Hemoglobin levels
I’ve been struggling for years to get my hemoglobin into the optimal range for a male. It constantly sits around 8.3–8.7 mmol/L while the reference range is 8.5–11, but ideally I want to be much closer to 11.
I’m 24, physically fit, train regularly, and have had a very clean nutrient-dense diet for the last 3–4 years (grass-fed meats, eggs, liver, kefir, etc.). Yet I still feel like my body is somewhat oxygen deprived. I’ve had shortness of breath upon exertion for as long as I can remember, even as a kid. My cardiovascular endurance has never matched how fit I look physically.
I honestly don’t think this is diet related anymore because I consistently get virtually every nutrient through food and have been very strict with my nutrition for years. I’ve also spent a long time working on my mineral status (iron, copper, selenium, etc.) and many levels now look much more optimal than before, yet my hemoglobin still refuses to go up to an optimal level.
One interesting thing is that some time ago I was doing B12 injections and during that period I actually felt noticeably better and even saw my hemoglobin improve somewhat. Since B12 is heavily involved in RBC production, it made me wonder whether this points more toward some sort of absorption/utilization issue rather than intake itself.
At this point I’m trying to understand whether this sounds more like:
\* iron utilization issue?
\* chronic low-grade inflammation?
\* hidden infection?
\* gut malabsorption?
\* mitochondrial/metabolic issue?
\* or something else entirely?
Mainly looking for people who deeply understand RBC physiology / oxygen transport rather than general nutrition advice.