Questions regarding blood tests: ferritin, transferrin saturation, erythrocytes.

[Gibbel]

I am one of those who have managed to very slowly wean myself off pramipexole (0.7 mg - terrible to get through) and now take pregabalin 300 mg a few hours before bedtime together with 30 mg morphine sulfate (22.5 mg morphine). Starting to be able to sleep about 4-5 hours in a row after midnight, still have restless legs and feet the first hours after going to bed.

I have just had blood tests taken after taking oral iron supplements for 1 year. My ferritin was down to 10 a year ago. After ½ year it rose to 36 and is now 88. Transferrin saturation was down to 0.12, rose to 0.23 and is now 25.

My new, young and perhaps not so experienced doctor regarding RLS is a little surprised that my erythrocyte count has not increased in line with ferritin and transferrin saturation. They are all within the normal range, just like my hemoglobin count is normal.

Does anyone have experience that the erythrocyte count does not necessarily move in step with ferritin and transferrin saturation in RLS?

Best regards and thanks for the great help from this forum!

Gibbel

[SueJohnson]

When ferritin levels are low, it often means there's less iron available for red blood cell production, which can lead to a lower erythrocyte count. However since your erythrocyte count is normal I don't think it is anything to be concerned about especially since for people without RLS your ferritin is normal.

Other factors, such as vitamin deficiencies (e.g., vitamin B12 or folate), chronic diseases, or bone marrow issues, could be affecting red blood cell production or your body might not be efficiently using the stored iron to produce red blood cells.

Has it increased at all or just not as much as your doctor expected?

[Gibbel in reply to SueJohnson]

Thanks for the answer Sue! I think you are absolutely right. I can see that I have had my red blood cell count taken in 2020 and 2022, when the numbers were exactly the same. I think I read somewhere that iron supplements for RLS patients with low ferritin (that was mine) will be used to build iron in the bone marrow and brain and not affect the red blood cell count significantly - if at all.

My new doctor is incredibly nice and careful! Since I am 83 years old, he probably thinks that when the red blood cell count does not increase in line with the ferritin, one should seriously think about hidden bleeding, cancer or similar. But this is not necessarily the case with RLS.

Kind regards Gibbel