Is 22ng/ml ferritin normal for male? - Pernicious Anaemi...

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Is 22ng/ml ferritin normal for male?

Hamayeshguy profile image

After injection my ferritin started to get lowered. I inject everyday. What can I do to increase it faster?

37 Replies
Gambit62 profile image

There isn't a direct link between B12 and ferritin that I am aware of. Ferritin is an indicator of iron status. The normal range for men tends to start lower than for women (menstruating women at all) so your result is probably in range but at the bottom of the range.Whilst ferritin is generally a good indicator of iron status it doesn't tell the whole story and acting on ferritin alone has been known to lead to toxicity.

If you have a problem absorbing B12 you may well have a problem absorbing iron from food so if you do have an iron absorption problem that isn't being treated then you could develop a deficiency. No amount of B12 is going to help with that - you need iron.

Because of the risk of toxicity I would suggest you speak to a medical professional to clarify if you are deficient/have an absorption problem, may be get a full iron panel done ... and take advice on what supplementation might be appropriate (eg from a pharmacist if you can't speak to a doctor).

Hamayeshguy profile image
Hamayeshguy in reply to Gambit62

Sorry my first post wasn't relevant because I didn't read whole your post and this one is exited. So you mean if I take iron without precaution can lead to toxicity? Is that right? And nackapan says after 3 months it should be monitored by GP not to go beyond it's limit. Is that right? I used to inject without any regular pattern and started to exercise then I saw my fatigue and muscle weakness are beyond of any kind of extreme fatigue then I stopped exercise and started everyday injection and my symptoms got improved so fast but my cardiologist wanted me to check most of blood biochemistry and everything was normal except this iron. ( He told me iron but left note for my GP and probably he was talking about ferritin and tomorrow I'm gonna find out). I think injection may not directly was caused decrease in ferritin level but maybe exercise caused muscle to start buildup and lowered ferritin. So I shouldn't take any kind if iron supplement on my own at all?

Gambit62 profile image
Gambit62Administrator in reply to Hamayeshguy

you get iron toxicity if your iron levels are high because of over supplementation which is why I am suggesting you confirm that you really are iron deficient before taking any high dose iron supplementation.not saying you have any toxicity from B12

Hamayeshguy profile image
Hamayeshguy in reply to Gambit62

Yes I got it. But my fatigue is beyond of any level of fatigue that I have and after four days injection in row I feel much better but before that my ferritin was within range. I don't know maybe exercise is the cause of ferritin decrease. I'm so worried because I've heard ferritin level changes is not good. And take time to get back to normal. In the meantime I'm male 48.After injection for four days I feel much better and I didn't want to change that. Do you think is it better to go with BNF guideline or just continue everyday injection and probably on and off take iron supplement. I think there is no absorption problem but exercise depleted ferritin and even my b12 was also depleted because of exercise. Last year September I was experienced RBC megaloblastic and I think it's gonna take long time to get back to normal.

Gambit62 profile image
Gambit62Administrator in reply to Hamayeshguy

testing continually and focusing on test results isn't helpful. I'm not qualified to give you medical advice and this forum isn't a substitute for professional medical advice. Everyone has good days and bad days and it could just be that.Ask a pharmacist about a suitable iron supplement

Hamayeshguy profile image
Hamayeshguy in reply to Gambit62

I have referral for internist doctor next week but in hospital ER doctor told me your hemoglobin is normal and just iron level is not everything in it's own and your iron is not low. I think probably I had muscle damage due to B12 deficiency and healing of that damaged muscle requires iron and maybe supplement would be required.

Yours us at thd bottom of the range as In that measurement it starts at 20 ng/ml for men it seems.

For women lower

Mine is measured in ug/ L which I think is the same

As Gambit62 has stated it shoukdnt be looked at in isolation .

Mine did drop from 61ug/L aftef loading doses continued to 29

The GP recognised I needed iron snd prescribed it.

Once on iron you need regular bloods until s maintenence doses found

I've never needed iron before .

It took nearly a year to get back to where j was .

I've bee told anything under 30 ug/L cdn indicate anaemia now in nice guidelines.

To aim to keep it above 50ug/,L

Hamayeshguy profile image
Hamayeshguy in reply to Nackapan

You mean by taking iron I need blood transfusion

Nackapan profile image
Nackapan in reply to Hamayeshguy

No.I mean if you take prescribed iron you need a blood test to check the level 3-= months after taking iron.

As stated it's bad for you if too much iron taken.

It needs monitoring by your doctor.

Hamayeshguy profile image
Hamayeshguy in reply to Nackapan

Thank you

Scientist, not medic.

Just suppose: If you were anaemic before your B12 treatment, assuming it was a megaloblastic anaemia, as you recovered from the anaemia your iron utilisation would increase. A treated megaloblastic anaemia with borderline iron stores could easily then result in a microcytic picture, as you've used the iron stores up. It's very finely balanced. Iron is scarce in food, and as a consequence we don't have a means of excreting any excess, so we store it. This can lead to 'Iron overload' because it gets stored in various organs and eventually can lead to failure of various systems.

Iron toxicity is another matter. This happens when a large amount of iron is ingested, and 'free radicals' are generated. This is very, very serious indeed.

Ferritin is a good indicator of iron status but it can fool us. In severe protein malnutrition, a low ferritin may be seen. In chronic inflammation, a raised ferritin can be seen. Neither of these situations indicates iron deficiency. Other tests can help, and a normal FBC, with normal Hb, MCH and RDW are good indicators of a reasonably healthy state.

As others have said, don't simply take iron without medical supervision. It's dangerous. You're doing the right thing by asking questions! Good luck.

helvella profile image
helvella in reply to FlipperTD

You mention severe protein malnutrition.

Could severe deficiency of one or more specific amino acids result in low ferritin? Even in the context of adequacy of most or all the other necessary amino acids.

FlipperTD profile image
FlipperTD in reply to helvella

That's a very good question, but I don't have an answer to that. To get deficiency of a particular amino acid it would probably require a 'chemically defined diet' manufactured in a laboratory, something that is [or has been] used in research. It's not easy to set up such a process.

When I say 'severe protein malnutrition', it's more a matter of extreme starvation, rather than 'not getting quite enough'.

helvella profile image
helvella in reply to FlipperTD

What was in my mind is very much the fashion of food - to buy products which proclaim protein. But the ingredients of which might be a limited subset of amino acids. For example, I think that soy is low in methionine and lysine.

Someone could easily think that all "protein" foods contain all essential amino acids. And if their diet is extremely skewed...

But if it really is only in severe protein malnutrition, then my suggestion seems less likely.

Thank you.

FlipperTD profile image
FlipperTD in reply to helvella

I think you're right. It's quite difficult to exclude some things from the diet unless you try really hard, and some folks will. Very restricted diets have resulted in the discovery of all sorts of things. Beri beri was discovered due to the feeding of polished rice to chickens. [If my memory serves me properly.]

Animal products are very good at supplying us with what we need, whereas strict vegetarian/vegan diets can be consdierably more challenging.

We're very good at recycling loads of stuff, and proteins are dismantled and reutilised effectively. The recycling of Haemoglobin is a good example, because we take the molecule apart, recycle the globin, take the iron out of the Heme and reuse it, and then throw away the other breakdown Heme products, from bilirubin and a whole host of others that come in a wide range of colours!

Hamayeshguy profile image
Hamayeshguy in reply to helvella

I have balanced diet and probably unlikely protein deficiency was the cause of low iron. But you are right in someway. Damaged muscle healing require amino acids and subsequently iron should also be used

Hamayeshguy profile image
Hamayeshguy in reply to helvella

I eat lots if cheese and yogurt everyday and calcium in yogurt and cheese impaired absorption if iron in foods I think. I have to eat variety of foods and mire iron rich foods without calcium and porphyrin which is in coffee and tea.. more seeds like lentil and olive and meat can help. Heme iron supplements can help with less constipilation but elemental iron have lower absorption and as well cause constipation but vitamin c increase absorption

I have appointments with internist doctor and er doctor in hospital told me your hemoglobin is normal so just iron level on it's own can not be indicator of low iron. But I think damaged muscle healing can use iron . During deficiency I was so physically active and for sure I have lots of damaged muscled. Sever pain in my stomach muscle I gave for couple if years and doctors could find the reason . And now my back muscles also have severe pain too. These damaged muscles need iron to get repaired. Sport medicinal specialist recommend iron supplement to some athletes like marathon runners. But soon I'm going to see internist doctor.

It seems like you know your own body.

It's possible for your Hb to remain normal whilst you're developing deficiencies, but once they get low enough, your body will react. Ferritin is one indicator of iron but it's not perfect. It's easy and quick, and most of the time it's OK, but there are times when measuring serum iron and transferrin can add more information. Dosing up with iron, without knowing whether there's a deficiency, isn't a wise move. Seeing a doctor to discuss it is a good move.

Good luck!

But I have extreme weakness and when I walk I sweat alot it's like climbing mountain. I'm some worried and have appointment with internist doctor. Thank you for your recommendation but do you think ferrous biglycnate can help to take. 28mg . Untill I visit doctor?

Hi. Remember I'm a scientist; I can't recommend any sort of therapy. All that I would say is that if you're going to dose yourself with iron in any form, don't overdo it, don't take too much, don't take it for too long, and have a chat with a pharmacist. Keep records of how much you've taken and tell the doctor what you're doing, and any side-effects you notice.

If your Haemoglobin level is within the reference range, and the same goes for your MCH [or MCV] and your RDW, then it might not be anything to do with iron. Don't leave it too long before you speak to a doctor.

There are lots of other things they can consider. Good luck.

Last year September I think experienced RBC megaloblastic based on my symptoms Because neither my GP nor hospital didn't ask for relevant test so after 7 months on pills I started injection but non pattern based . My LIKELY RBC megaloblastic symptoms resolved in less than two or three months but not my neurological symptoms. I didn't have current symptoms there was not much fatigue and severe muscle weakness except my stomach muscles and it caused umbilical hernia on it's own. Now I inject everyday but I have no clue for how long it takes these extreme fatigue severe muscle weakness and muscle pain and blurry vision , double vision symptoms can get improved. But I'm going to see internist doctor to find out low iron problem requirement for supplement soon. Thank you for your recommendation.

Megaloblastosis can resolve remarkably quickly, and the results can be seen at a laboratory level in a very few days, when treated with the appropriate material. All of your blood cells are replaced every four months. So, if you've got adequate supplies of B12 then the macrocytic picture will resolve within that time, as long as you don't run out of iron in the process.

However, as you've noted, neurological changes take much longer, and can take very, very much longer.

Stick with it!

I had some improvement but I think exercise is so iron demanding process during injection because body starts to repair mostly damaged muscles specially vascular smooth muscles which work as blood vessels constrictor and I feel I don't have dizziness that I had before. My hand numbness also is much better but the cost I think is iron level. That's why it takes long time to get healed. And my guess is if I provide more iron along with exercise and keto diet it can accelerate repairing process. It just a guess not scientific reasoning. I think there is a priority in our body to repair itself after damaged myelin sheath are got repaired. Maybe during b12 deficiency period in physically active people's nerves related to muscles are damaged first and consequently related muscles so the last and largest myelin sheath repair is related to those muscles and after muscles tries to get back to normal use more resources like iron.

Hi. You've clearly done some reading round the subject!

The vast majority of iron usage is in Haemoglobin, and then after that, Myoglobin, and various other respiratory enzymes. The total daily 'normal' diet is around 20mg, of which only about 10% is absorbed. The rest goes 'straight through'! A healthy adult has a total body iron content of less than ten grams, incorporated in all iron-containing proteins, plus some stored, mainly in bones, but also some in other organs. We don't have systems to excrete excess, because we've evolved to make the best use of the scarce iron in diets. Red meats are a good source of iron, whereas cereal-bound iron is harder to absorb. Good luck.

I think malabsorption of iron in my diet is because of drinking orange juice and eating yogurt and cheese with my meals. And since I didn't has variety of foods ( I eat dairy and orange juice with each meal). At the same time I exercised. Both depleted iron stores. Damaged muscle repair requires iron along with other nutrients like vitamin c and zinc. That's why my extreme fatigue was beyond the fatigue I already had and forced me to stop exercise. So I'm going to change diet and probably take a little supplement innheme form.

The orange juice will probably help absorption, as vitamin C is good for assisting iron absorption. Tea, on the other hand, could reduce absorption because of tannins, but a dietitian is generally a better source of advice on this sort of thing.

But for better absorption of vitamin D3 it is sold with orange juice because of high calcium of that. And even for mire dense bones regularly drinking orange juice is recommended. If you google it can see content of high calcium in orange juice which probably prevent iron absorption.

In the meantime almond silk drink, fig, sardines, tofu, broccoli, canned salmon prevent iron absorption too. I think tomato juice is better than orange juice to increase iron absorption. Heme iron form doesn't need to be taken with food and has no constipation side effects and I'm going to take it for two months. (11.6 mg) which seems to does not affect my blood ferritin alot and can fix my iron problem.

Hi, I'm not medically qualified, but yes, I agree with others that your ferritin level is at the low end, for whatever reason.My own story is that I've always had a normal haemoglobin level, but for many years had symptoms of iron deficiency anaemia.

Eventually a doctor checked my ferritin which was only 6.

I was prescribed iron tablets but years passed when I'd get my ferritin levels up only for them to fall again, yo yo-ing up and down ...

Whenever my ferritin levels normalised, I often said to the doctor ; " Yes I feel a bit better, but it doesn't feel like the whole story ... "

Of course it wasn't the whole story - I was also suffering B12 deficiency, but I had to work that out myself years later then try to get an official diagnosis of PA.

What I'm saying is that for me B12 and iron deficiency anaemia have definitely gone hand in hand.

Best wishes and hope you feel better soon !

Hamayeshguy profile image
Hamayeshguy in reply to Ghound

I agree that but I inject everyday and before that it was normal

Hamayeshguy profile image
Hamayeshguy in reply to Ghound

Actually myoglobin traps oxygen in skeletal muscles and provide oxygen for muscles and heart to produce energy and during b12 deficiency and myelin sheath damage non functional nerve cause release of myoglobin and after providing B12 repairs muscles myoglobin which requires iron to hold them in muscles and iron through sweating can leave our body. One of the iron shortage symptoms is nail brittleness. But muscles recovery ( muscle can not divide post-mytosis) requires more vitamin c for collagen repair and as well zinc .( Saggy cheek is the symptom of low vitamin c and or collagen). So losing iron is normal and lack of energy and extreme fatigue us the result of myoglobin and consequently iron shortage in muscle cells.

Nackapan profile image
Nackapan in reply to Ghound

For me too

Iron absorption is improved with Vitamin C. Google the sentence and you can read about ir on a number of sites. Because neither the doctor nor you know you iron status without a test, the first thing to do is have a test. It would be interesting to know how the test was arrived at. Many blood tests are next to useless and even dangerous. One is magnesiumthe serum magnesium doesn't measure what is in the body but only what is in the blood ,

about 1 percent. There is a whole body test. It was developed by two New York researchers

a few years ago but I doubt its available here. Magnesium allows calcium into the cell

without correct magnesium levels all manner of things will not work properly.

I was diagnosed with arrythmia a few years ago . The doctor had me do the 24hour test

a cuff on the arm. It wasn't any use. As chance would have it I was browsing in a book shop and came across a book "the Magnesium Miracle". I read it and discovered that any old

magnesium won't do. there are about 18 different combinations and they are all absorbed

differently. The common ones are magnesium sulphate, carbonate, oxide, chloride.

Dr Caroline Dean who wrote this excellent book recommends magnesium chloride which

as a liquid can be rubbed on the skin and is absorbed directly in to the blood stream,

Dr Sheahy MD Phd referred to in the book, recommends a 25 per cent solution of

mganesium chloride which restores intracellular levels within 4 - 6 weeks.

The amount of magnesium in one spray is between 13-18 mg. So if you spray 6 times

on each leg and the same on each arm that will give 400mg the RDA. Also a 50mg

tablet of the active form of B6 helps the absorption. Good luck

Condthe result for me of using the magnesium chloride oil spray was an immediate

disappearance of arrythmia. And not just that but with regular use a lifetmes

constipation gave way to daily regularity. What a blessing.

Hamayeshguy profile image
Hamayeshguy in reply to porter5

I have done all tests and ferritin was dropped but still in range but cist me severe symptoms so I have referral for internist doctor. Cardiologist told me I need to work in my ferritin and my other blood works are in range. I think wrong diet for long time( no much variety and iron absorption preventive diet) and exercise at the time of B12 injection caused the problem so I'm trying to fix it.

Self discovery the way to go.

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