Transgender and haemoglobin connection ?

[Teresa]

I regularly donate blood twice or three times a year but for some time I've been hit and miss sometimes falling below the required level ( the NHS requires 135g/l for men and 125g/l for women ) my reading was 127g/l.


My question is has anyone found in the physiology the connection between TG and haemoglobin levels. I know we are wired differently but how different are we in other ways. I have searched briefly online but most connect with changes due to hormone therapy, I'm not on any medication at all.

I was nearly tempted to ask the question during the screening process last time but felt I should see if I could find anymore information about this subject. I'm not sure what the difference is between using blood donated by a male and that of a female, or someone in between .

I will add that I have a balanced diet and my iron levels should be OK , they will make me wait three months now anyway before making my next donation.

I hope I can continue to donate blood freely, it may be a small thing I can give back to the community but it's a big thing if it saves someone's life !

[Laura912]

There are several biological measurements that have male and female normal ranges, and, as we are now learning, some factors that should have ranges according to race and ethnic backgrounds. There are not enough data to judge if male normals should be reset to female normals when HRT is started.

[Teresa]

Laura,
I'm not on it but I did find conflicting data between surveys, it's one of those areas where they may struggle to get sufficient information .

[Allisa]

I donate occasionally and the woman always comments on the color and the flow, I've never donated en-femme, I wonder what will happen? I'm not on any kind of therapy or supplement, what will they categorize my gender as. What if they give my blood to another male and he suddenly has an urge to wear panties?

[Pat]

Wow. It's been a long time since I donated blood, so I'm out of touch with it but I never suspected there were weight minimums. What happens if you don't pass? It seems like it would still have valuable platelets, plasma, etc. Teresa, if you don't mind my asking, are you on HRT or are you just naturally "light"?

[Kate Simmons]

Our metabolism will vary from time to time. Don't forget we are a completely different person body wise than we were 7 years ago. The cells just "remember" who we are.

[Alice Torn]

Foe a few years, I was giving blood plazma, but quite a few times was rejected.

[Teresa]

Lisa,
I was waiting for that joke ! No problem but it is a serious question, if our physiology is different along with our wiring.

Jennie,
Maybe you misunderstood but the figures are haemoglobin levels in the blood . I weigh 147lbs and I'm not on any medication or hormone treatment.

Just for the record I was to asked to take part in a trial for a mobile unit to donate platelets, that really takes it out of you, I was hooked up for 90 minutes , it operates on a cyclic system of taking so much and then putting plasma back into your system with an anticoagulant . It's the equivalent of several normal blood donations.

[PaulaQ]

At least in the US, there is very little general medical data on trans people because we are erased from surveys. It's improved SOME recently - they actually record us on HIV statistics, for example, but for anything else? Nah. As for blood donation, you can mostly forget about it if you are trans and in the US. We are all categorized as men who have sex with men. (Including trans men - many of whom do NOT have sex with other men.) They've actually relaxed on that part recently - Pat got a letter that will allow him to donate blood again, finally. Maybe. We are openly discriminated against by the US government in this area as trans people. So there isn't much data on us.

[Teresa]

Paula,
Just a question of differences between the UK and US. In the UK the NHS runs the National Blood Transfusion Service so all the information is available throughout the country under the NHS umbrella. Is the US a nationally run system under the same type of umbrella,so all the information is centrally available ? I know private systems are more the norm in the US .

[PaulaQ]

The FDA, which is a federal agency, sets the policies I mentioned. Some data is collected federally, much is privately collected. There are many federal databases though that don't distinguish trans people from others.

[Pat]

Jennie,
Maybe you misunderstood but the figures are haemoglobin levels in the blood .

Ah. Yes, I was misunderstanding what was being measured. Never mind...

[Amy Fakley]

... What if they give my blood to another male and he suddenly has an urge to wear panties?

Hemoglobin's not it though ... that'd be the glittery pink polkadot Midiclorians. Also known as "cooties" in days of yore.



"Y'see kids?! This is what happens when you catch the cooties" ... omg ... I think I've got a new catchphrase :-)

[jeanieinabottle]

Teresa,
I also give blood about 4 times a year as well as platelets and plasma. As a doc, this is important to me. I’ve never been denied since my iron levels (which is what the American Red Cross checks before dontation) were at least above the minimal levels. However, when I’ve had a CBC drawn (Complete Blood Count) every so often my hemoglobin which carries oxygen to the tissues and hematocrit (% of red blood cells) are low and I go on iron for awhile. I’ve never been able to figure out why and have ruled out other important reasons such as a slow gastrointestinal bleeding such as would be with colon cancer, etc., by regular colonoscopy, particularly of interest since there has been colon cancer in the family. We have not done a bone marrow biopsy but that may be coming down the road if this becomes more persistent rather than episodic.
Physiologically some have suggested that males have a higher hemoglobin/hematocrit than females possibly because of testosterone which may increase RBC production (seen in testosterone supplementation) to supply increased muscle mass as well as RBC (red blood cell) loss in females due to menses. However, the problem with that is that RBC production in the bone marrow is stimulated by a hormone secreted by the kidney called Erythropoietin or EPO. When we have enough RBC’s the EPO is turned off and when we need more EPO is secreted by the kidney, controlled by what we call a negative feed back. The catcher is that regardless of the differences in hemoglobin and hematocrit in males vs. females, the EPO levels are essentially the same in males and females when we would expect it to be higher in females than males to get the hemoglobin/hematocrit levels closer to equal. So it has to be something else, maybe just a physiological manifestation of muscle mass greater in males and oxygen delivery systems, possibly more efficient in females.
So when it comes to if there is a reason related to one being transgender, particularly without hormone supplementation, nothing seems to fit or provide a provable reason. We know our wiring, our physiology, our receptor sites are different, dictated before birth. With some of the questions still remaining about differences in hemoglobin/hematocrit in non-transgender individuals, I’m sure I won’t find a verified reason before I’m gone.
While I am not a hematologist by specialty, if one has a regular deficiency in hemoglobin/hematocrit, I’d tend to make sure that is it isn’t something else other than due to being transgender.
Dr. J
PS….sorry for the long response. I tend to lecture when I get to something I like and know a little bit about. Sorry y’all.

[PaulaQ]

Physiologically some have suggested that males have a higher hemoglobin/hematocrit than females possibly because of testosterone which may increase RBC production (seen in testosterone supplementation) to supply increased muscle mass as well as RBC (red blood cell) loss in females due to menses.

Increased RBC's due to testosterone is readily observed in trans men, and is one of the reasons FDA restrictions against their donations was so horrible - some trans guys literally need to give blood because their RBC & hematocrit are through the roof and dangerous to their health.

[jeanieinabottle]

The excessive numbers of red cells or "polycythemia" increases the viscosity of blood (higher percentage of cells to liquid portion of blood) which makes occlusive phenomena more likely, such as strokes, heart attacks, etc., which is the same with all polycythemic patients whether on testosterone supplements or not. People with chronic obstructive lung disease (emphysema/chronic bronchitis) also get a polycythemic response which is why they have that ruddy complexion.
But again going to the original question as to whether being trangender and not on any hormonal supplementation would be the cause of a lower hematocrit or hemoglobin, even assuming a possible lower level of testosterone, that is not what sets the physiologic limits because even while females have a lower normal range of hemoglobin and hematocrit vs age matched males, they function physiologically well with the lower values and with equal EPO levels.
Therefore, if someone has a persistent or commonly occurring low hemoglobin or hematocrit, as a physician, I think I would tend to recommend someone to look elsewhere rather than on being transgender as being the cause. That would be my recommendation.
Dr. J

[Diane Smith]

Hemoglobin was 124 g/l as of my last CBC. This is actually a fairly high reading for me. A form of anemia called beta thalassemia runs in my family; it is traceable at least back through my mother to my maternal grandfather. I take lots of other medications but no gender altering hormones. I have several medical conditions that separately or together disqualify me from donating blood, so I've never had that experience.

It's an intriguing idea that this may be related to TGism, although proving anything about it will probably be as elusive as the proposed correlations with birth order, left-handedness, DES, etc.

- Diane

[jeanieinabottle]

Hey Diane
I would think the Beta Thalassemia is your culprit. Its a genetic condition listed under what we call hemoglobinopathies of which there are many such as Beta major and minor, alpha and sickle cell, etc. The genetic defect codes for abnormal protein in the hemoglobin portion of the red blood cell and deficient hemoglobin, therefore low as well. We see it mostly in mediterranean descent males but can be in others. But I would think most likely that would be the cause of your lower hemoglobin values
Dr. J.

[Teresa]

Dr.J,
Many thanks for your full reply, I can see there will never be a proven case with the connection, it was just a thought.

I did suffer from hypercalcaemia, and at the moment have two large stones residing in my left kidney, which they advise to leave alone but when I get any discomfort it's usually my right side that feels it. I would say my kidney's may need checking , at one time it was checked every six months, but the checks were withdrawn because 3M stopped making the medication. Strangely it was a life long condition but my last checkup showed my calcium level to be normal.

[sometimes_miss]

So it has to be something else.

Yep. Most likely hidden somewhere in all that 'junk' DNA that modern science tells us doesn't code for anything. I'm one one of those who believes it all codes for something; we just don't know what, yet. It's just another one of those 'we already know everything' assumptions that scientists make sometimes to make themselves feel smart. But it's in there, alright; figuring out where? Well, that might be just a little more difficult......

[rachael.davis]

hemoglobin is based on iron, women have a problem with iron metabolism
http://www.ncbi.nlm.nih.gov/pubmed/25083899

unless there are some massive breakthroughs in GRS transgendered women won't be facing the same problems.

[Loveday]

Wow, thanks for all the information jeanieinabottle , PaulaQ , rachael.davis . In 2014 and 2015 I went extremely anemic. The doctors thought I was bleeding on the inside but still to this day have not found out where it is. I had to get get 12 bags iron put in me before and after a triple bypass to get my iron levels and hemoglobin back right again. You have given me alot to think about.