Iron test

[tagaxel]

Which is the most important, serum iron or serum ferritin?

[SueJohnson]

ferritin and also transferrin percentage TSAT)

[ChrisColumbus]

From the Mayo Algorithm:

"Iron Therapy•

Determine the patient’s iron status (early morning, fasting iron panel: serum ferritin, iron, total iron-binding capacity, and percentage transferrin saturation).

•

If serum ferritin concentration is ≤75 μg/L and transferrin saturation is <45%, administer an oral iron preparation (elemental iron 65 mg) with 100 to 200 mg of vitamin C every 1 or 2 days on an empty stomach. (Note that in the presence of inflammation or malignant disease, serum ferritin concentration may be misleadingly high, and thus transferrin saturation <20% may be a more accurate measure of iron deficiency.)

•

Consider intravenous administration of iron if transferrin saturation is <45% and (1) serum ferritin concentration is <100 μg/L and a more rapid response is desired than is possible with oral iron; (2) oral iron cannot be adequately absorbed because of disorders of the gastrointestinal system, bariatric surgery, or chronic inflammatory conditions; (3) oral iron is not tolerated; and (4) restless legs symptoms do not improve despite an adequate (3-month) trial of oral intake of iron."

[SueJohnson]

What was your ferritin and transferrin saturation?

[tagaxel in reply to SueJohnson]

Serum Iron = 146; %saturation = 41.6; Ferritin 55

[SueJohnson in reply to tagaxel]

OK then take 325 mg of ferrous sulfate which contains 65 mg of elemental iron, the normal amount used to increase ones ferritin, or 50 mg to 75 mg (which is elemental iron) of iron bisglycinate with 100 mg of vitamin C or some orange juice since that helps its absorption. Ferrous sulfate is fine for most people, but if you have problems with constipation, iron bisglycinate is better. Take it every other day, preferably at night at least 1 hour before a meal or coffee or tea and at least 2 hours after a meal or coffee or tea since iron is absorbed better on an empty stomach and the tannins in coffee and tea limit absorption. If you take magnesium, calcium or zinc, even in a multivitamin take them at least 2 hours apart since they interfere with the absorption of iron. Also antacids interfere with its absorption so should be taken at least 4 hours before the iron or at least 2 hours after. Don't take your iron tablets before or after exercise since inflammation peaks after a workout, don't take tumeric as it can interfere with the absorption of iron or at least take it in the morning if you take your iron at night. If you take thyroid medicine don't take it within 4 hours. It takes several months for the iron tablets to slowly raise your ferritin. Ask for a new blood test after 3 months.

[tagaxel in reply to SueJohnson]

It was 96 on 9/20/21; 73 on 6/21/23 and now it's 55 even though 3 months ago I started using a larger iron supplement.

[SueJohnson in reply to tagaxel]

What was the name of the iron supplement and how many mg

[tagaxel in reply to SueJohnson]

The brand is "Pharbest" ferrous sulfate 325 mg which delivers 65 mg of iron as ferrous sulfate. I started taking this three months ago, replacing a supplement that only delivered 45 mg of iron. I can't understand how my iron went from 96 back in 2021 to 50 here at the end of 2023.

[SueJohnson in reply to tagaxel]

That is strange! The only thing I can think of in that in 2021 when you had the test you took the test in the afternoon or you didn't stop taking iron including in a multivitamin 48 hours before the test or you had inflammation or an infection (cold or flu or covid or even a covid shot) within 2 months of taking the test or it was within a few weeks of surgery OR you have been taking it twice a day or within 24 hours of each other. Otherwise I have no clue. I know you know how to take it and what not to take within 2 hours of it, etc

[SueJohnson in reply to tagaxel]

The iron supplement may not have had enough elemental iron which is why I asked. If you name it and the mg I can tell you.

[tagaxel in reply to SueJohnson]

The brand is "Pharbest" ferrous sulfate 325 mg.