B12 injections and Ferritin

[B52s]

Can anyone please answer this question.

Will B12 injections increase ferritin levels.

My Hematologist says not, but since I started on the B12 injections my ferritin has increased from

9ng/ml to 90ng/ml

My diet has not changed and I am not taking any supplements.

has anyone got any ideas why

Thanks in advance

[Nackapan]

Mine dropped from 61 to 29.

ferritin rises can be caused by information in the body.

90 definitely better thsn 9ng/ ml though !

Perhaps someone else has a explanation?

[B52s in reply to Nackapan]

So yours went down after B12 injections. From what I can find out it seems to suggest that Ferritin goes down so it's puzzling me why mine has gone up

[jade_s]

It is puzzling , as you say if it was raised then fell after injections, that would make sense. But without any other results eg iron, transferrin, RBC panel, it will be difficult to say what has happened.

I did a quick search and didn't find anything useful.

I know sometimes ferritin can appear to be falsely low, in relation to iron, but I'm not sure what causes that.

Paging FlipperTD

Radd on the thyroid UK group also knows a lot about iron.

[FlipperTD in reply to jade_s]

Oh dear... Right then. I'll go off in a bit of a ramble.

If you're got a mixed deficiency picture [microcytic, hypochromic anaemia] as well as being B12 deficient and you treat the B12, then the ferritin will almost certainly fall further as the marrow starts to produce more new red cells, incorporating what bit of iron you've got left. [Bone marrow is great at that sort of thing.] Treatment with iron is only necessary when we know there's a deficiency, because in excess, it's toxic. Historically, it's been a fairly common cause of poisoning.

Ferritin is a great, simple to perform test for monitoring iron status, but it's not a pure measure as it's known that it rises as part of an acute phase reaction, like lots of other things, such as CRP & ESR. If CRP rises, and ESR increases, then ferritin isn't going to be the best indicator of iron status at that point. The old fashioned test for iron deficiency was the presence or absence of haemosiderin in the bone marrow, requiring a bone marrow biopsy. A bit of a blunt instrument, but sometimes it's the best measure and can detect other problems at the same time.

Interesting finding: If you're deficient in Erythropoietin and consequently anaemic, treating the Epo deficiency will generate more red cells. Even if you've got stores of iron, the Epo response can be so spectacular that your body can't get the iron from the stores fast enough, so you can produce a microcytic hypochromic picture. Consequently, iron infusions may be given at the same time to avoid this, and they seem to work very well.

[Sunshine1932 in reply to FlipperTD]

This is interesting thank you. My ferritin is always low and perhaps now I know why. I was given iron tablets a few times but told it will be OK after them. Interesting to know how the body works. I have recently increased my B12 so should I expect ferritin to fall again?

[FlipperTD in reply to Sunshine1932]

Not necessarily, but it sounds like your iron balance is a bit flimsy at best. Some people manage on lower levels than others. I knew a 'junior doctor' many years ago and he developed iron deficiency anaemia. He was taking aspirin daily, in the form of 'Alka Seltzer' and having regular small gastro-intestinal bleeds, which he thought were 'normal'. [Heaven help us; these folks are there to look after us!]

If you are not suffering from Iron Deficiency Anaemia, or on the borderline then it might be OK. Whatever you do, don't start popping iron tablets without medical supervision and regular testing.

One millilitre of red cells contains about 1mg of iron. One doesn't need to lose much blood on a regular basis to become anaemic.

Take care!

[Sunshine1932 in reply to FlipperTD]

Thank you.

I think my actual iron was OK it was just my ferritin stores.

If I get tired or symptoms I will ask them to repeat.

Cheers

[jade_s]

B52s after FlipperTD's reply I'm inclined to think you need a full iron panel to know what's really going on, for example if your 2nd ferritin is falsely raised.

Serum iron, % saturation, TIBC, ferritin.

[B52s]

Here is my latest results

Serum iron level. 16.4 umol/L

Serum TIBC. 70umol/L

Transferrin saturation

24%

Serum Transferrin

2.78 g/L

Ferritin 90 ug/L

As mentioned previously I have always had low ferritin levels until August last year then it has gone up without any change in diet or suppliments

[jade_s in reply to B52s]

Sorry I missed your reply because you replied to yourself instead of me

Saturation looks like it could be a smidge higher but serum iron looks fine. I can't tell about TIBC and transferrin because there are no ranges, and we use different units in my country. But it does not really look like iron deficiency. Do you eat iron rich foods?

All I can think of is that either B12 injections improved digestion, or the first test was a fluke. I guess you don't have a full iron panel to go with the first ferritin test? Otherwise I hate to say this because I always like to get to the bottom of things, but don't worry about it?

[Zima22]

I have regular B12 injections I SI. My ferritin is low (18) bad has been low for a while , prior to PA diagnosis and B12 injections. I've recently been on Ferrous sulphate 200mg (for 5 months) and levels remain exactly the same. My platelets are always elevated, same as my white blood cells.