your ferritin go up and down, on average?

Serum ferritin levels in normal individuals have been reported to vary by 15% in men and 27% in women on a day-to-day basis [54], with variations of up to 62% when measured over a longer term [55]. 

https://www.hindawi.com/journals/ijcd/2018/9394060/

so, if 12 is the amount measured when i'm fasting at 10 hours, it would be the absolute minimum amount. right? before i accept any sort of iron bombardment, i'm going to request another blood test, but done without fasting. if that number comes up into the 50+ range, i think i have nothing to worry about - i'm just demonstrating variability, and need more warmth than other people that are better adapted for colder climates.

see, when i look at a study like this...

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235141

what are they doing, here? they're defining the amount of iron that africans need by looking at the amount that europeans need, and then deciding that africans are anemic because they don't get the amount of iron that europeans do.

but, the reason that europeans need all of this iron is an adaptation to the colder climate! some of these african cultures live exclusively on meat. if they're not absorbing the iron, perhaps it's because they didn't evolve the need for it, because they aren't living in climates that required it.

so, if you follow this line of thinking, what is there to say about the need for "intervention strategies" in african populations to increase their iron levels? it would be racist, if it wasn't clueless.

so, i need to form a position on this. i've sent an email to my sister asking her to contact my stepmother, who is both an expert on bone marrow cancer and the person best positioned to provide information about my father's health. once i get that information, i'm going to need to make a choice:

1) am i actually iron deficient? if so, i guess the only thing i can do is bombard my stomach lining and try to force it to absorb more than it's designed to - to try to break my programming, so to speak.

2) or am i just evolved to thrive in a warmer climate, where all of this excess iron absorption is not just unnecessary but potentially even harmful? i mean, i don't want to give myself alzheimer's...which seems to be correlated with high iron absorption. if so, i should just accept that my ferritin is low due to genetic variation, and try to adjust my environment so it's warmer.

this isn't exactly what i'm thinking, but it's in the right neighbourhood:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066702/

but, my position is actually as follows, and i'm going to double down on it - i think i'm poorly evolved for the canadian climate. which means what, exactly?

supposedly, something like 30% of the global population is unable to absorb "sufficient" levels of iron, and that is something that is strongly correlated with being brown. when 30% of the population has a disorder, that sounds more like variation than a disease - and that you'd only call it a disease if you're white.

while people have migrated around all over the place for thousands of years, and trying to build strong geographic correlations is no doubt futile, it seems like increased iron absorption is probably an adaptation to colder climates. i wouldn't even be surprised to find out it's neanderthal in origin. it follows that people with genetic backgrounds in warmer climates may just not need as much iron - until they move north, and find themselves up against a wall they can't scale.

the actual best solution is for me to move south, and i know that. if i get some source of wealth, right?

in the mean time, i'm stuck between figuring out a way to warm up and figuring out a way to adjust - and want to lean towards the former more than the latter.

does estrogen affect iron levels?

it seems to be unclear, with studies arguing both positions.

what i'm going to say is this: while it's certainly possible that estrogen may be exacerbating an underlying issue, i just got an email back from my uncle confirming that this issue with "poor circulation" is something that he has experienced, his mother has experienced, and two of his sisters have experienced.

so, everybody on that side of the family has this condition.

there's clearly an underlying mechanism, and it needs to be addressed, regardless.

i guess i can't spare much blood, huh?

what am i doing about this?

well, i went to the store looking for heme iron and the only option was an expensive supplement with a measly 11 mg/tab. if i do the math on my diet, i'm already getting more than that. so, that struck me as a waste of money - if i can't absorb it in my diet, what's the use of taking a pill?

i'm checking the formulary and, while heme is not covered, they have these, like, 200 mg tablets of elemental iron that are. well, that's at least worth a shot, i guess - it's at least a substantial increase from what i'm getting, even if i can only absorb 10% of it. that seems like a crapshoot, and i wonder what the side effects might be, but if i can't absorb it...

i sent an email to my mom and she's feigning ignorance. i sent one to my uncle, who may be more useful. i'm trying to avoid contacting my stepmother, if i even can. i'm going to send something to my sister.

what else can i do? 

well, i need to figure out if i'm bleeding, but the more i've processed this, the more obvious it is that this is a genetic concern. my dad never said to me "i'm anemic", but it's pretty obvious that he was. 

so, if i'm not bleeding, and i can't absorb it, it seems logical to look at injections. unfortunately, that seems like a really bad idea - we need iron to create blood, but introducing it into the blood directly seems to have a large amount of dangerous side effects. the preferred approach seems to be iv, but that doesn't seem to be less dangerous.

so, these high potency supplements might be a crapshoot, but it's probably the best choice i've got.

i just wish i could take 50 mg of heme instead of 200 mg of elemental.

wait.

i'm low in iron. i just got a blood test. now i'm tired. obviously?

i mean, look at the fruit bowl.

yes, it has a lot of wheat bran.

but, it has 100% of the iron (some of it fortified in the bran), 250% of the vitamin c + high fat, premium ice cream. that should be good enough.

obviously, it isn't - obviously, something is going wrong along the way. but, i don't think that removing the bran is the right argument.

i could be just eating too much wheat, too:

https://pubmed.ncbi.nlm.nih.gov/2820048/

i need to do some typing, but i'm exhausted. i'm still convinced that the second-hand smoke is the primary problem - i didn't develop an iron deficiency recently. whatever exists was always there. and, i was frequently cold before i started eating all this bran, too. - but it's certainly not helping.