Hi,I posted recently a bit confused due to ferritin results...
March 25th 48 (nhs)
8wks later after loading dose-37 (nhs)
2wks ago 85 (medichecks pinprk) after 1 wk not taking iron-advanced thyroid check.
Last wk 110 (medichecks Iron Panel-no.other results worked)
I've only been taking 1 ferrous fumarate daily, have 3 arrows finally arrived at ready,but obv been off iron to.preoare for these tests.
Should I just be seeing this as a miracle rise please, as it usually takes so long to raise ferritin levels,then they drop as soon as i cut back on iron supplements. I can't ask for an nhs one until mud Sept, and dubious they'd give one seeing as ferritin was 37 on last testing
Have asked medichecjs but bn advised it can raise quickly and uts not any use comparing different labs anyway.
Crp fine...thank you for any ideas or anyone else who's seem such a speedy rise in ferritin.
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37 is low for a PA person. Fluctuation can happen when injecting B12 as ferritin is used to make healthy blood. My ferritin level has fallen after an infusion which I (and my haematologist) interpret as increased iron (Three Arrows) being used with the ferritin to raise my haemaglobin level. I think that, after prolonged deficiency of B12 and iron, it takes the body a long time (perhaps depending on the duration of the deficiency) to slowly recalibrate itself. I'm neither medic nor scientist but an informed long-term empirical project.
Hi, thanks for yr reply. Yes, quite agree, it takes time to recalibrate and for everything to start working alongside each other properly after potentially a long spell of not doing so & having to find other ways to survive..What is happening to you shows the great need you have for the iron, doesn't it and sounds like your body is making good use of it.
Guess that's my concern, I was expecting the drop in ferritin after loading dose, just not the sudden rise after, so quickly, with the small.amount i was taking. Thinking if its risen 25, that much in a wk, will.it continue at that rate? Time will tell and maybe I should be celebrating,lol, I've had very low and slow rising! ferritin over yrs & wished it would speed up! Now it has & I'm still not happy Keep making good use of that iron...
Scientist, not medic. Ferritin isn't just ferritin. Not all tests are the same. The ranges aren't all the same. So, comparing results from different NHS labs around the country won't give the same results if they're using different methods and analysers. They all participate in external, Government sponsored Quality Assurance. This assures us that the results are reliable. The EQA scheme even compares performance between different methods, but this doesn't help you. If there was one piece of advice I could offer, it would be 'simply stop doing this!' When it comes to paying someone to test a fingerprick sample for you, well, it's your money, after all. But I wouldn't do it. Trust the NHS.
Thanks Flipper Td, fully appreciate what you're saying. I did the yearly thyroid test to get vit d, antibodies, active b12 tests that the NHS won't give me-even though vit d and active b12 have been very low in past.The ferritin result was included & I wondered why it'd jumped up in a short time. I've asked different Drs for iron panels over yrs, but no go& have found on private tests I've had a great need for iron at times, but would never have known if I left it to the NHS. So I did the iron panel last wk & wondered why it'd jumped up a further 25 in a wk & just concerned at whether I need to take supplements or not, as know its dangerous to overdo.
I've had ferritin at 11, and many similar low results it seems looking at past notes and not even been told, let alone advised to take iron or 3mnthly retests. I wouldn't have known ferritin had lowered after loading dose if I hadn't specifically asked, had been told all fine,as always. I do trust the NHS results, it's just the relaying of them and seeing the actions through I don't always!
I will relay my info to them & maybe they can offer an idea, but unless somethings changed I'll be lucky to gey a 3mnthly ferritin check when the last one was 37, regardless of the symptoms I experience? But we'll never say never and keep a trying! Thanks for your help once again,always appreciated.
Just putting paperwork in order to put away, and noticed that I had si.ilar results ferritin wise after 1st loading dose...3mnths after ferritin had risen from 24- to 83, then couple months later back to 26! Is this a coincidence do you think or something that temporarily happens whilst body is settling into b12? Worth me keeping an eye out in case it does a downward dive again. ..
Are these all from the same laboratory and sample type? If not, even harder to work out.
If you'd been deficient in something AND anaemic, and then got a boost, AND your Hb recovered, then you'd use iron, so your ferritin levels would change. If you'd had some inflammatory condition in the meantime, that could disturb your ferritin too.
Hi FlipoerTD, thank you..same as this time, low result from nhs, high results from yes the same provider,so appreciate you can’t compare as such, just seemed a strange coincidence. Haemoglobin was 135, so not underage.
Is CRP the only marker for inflammation, it always returns fine, however I’m feeling, whether sinuses bad, allergies worse etc, please?
Have reported changes to Dr to see if I can have a ferritin check when 3months around & I’ve been given an apptment in 3wks to discuss. Many thanks again…
ESR is another inflammatory marker. As is Plasma Viscosity. Total fibrinogen? Yes, that's another. But they all have a range of other things affecting them too, so interpreting the results is complex. CRP is very sensitive, and reacts very quickly. Up like a rocket, down like a stick. The others take longer to go up and down.
CRP is so sensitive that just about anything sends it up, and it comes down again as quickly! A reaction to an injection, an infection, stuff like that.
Ah right, thank you! Promising in a way, as I've never yet managed to catch mine being raised, so what I've thought of as infections of some type could well have been just very poor health due to b12 deficiency, thyroid,etc...
Inflammatory markers are best tested for as multiple types of test, because some go up & down quick, some go up slow and down slow. Some go up quick and down slow, so it's purely a matter of timing your shot for when you squeeze the trigger [oh, no, that's something else I'm thinking about!] The ESR is a great test [providing it's a 'proper' ESR, as in a Westergren, which takes an hour. There are numerous spoof ESRs that aren't real ones.] It's one of those tests that was invented when someone [Westergren, this time] was looking for a means to detect pregnancy. It worked. However, it wasn't very specific. But just because you feel ill doesn't mean to say we'll be able to find a suitable test to prove it. You've already proved it to yourself.
Thank you...very interesting! Nowts simple is it! No, true! Just frustrating when you keep seeming like you've regular infections, temperatures, etc but Drs do crp & it's not showing anything.
Have had far too many antibiotics thrown at me at such times, when actually probably general.immumity needed raising with these deficiencies. Body tries to tell you, but takes time along life's way to work out what and why its trying to say! Appreciate your time...
Hi Flipper Td. I have another iron question if you don't mind please?Back to these ferritin rises, I know you've explained various reasons as to why, but the same company that found it to be 85, 110 over last 2 wks, says its 59.9 this wk.
The iron panel worked, which I've posted on a separate post, but seems to.indicate serum iron could be more optimal, but TIBC only 19%through range & Transferrin 44% through range & been suggested I don't have capacity for supplementing more at moment?
Do you think the rise in ferritin could be because I don't have this capacity at the mo & that by not taking iron for a month the ferritin is going back down by any chance? Just an uneducated idea that has sprung to mind:)?
As always any if your thoughts much appreciated please...
Oh, this is a tricky one. My favourite test under these circumstances is simply an FBC. That tells me more what's going on than anything else. If you're iron deficient and anaemic, your MCH is depressed. [Aren't we all at times?] and the MCV is lower too. If it's in a state of change, then the RDW is raised. But then, if we treat the deficiency, the MCH rises, the MCV rises, the RDW rises, and so does the Hb unless you're losing blood as fast as you're making it. I would [personally] simply monitor what's going on FBC-wise as all the others can be too confusing to follow at times.
Ferritin is storage iron, so if you take on board more than you're using, ferritin goes up. There is some fancy stuff going on that stops you absorbing and storing too much at one time, but an excess of un-stored iron is dangerous. Read up on 'free radicals' and scare yourself.
Thank you..lol, fancy stuff going on, my kind of understanding.Yes appreciate the full count need, but been refused one of those as the last one at mid June when ferritin was 37, mch was overrange and haemoglobin higher in range all considered normal. I explained what yd said about mch, etc should normalise by 4 months, but nurse asked Dr & he said its normal to be overange?
I do know that last time that feeling very unwell seemed to correlate with lower ferritin and overange mch, but what Di I know!
In your opinion, out of interest, would you seek a full blood count or take iron and retest in a few weeks.
For me, I'd look for an FBC before anything else. If there's no evidence of iron deficiency in the FBC, then 'iron for iron's sake' might not be very much help. A lot of iron dosage stuff can be a bit unpleasant. The old Ferrous Sulphate was the standby, and gave lots of folks stomach upsets. More organic supplements were arguably kinder, and there's reason to argue that Haem iron compounds can be easier to take too. Just don't launch into self-dosing with iron in the absence of advice.
Thank you.. I'll ask when I see Dr then, & if not have found a lab in the city so have that option, seeingbas I've symptoms still that I've associated with lower ferritin in past. I wont know whats happening haemoglobin etc wise until i do. For whatever reason if its telling me I've not got capacity for it at mo, then yes taking more is not going to help.
I just expected the b12 to continue to make use of the iron, but expect the unexpected!
My nice pot of haem iron will sit here for a bit longer! At least I hadn't just started that though as would've thought it a miracle maker to whack the ferritin up.(not saying it wouldn't,but it's usually such a slowww job)
Hi flipperTDThanks for yr help with ferritin. Dr has offered 3 mnthly blood tests for yr to keep check on fbc,ferritin,b12,folate, to watch what they all do as he's also reinstated my monthly inj from every 2mnthly to see how I feel...so very pleased with that!
In terms of iron, he's fairly said not sure about it but feels shld be OK to take one EOD & see. I can always redo iron panel, but will await the fbc/ferritin before starting, then prob have to kp check with iron panel tests? Don't want it to overload,but then again don't want ferritin to lower either!
That sounds sensible. Just keep an eye on it, and if you're up to it, spreadsheeting and charting is useful. If not, simply tabulate it and see what happens. A spreadsheet allows you to list the lot and plot from test to test. Good luck.
Thank you. I actually made a table, with ferritin, b12, haemoglobin, mch, vit d, thyroid,etc, as well as little space for random test results thatmay be useful along top, then years I'd been tested down the side, over 2 A4 sheets of paper to take to my apptnent.Explained to Dr I've been trying to look for patterns & we could see there were times when ferritin got really low, b12 seemed to be very high as if not being used, folate lower & i was definitely feeling worse and otherhand times when ferritin was better, b12 seemed to be being used & folate had naturally increased. So it helped in that sense & much quicker than lots of explaining, time is precious isn't it!
This led to the Dr being very fair, saying he didn't know enough abt it tonstop me having monthly injections,so reinstated them and was interested in continuing this tracking in relation to how I'm feeling, so that's great! He's willing to learn with me!
If I have to seek further help along way in regards to b12 & iron, I at least feel he'll be interested & supportive.
Thank you, I did it with pen & paper, old fashioned I am, but yes thinks it a great idea to store & access results easily...
Paper works fine, as you've seen. MCV is good to follow, and RDW too, if it's reported. I wouldn't [personally] plot MCH separately because it's a derived value; (Hb/RBC) but that's because it's my subject, and I'd be plotting various other things and relationships, making it far more complicated, whereas you've kept it simple, and it's worked for you.
You've done very well, and you've got a good GP who has learned something from the process too. Well done.
It occurs to me that we're communicating via computer keyboards. Your task, if you choose to accept it, is to teach yourself simple spreadsheeting! If you're a Microsoft user, then you may well have access to Microsoft Works, which is a simple way in. It's friendly.
Thanks for your kind words and encouragement. I do feel very lucky to have found a Gp who acknowledges he's learning too and willing to monitor alongside me. It's taken 6 months to get down from 3,to 2, to back to my once a month,but we're there now. :)No idea how I'll fare on it, but with watching all of these other factors & with thyroid to consider, it feels I'm at least working with it all & tecording progress, rather than floundering.
When I had bad times on the injections before, fact that mch had risen. Ferritin lowered. Etc, no-one seemed to much care, whereas I feel this Dr is interested & will understand if he can't help, I will have options with you guys &specialists mentioned on here.
He's interested in the link between iron & b12, so I will try to learn more & put down some info abt it. Also told nurse abt Dr Chandrys book so she's requesting one of those.
Guess I tend to watch mch & haemoglobin as they're main things that change, as well as mcv nearer top,but yes appreciate its a derived value.
Yes, that's me,lol,keep it simple, after being a primary teacher of the younger ones, I'm used to simplifying things but very grateful yre a scientist getting my brain shifting up a few gears!
I did learn spreadsheets about 15 yrs ago, took a computer course, so I've no excuse, put that on my things to do list
Well done. Good to hear from you. It's slightly perverse to find your ferritin goes down when your MCH has risen, because ferritin is a source of iron. If your MCH went down when your ferritin went down that would be easier to explain, but we have to remember that ferritin is an acute phase reactant too, so when 'something inflammatory' happens your ferritin will rise, and then come back down again. Your MCH reflects what's going on in your bone marrow, and MCH ^, [whilst within range] suggests that your iron is being utilised. When MCH falls below the range, then that's suggesting a reduction in iron utilisation. But it's all complicated by lots of other stuff. I'm spoiled with having had access to results on line in a hospital setting, and the ability to copy and paste and chart results. I sometimes forget how lucky I've been in that respect.
lol, I’ll try! Yes, I know, that does seems odd that ferritin is sometimes as low as 11/15, but MCH raised & it correlates to me feeling worse, maybe I’ll eventually suss out why!
Perhaps it’s just that I’ve not had quite enough b12 available, but enough to use iron and lower the ferritin? & so a need to supplement iron too? Although these recent iron profiles are saying not to supplement, but that I need it, ho hun, time will tell.
Dr couldn’t understand why CRP was good, but ferritin had whipped up high, then lowered, neither. But if a thyroids somehow capable of raising MCH too, then maybe that’s behind a lot of it & the reason I’m struggling to keep these things all up & running.
One thing at a time at mo, b12, iron, am raising vit d, folate sometimes improves itself and if it’s all optimum & things still not right, try to sort thyroid!
Some may call it spoiled, some may call it working hard & a little perk!
If it was simple we wouldn't do so many different things. CRP can go up like a rocket and down like a stick, whereas ferritin is slower on the up and down. ESR can go up quite a bit, and stay up, before finally coming back down. That's why charting them helps.
If your MCH goes up, then it may well be a lack of B12 or folate. We can manage on very low ferritin values at times. Iron is difficult to get rid of. We don't have a means of excreting it, as it's short in our diet, so we scavenge and recycle. I'd take the view that if your MCH doesn't fall then you've got enough iron. Supplement iron and if you can absorb it, you will, and too much is probably worse than not enough.
WORK WITH YOUR DOCTOR, AND EDUCATE EACH OTHER! [sorry to shout.]
Thanks, I Am IAm,lol! He's looked at iron profile & doesn't know why it's conflicting, so it's up.to me to try to.find out more.Appreciative can manage with low ferritin, but whenever I've been feeling pretty dire & had blood tests, invariably ferritin is 11-50ish. When it was 11 initially, I was crawling around & diagnosed with ME, so am going to do best to keep it a bit higher, without as you say overloading it.
Im not leaping ahead, but due to thyroid numbers being 30% ish through range, Do you happen to know IF thyroid is behind this and struggling how this effects iron please?
Fbc,ferritin, b12 in couple wks so will await & go from there...thank you
Worth a try... I think we need to get Mrs Flipper on here too then! Well if I've got to relearn spreadsheets, I think you could at least learn thyroid! 🤣
Funny you should say that, because Mrs F is keeping quite well with her Thyroid, and her TSH and Free T4 levels are spreadsheeted! [Remembering that TSH scale needs to be logarithmic. Using a linear scale, the TSH loses sensitivity.]
Great to hear Mrs Flipper is keeping well! Have been pondering over the logarithmic/linear you mention...is there any chance of a diagram to help us please?
It's when you come to charting the results. Spreadsheet of result and date. Then the date goes on the 'x' axis, and the result goes on the 'y' axis. Then you select 'Logarithmic' for the 'y' axis, and it's sorted. Hope this helps. Most of the other stuff can be plotted on linear scales.
Hi, I’ve got my results back & thought I’d share seeing as yve been really helpful.
The MCV gone up from 97 to 101, MCH risen to 33, Haemoglobin dropped from 145 to 136. Folate dropped from 7.5 to 4.7.
Ferritin was 37, now 36 ( not sure how relevant fingerprick were but for 3 consecutive wks was 85, 110, 60 & iron panel indicated a need for iron, but not capacity.
Lymphocytes still underange as before.
I know b12 result is irrelevant, but it’s dropped from 1800 to 900, so gather it’s being used?
So gathering this is shouting at me that it’s now 5 months aft loading dose, that the every 2 monthly jabs not enough or else the MC’s would be improving?
Can ask Dr, but he’s said he doesn’t know too much about it, but thankfully last wk agreed to monthly injections, so I guess this will be evidence in the need for more frequent…
Good to read that your Dr admits he's not that clued up, so you're in a good position for you both to learn. If your results are of fingerprick origin, then I wouldn't take too much notice about small changes. Work with your Doctor, and keep in touch.
Thank you...I had one other ask when you've time please. Did you used to include a blood smear in a full blood count test or does this have to be requested separately?Thanks
In my laboratory, FBC requests were sometimes accompanied by a request for a blood film, but we did many more than were primary requests. If there was anything suspicious or suggesting from 'the numbers' then we'd add a film request on, and these were reported as soon as possible, but taking considerably longer than simply reporting the FBC numbers. That caused the argument 'should we issue the numbers, and follow on with the film?' but trying that out, we discovered that the numbers were acted on and the follow-on film report tended to be ignored. So then, you delay the FBC and only report it when the whole thing's complete, and that way, we'd get repeat requests because the FBC hadn't come back. We found, like lower ranked football teams, we couldn't win most of the time! Blood films do take longer. The film has to be 'spread', then stained, allowed to dry and examined under the microscope. With the best will in the World, this adds time. In emergencies, we could do that inside an hour, but that was the exception. There are now systems for image analysis and interpretation, but they don't [in my opinion] replace the need for a skilled microscopist.
Have not read all responses to your question although another contributor to increased ferritin is inflammation as shared by my endo at UCLA (trusted institution). UTI, allergies, respiratory infection, etc. can raise ferritin.
Thank you mountmuir27, I have constant sinus issues, plus it’s that time of year for extra allergens I guess, and I have a type 1 latex allergy, but would know about it if that one that kicks off at least! So yes, thank, maybe something like that has caused it, though sinus issues are all year around for me.
Does your endo mention if anything else would be raised to signify those things, my CRP is at least fine please? I’ve had history of utis, but they’ve improved since b12 injections, and I usually soon get hit/cold/etc at the slightest little thing, but will bear all those ideas in mind thanks,
On ferritin as an inflammatory marker: 1. Pre-diabetes can increase inflammation so check your A1C and if above 5.8 that could be the case. 2. Constant low grade inflammation. I happen to have low IgA (immunoglobulin A - genetic - inexpensive lab) which makes me prone to respiratory and gastrointestinal illnesses so something for you to explore. Lastly, being that you are on a PA site, ferritin goes up with megaloblastic anemia, and you can indeed have iron and b12 deficiency at the same time and blood labs will appear normal since this anemia combo is a tug of war. Thus, if you corrected your iron but your b12 is still not optimal, voila, focus on b12 and perhaps folate, and your ferritin should come down. Unless you've simply increased your alcohol intake which can also cause high ferritin!
Hi mountmuir27Thank you for all that info...they said my blood sugars fine, 34,so well below range.
Is the IgA you mention similar to SigA please? I've been tested for that previously and it's been very low each time,but I've not really addressed it? It was a while ago, so not sure if it's improved now...how do you deal with that? Is there anyway you can help.yourself in that area?
So ferritin rises with megaloblastic anaemia? My MCH was overange 32.8, (upper range 32) prior to loading dose & ferritin was 48.
Mch dropped 32.5 10days after loading dose.
8wks after mch back to 32.8 & ferritin lowered a bit to 37.
Now the ferritin has risen pretty quickly but I don't know mch or any other blood counts currently. I've asked nurse if I could have a ferritin test/ blood count,but no go, just a drs apptmt in 3 wks to discuss last blood results from 2 months ago. He's told nurse a raised mch is insignificant anyway.
I've just posted of my retry for iron pan today, so it may throw a littke more light, though appreciatevas FlipperTD pointed out I can't compare nhs to private company, but at least I'll see if it's gone up or down from last wk, fingers crossed it works!
I have a nicevpot of Three Arrows at the ready, which has taken wks to arrive,lol & darentbstart taking that yet. If I get no joy from this iron panel,will.prob have to fork out for venous attempt,just to try to get a better picture.
Yes all a bit of a job,trying to work out what's what isn't it!Thought I'd try & sort b12 & iron first, then look at folate.
No, no alcohol,lol,well.unless my body has managed to work out how to make that itself!
Life's difficult enough to get comparable results from two analysers of the same make, in the same lab, on the same bench, side by side. I wouldn't be concerned about changes in MCH at that level, because the MCH is derived from the RBC and the Hb. Both of these are measured fairly precisely, but they have inbuilt margins of error, and when you start mathematical manipulations then the errors rise because you're multiplying those too. If you start following the MCHC it gets worse, because that's got MCV in the calculation too. It's easy to fall into the trap that if it comes out of the lab, it must be right. In the words of George Gershwin, from Porgy and Bess, 'It ain't necessarily so'! Factors that can affect all of these things include sample collection issues; [is the tube full?] Was the sample mixed on collection? [to ensure adequate anticoagulation]; how long did it take to get to the lab? [sample delays of less than an hour can affect some results]; how long did it wait in the lab before analysis? [they don't improve on storage. What make and model of analyser was it tested on? [they aren't all the same. They're all precise, but they certainly aren't all the same.]
We do our best with your samples, but there are so many pre-analytical variables, it's a very complex picture.
This is very interesting information. Do you have any articles you can share? I’m struggling with my health after SI for almost two years. I keep upping my B12 (up to 4,000mcg day hydroxide injection), but I’m thinking some of my neuro issues may be low ferritin. However, I do have hemochromatosis. Was diagnosed recently. It’s not an issue now as I haven’t gone though menopause. I need to follow up with my hematologist. Any info you can share would be appreciated.
You either have hemochromatosis (a medical disorder) or you have high iron from over-supplementation. Have you had your TIBC checked recently? Do you have PA? What are your neuro issues? Many menopausal symptoms overlap with PA symptoms. Putting all of this another way...what are your most bothersome symptoms near-term and long-term? Many here will fill in the gaps!
I just looked up sIgA and it is the secretory lab of IgA and a lab I've not done nor am I well-versed. A quick bit of research points towards the following: sIgA is variable throughout the day although if low is an indicator of food allergies (do you have issues with gluten/celiac?). I was tested for celiac and other food allergies and have none. Whereas IgA is more of a marker for risk of respiratory and gastrointestinal infections so not allergies, rather, infections (less of a natural defense). So, if you have low sIgA if you haven't already done so consider food allergy tests/labs. If you have gut inflammation from food allergies and/or severe enough ie celiac those are enough to cause low-grade intestinal bleeding which could be the culprit behind your iron anemia. I take colostrum and zinc supplements to keep immune system as strong as possible. You might consider l-glutamine (powder, dissolve in water) which is excellent for the stomach lining. I take this now on a 2 week per month basis since PA caused gastritis, or vice versa. I had unrelenting diarrhea before my PA diagnosis. The diarrhea in my opinion or in retrospect - 3 weeks non-stop - seemed like it was the end-stage resulting in B12 anemia, and l-glutamine, high dose (over 5 grams, studied and safe even up to 13 grams) per day helped immensely. Why 2 weeks per month now? My own decision to help my tummy and low risk with no side effects.
Thank you very much for taking time to look that up...I was borderline gliadin once on a saliva test, and been gluten free for years,but never really sure if it makes a difference! Am milk intolerant according to a York test yrs ago, ever since I caught a sickness bug during early yrs of teaching. If I try to reintroduce. get a temperature and fluey symptoms,bah!
Developed a type 1 latex allergy which cross reacts with some foods, about 30 yrs ago, after copious amounts of antibiotics! Think it's looking like when my b12 symptoms prob began too looking at old results I have very blocked sinus, inner ears, finding things soon aggravate ne more allergy wise at mo since b12 issues worsened and had this 2nd loading dose,so guess there are connections somewhere.
Thank you so much for all of those suggestions to help. I will have a read and look into. So glad it's making a difference to you, sounds awful before.
My iron panel results actually worked after so many attempts last yr! Have put on a new post, seems ferritin gas dropped from 11p lst wk to 59.9 this wk. Crp still low, had a period between the 2 results, but wkdnt thought that wkdve made a difference. Thank you again...
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Keep making good use of that iron...
Hello, looking for advice please
Please help me with understanding blood test results!
B12 defficency?
Medichecks blood results - still unsure what's causing symptoms.
