About a week into taking B12 loading doses I went to get tested to see what it was doing to my iron levels and honestly was surprised that my levels had gone down.
I have some variability in my energy levels still but seem to feel progressively better every day.
Just out of curiosity what is likely going on that my levels would drop so fast? And should I consider taking an iron supplement (in addition to the 1+lb of red meat I eat a day) or should they naturally rebound?
Hi Ashton06. Serum iron and % saturation are low but your ferritin levels are high (and rising). This pattern could be indicative of anaemia of chronic disease or something called 'iron-out-of-balance'...or indeed, other things too.
Iron supplements are not always advisable when ferritin levels are high (iron overload can be a dangerous issue if iron is over supplemented). Certainly wouldn't recommend iron supplements when ferritin is high (and your appears to be rising).
Here‘s a link to a good website that explains more about iron...
irondisorders.org/Websites/...
Having B12 injections won't impact on iron levels although those with B12 deficiency may also have other absorption issues (I.e. iron, vitamin D or folate) and may suffer iron deficiency anaemia because they don’t absorb iron well (or their diet is deficient). However, in your case your diet is iron rich and your ferritin levels are rising - this indicates you are absorbing iron from your diet, so you don't apparently have an issue with iron absorption (but may (or may not) have an issue with how your body 'manages' iron on a more complex biological level).
Iron can be very complicated 😉.
So...it would be best to take these results and discuss this with you GP (who may want to do their own tests). They can factor in your medical history, consider if further investigations are required, and decide on the best way to proceed.
Good luck.
It is known that treatment with B12 injections can cause iron to drop. It's thought that b12 deficiency can mask depleted iron stores. I know to little about all the various iron-related lab tests to interpret your values, but this article may be of interest:
ncbi.nlm.nih.gov/pmc/articl...
"Cobalamin Deficiency Can Mask Depleted Body Iron Reserves"
The idea is that as soon as the body get enough b12 it starts using more iron, and as a result iron levels may drop.
please note that the test results above don't quite fit with the results in the study in that the study showed ferritin levels falling whereas the above have them rising, so would advise following up on the possibility of another type of anemia going on as suggested by Foggyme
I was trying to figure out how to post more than one picture so I could show the results of a CBC at the same time, but interesting enough despite what is going on with the iron the CBC was pretty good.
Saturation may be 12% but hemoglobin was 15.6
When did you start with b12? Looks like ferritin was never tested after November 2019. Was that before or after b12?
I had been taking 500mcg of B12 (injection) daily since ~the beginning of October.
Jumped to 5000mcg B12/day a week ago.
That's why I was kind of surprised it dropped so fast after changing the B12 dose. I had been taking Proferrin in the past but as you can probably tell it didn't make a noticeable difference in my serum iron with the lower dose B12. But if the increased B12 requires more supplemental iron then I have no issue taking it again.
Hi again Aston06.
Following on from my reply above...
When iron deficiency anaemia is present, ferritin falls and changes to the red blood cells can be seen in the CBC. You say in your reply above that your CBC was normal and, as before, your ferritin is rising (rather than falling).
This points away from iron deficiency anaemia caused by absorption issues (low iron) and points towards potential issues with iron metabolism (what happens at a more complex biological 'iron management' level).
The individual elements of your full iron panel cannot be read in isolation from each other and must be viewed over and against each other - and in relation to all your other results, so just considering % saturation and total serum iron whilst excluding the high ferritin finding does not sufficiently 'explain' total iron status in the body...or how your iron is being managed (metabolised) by your body.
Also - as noted by Gamibt above - in the research paper in one of the replies above, ferritin levels were shown to be falling. Yours are rising (and your CBC is normal) so your iron status is showing a different profile than that under discussion in this research paper (which focuses on iron deficiency (low iron in the blood), rather than iron issues due to problems with how the body metabolises iron.
Just reiterating this because most people don't realise how dangerous it is to over-supplement with iron - and your ferritin levels indicate that there is plenty of iron in your blood - it's just not getting where it needs to go (hence a possible metabolism issue rather that an actual ‘deficiency' issue due to low intake of iron (if you get what I mean).
There are numerous causes of iron anaemia which can have nothing to do with deficiency of iron (low iron, in the sense of how much dietary or supplemental iron is ingested (or not))...or indeed with how much vitamin B12 is ingested or injected.
So...sorry if this sounds like I'm 'banging-on' about iron but I really want you to be safe, so...in interest of your own safety...I would sincerely urge you to discuss this with a medical profession before considering taking more iron supplements. At least with a doctors advice you can be sure whether you need iron supplements or not, and take it with peace of mind if you do 😉.
Certainly, it would not be advisable to take any iron unless your ferritin level drops significantly (and even then, this is not a good marker of total iron status in the body).
It's very easy to get iron in...but impossible to get it out if too much is taken and it ends up lodged in the tissues or joints (what happens in iron overload).
Good luck...be very interested to hear how it goes.
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