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Slight Anemia Following TULSA-PRO procedure
In October 2024 I had the TULSA-PRO procedure done at Mayo Rochester. About 50% of my 100cc prostate was ablated. Just prior to my procedure they did blood work and my Hemoglobin was 13.5 (in the normal range). In January 2025 I had my annual physical exam. Bloodwork was again done and my Hemoglobin had dropped to 12.9, just below the normal range. My primary care physician flagged it and said let's retest again in a month. Did the retest. Same result. We then checked my iron levels. All came back normal. My primary care physician didn't suggest any further testing to see what's going on. Had my 6 month follow up at Mayo and doctor there who did the procedure didn't seem concerned or felt there was a cause-effect relationship with the procedure. Yet to me this is the only variable in the equation. All of my past years I've never had an abnormal Hemoglobin test result. I'm just wondering if anyone out there in our community has experienced anything similar? My plan at this time is to just keep on keeping on until my next visit to Mayo for my annual checkup in October. Any other suggestions would be welcome as well. Thanks!
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After 20 months on Darolutamide my Hemoglobin is 11.9, it was mostly in the normal range when I was on Zytiga before that. Are you on any drugs?
Low hemoglobin is not a normal side effect of TULSA-PRO.
I'm on no drugs. I do take a statin Crestor on lowest dose possible of 5mg. But nothing else. I can't figure out why just before the procedure on October 9 my Hemoglobin was 13.5 and three months after the procedure it's 12.9. And while it's just below normal I'm not terribly alarmed but none the less something changed and as an engineer by training I'm having angst not knowing the root cause. I started Crestor in February 2024. From what I've read, continuous blood loss can cause low Hemoglobin counts. Had urine tests and found no blood in my urine either. I don't know what else to do but wait to see where this is going.
What is your ferritin level? Probably not in the ideal of 50 to 80 ng/mL area is a guess.
It’s the radiation. My bloodwork after photon SRT was horrible - all from marrow activity impacted by the radiation.
I realize that proton radiation is not supposed to do this, but let’s get real - there’s no way some energy wasn’t imparted to your pelvic bones. But it’s not a big drop so I think a 6 month test will show it back to normal.
Phil
My test result for ferritin was 253 on a scale range of 60 to 336. So I'd say within the normal range for that set of numbers.
Radiation from what Phil? I had no radiation that I am aware of. Yes, I was in an MRI machine during the procedure, which might have last a couple hours I suppose. But no radiation, unless MRI is considered radiation.
Normal isn't always what it seems by ranges, you have inflammatory condition that is causing the ferritin to not be used properly and made into RBC is what that says from your labs. So you should target inflammatory condition of some sort, in mean time look into things like boswellia serrata to help alleviate the inflammation. If you didn't have CRP lab that might be good measure here too, and look to bring that down. Ferritins above 100 are often inflammation but sometimes not, but since hemoglobin is down that is kind of classic long term inflammation of some sort. Look into liver enzymes too, these should be mid range, if not look into things like NAC as a supplement.
My Hemoglobin went from 15.7 to 12.7 after 3 months on ADT. Haptoglobin fell out of the bottom. Currently I am anemic and feel like it. Typical of ADT treatment. I wouldn't stress about 1 point. We can get wrapped up in every single fluctuation and drive ourselves nuts.
I'm 3+3 AS at Mayo Clinic in Phoenix. Happy with the care. However, if I were to require intervention. I would want to do Tulsa. Was your procedure in Rodchester done with Medicare and/or Tricare coverage? Did you need any calcifications cleared out before the procedure? Thanks!
Just to give you a bit more data without any conclusions: I also had the TULSA-PRO in October, 2024. My Sept. 2024 pre-op hemo count was 14.3. At my six month follow up in Apr. 2025 my hemo was down to 13.7, still within the normal range. In looking at my 10 year hemo chart this change was within the range of variability of past blood draws and never caused any alarm from my docs.