ferratin/iron

[fiftyone]

If my ferratin level is normal,why has my iron plummeted over the past few months?

[FlipperTD]

Scientist, not medic.

Numbers, please!

Ferritin has a wide reference range, and it's also worth remembering that it's an acute phase reactant. So if you have any inflammation, it goes up. So it's a useful indicator of iron status but it doesn't tell the whole story.

The FBC is a good indicator of iron status, because if you start running out of iron, your MCV falls; so does your MCH. Your Hb falls too, but the timescales are different, and not entirely predictable.

If you test enough things you're more or less bound to get something abnormal, because the reference ranges capture 95% of 'normals' whatever they are. So 5% of 'normals' can be outside the range whilst still being normal.

[Schpsych2414 in reply to FlipperTD]

I have the same question.

My numbers are … what numbers should I include? I have a recent CBC report, Iron and Total Iron Binding Capacity and Retic count.

[FlipperTD in reply to Schpsych2414]

Hi, and welcome.

Useful stuff starts with Hb, and then MCV, MCH, RDW, Retics, Iron, TIBC and Ferritin, if you've got them. Then I can have a stab at working out what's going on. Plus it gives us a starting point and then we can see where it's going, if it's going anywhere. If it needs to go anywhere. It's good if you can include the reference ranges quoted with the results too.

[Schpsych2414 in reply to FlipperTD]

Thank you. Is it appropriate to sent a file with the lab reports?

[FlipperTD in reply to Schpsych2414]

Of course.

Just make sure it's anonymised, for security and to suit the site's protocols. The more data, the better, within reason.

I look forward to receiving it. Please note I'm a scientist, not a medic, so I can't give advice, but I will try to help you interpret the numbers.

[Schpsych2414 in reply to FlipperTD]

Thank you in advance fir reviewing my labs. I’m having much difficulty attaching a file. I will send three separate pictures.

CBC and Iron

[Schpsych2414 in reply to Schpsych2414]

2nd pic

CBC and Iron panel

[FlipperTD in reply to Schpsych2414]

So far, so good. [That's the scientist in me.]

These results are within normal limits. Your Hb is toward the lower end of the range but that's fine, honestly. If you have previous results showing your blood results being much higher, that might make me think otherwise. In general, we tend to be well-balanced in a steady state, so it's a good idea to compare our results with previous, rather than just the reference ranges.

Your Iron and TIBC are a little on the lower end, but not by that much. If you were iron deficient that would show up with a reduced MCH and MCV.

The easy way to become iron deficient is through regular, chronic blood loss. Menorrhagia will do it easily, but at the menopause, that stops, and iron loss ceases. Obviously any GI tract bleeding can cause iron deficiency too.

Reference ranges are 95% confidence limits. This means that 95% of 'normals' fit into the reference range. That means that a further 5% don't fit in the range but they're still normal, so hovering round the limits of the range are not generally something we'd worry about.

Try not to worry, and good luck!

[wedgewood in reply to FlipperTD]

Awarding a star and a medal ! 🥇 🌟

[fiftyone in reply to FlipperTD]

another very good way to become iron defficient is through non absorbtion, like me. And non absorption most likely as a result of medication I am prescribed!! (metformin, PPI)

[Schpsych2414 in reply to FlipperTD]

Thank you!

[tomdickharry]

Ferritin is the protein that regulates iron. If your iron is low then ferritin has nothing to work with. Iron being low is likely to be from poor diet or internal loss. If too low then other blood factors will show it.

[fiftyone in reply to tomdickharry]

but my iron is low cos I don't absorb through my stomach. My ferritin is normal. So what then. My iron has plummeted and last reading was 7, lower than when I had an iron infusion. But my ferritin is normal.

[tomdickharry in reply to fiftyone]

If you mean 7 micrograms per dL then that's cause for alarm. Are you in UK? I don't know what units other countries use. Your MCV, MCH, and Hb would show abnormal readings. Please get checked.

[fiftyone in reply to tomdickharry]

the range goes from 2 - 33

[tomdickharry in reply to fiftyone]

Then you are within range, though a bit low. If other blood values, like Hb or MCH, ore ok then I wouldn't worry.

You don' say what medications you have to interfere with iron.

[fiftyone in reply to tomdickharry]

I dont know what medications would interfere with iron. But is being 'in range' enough. As there is a range, being higher up would still be okay, I presume. And as I feel very tired, even after 7 hours sleep, and slightly dizzy when I walk, I wondered if extra iron would help. My transferrin is also abnormally low. Thoughts?

[tomdickharry]

Ferritin and iron are two different things. If you get supplemental iron by infusion, and your iron stays low, you are losing it somehow. That needs to be investigated.

[fiftyone in reply to tomdickharry]

could it be reducing because I am using up iron in everyday living???

[tomdickharry in reply to fiftyone]

As far as I know the body doesn't use up iron in that way, but if your other tests are normal then I wouldn't worry.

I don't know what you've had tested, but there's Hb, MCV, MCH, transferrin, TIBC. They are the ones I know, but I don't know about your medication or what it interacts with.

However, your iron level shouldn't change appreciably without cause.

[fiftyone in reply to tomdickharry]

there's no blood loss...