Iron and Testosterone, A Complex and Toxic Relationship: To Donate or Not?

Rudolph Eberwein, M.D.
Founder, A New You Wellness, Miami, FL

This lecture explores the intricate relationship between iron and testosterone replacement therapy (TRT), delving into the pathophysiology, clinical implications, and management strategies of iron overload. Although iron is an essential trace element, it is also a toxin that is cumulative and not easily excreted. Iron overload, a condition characterized by excessive accumulation of iron in the body, can lead to serious health issues such as liver cirrhosis, heart failure, diabetes, hypogonadism and sexual dysfunction. The lecture examines how TRT may impact iron metabolism and how iron overload can be a cause of hypogonadism. Central to this discussion is the hormone hepcidin, a key regulator of iron homeostasis. Testosterone is shown to influence hepcidin levels, thus potentially affecting iron absorption and storage. The lecture emphasizes the risks associated with iron overload in the context of TRT, including organ damage and cellular dysfunction. It also covers diagnostic approaches to detect iron overload early in patients undergoing TRT. Finally, the lecture provides guidelines for safely managing iron accumulation while on TRT, highlighting the importance of regular monitoring and individualized treatment plans.

Duration:46m59s