Iron levels.

[AzraCG]

Hi . I've had 12 transfusions after internal bleeding and surgery in April. My hb was at 6 before the transfusion. My levels are as below. Is this sufficient or would I still need a supplement. I am weaned off pramipexole now but while is hospital I was given tramacet and that was helping my legs. I don't want to be reliant on it now that I've been discharged.

Thank you

[Madlegs1]

Your ferritin is fine-- don't let anyone tell you it is at dangerous level.

Take whatever medication relieves your symptoms ( apart from the DAs)

Low dose opioids are perfectly acceptable for refractory RLS and have negligible danger of addiction.

Give it a while for the Pramipexol to completely get out of your system. That may take months.

Meanwhile look at possible triggers - food ,drink and medications.

Good luck.

[AzraCG in reply to Madlegs1]

Thank-you. The docs said it's fine now.Haemoglobin was very low before my transfusions.

[Joolsg]

Your serum ferritin is at a 'normal' level for RLS patients. Many need serum ferritin above 300. Your serum iron is below the 60ųg/L that our US experts like to see.So, you could keep taking ferrous bisglycinate every other night to raise levels, as your transferrin percentage is below 45%.

You clearly want to be med free and that may be possible if you keep your iron and ferritin levels up.

If you then get occasional RLS, you could take a 30mg codeine or tramacet.

[ChrisColumbus]

Just to put that ferritin range in context, the '13-150' range quoted in your results is lower than most 'normal' ranges given. There is no absolute normal range: the Mayo Clinic quotes 'For women, 11 to 307 mg/L', Cleveland Clinic says '5 to 205 ng/ML for women', the UK NHS quotes various ranges including 'Adult female 10 - 300'. The bottom limits of all those quoted 'normal' ranges is rather low and would indicate a need for supplementation; the upper limits given in all of these are fairly conservative: some RLS patients need approaching 300 or more to get relief. As long as your TSAT stays under 45% continued supplementation would be OK. Haematology at Oxford University Hospital Trust do not have concerns about figures up to 1000 as long as (i) the reason (e.g. an infusion) is known and (ii) the figure starts to decline after the causative event. One does have to be aware of the possibility of haemochromatosis (iron overload), but not at the levels that you have shown.

[AzraCG in reply to ChrisColumbus]

Thank you Chris