Confusing ferritin results and ranges? - Thyroid UK

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Confusing ferritin results and ranges?

shambles profile image
8 Replies

Since trying T3 a few years ago my ferritin levels have risen. I use both Blue Horizon and Medichecks and my results are very similar. However when I have presented the labs to my GP he has re-tested but it always shows a completely different outcome.

Ferritin results

Nov 15 249 (20-150) BH

Nov 15 110 (20-291)NHS

Mar 16 194 (13-150)MC

Mar 16 124 (20-291)NHS

April 16 137.2 (20-150)BH

May 16 234.5(13-150)MC

Nov 16 199.8(13-150)MC

Nov 16 113 (20-291)NHS

I can I just add all that the private tests were finger prick tests and the NHS test is a blood draw.

I mailed both companies and rightly they say they cannot comment on the NHS lab but one of them offered to retest!

I just want to know is my ferritin over range or not. All other inflammations markers are normal, low in fact. But my iron levels are high in range.

Appreciate your thoughts please.

Thanks in advance

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humanbean profile image
humanbean

Since there is confusion with the results of the ferritin test it would be a good idea to get some other info on your iron results. Have you ever thought of doing this test?

medichecks.com/iron-tests/i...

Do you ever get a Full Blood Count done? The levels of Haemoglobin, Haematocrit, Red Blood Cell Count all give you extra clues to what might be happening with your iron levels.

I've found this document (and the website it comes from) helpful, particularly the chart at the bottom :

irondisorders.org/Websites/...

Another issue to consider is whether or not the conditions for each test are the same.

Any iron related testing should be done first thing in the morning, having fasted overnight.

Another issue is whether or not you are squeezing/milking your finger for the finger-prick tests.

You can get some tips (which you have probably already read) here :

medichecks.com/dl/Medicheck...

bluehorizonmedicals.co.uk/W...

shambles profile image
shambles in reply to humanbean

Thanks Humanbean

grateful for you taking the time.

My iron is high and has been over range in the past year or so.

My results vary so and I have to say I get confused.

Iron

22 Oct 201624.16.60 - 26.00

24 Aug 201637.06.60 - 26.00

Over range but taken vitamin C

11 Nov 201524.56.60 - 26.00

T.I.B.C

22 Oct 201657.441.00 - 77.00

24 Aug 20165941.00 - 77.00

11 Nov 20156241.00 - 77.00

Transferrin Satuaration

22 Oct 201641.9920.00 - 55.00

24 Aug 20166320.00 - 55.00

Over range

11 Nov 20154020.00 - 55.00

RBC constantly below range, MCV constantly above range. Have checked all levels related PA and B12 and negative. Folate does drop low if I don't supplement. Haemoglobin is fine.

I never eat after 8pm and all tests are completed first thing prior to food.

As for the finger prick test, I have no problem filling it luckily. One lancet and it's filled in a few seconds!.

I do not have the gene for hemochromatosis.

I do not like the idea of high iron, I believe all in all it's not good. I was thinking of maybe donating blood but not sure if I can with low RBC's and autoimmune.

humanbean profile image
humanbean in reply to shambles

Nov 2016 (actual dates?)

Ferritin (MC) = 199.8 (13-150) Over range

Ferritin (NHS) = 113 (20-291) 34% of the way through range

****

22 Oct 2016 (NHS or private?)

Iron = 24.1 (6.60 - 26.00) 90% of the way through range

TIBC = 57.4 (41.00 - 77.00) 46% of the way through range

Trans Sat = 41.99 (20.00 - 55.00) 63% of the way through range

****

24 Aug 2016 (NHS or private?)

Iron = 37.0 (6.60 - 26.00) Over range but taken vitamin C

TIBC = 59 (41.00 - 77.00) 50% of the way through range

Trans Sat = 63 (20.00 - 55.00) Over range

****

May 2016

Ferritin (MC) = 234.5 (13-150) Over range

****

Apr 2016

Ferritin (BH) = 137.2 (20-150) 90% of the way through range

****

Mar 2016

Ferritin (MC) = 194 (13-150) Over range

Ferritin (NHS) = 124 (20-291) 38% of the way through the range

****

11 Nov 2015 (NHS or private?)

Iron = 24.5 (6.60 - 26.00) 92% of the way through range

TIBC = 62 (41.00 - 77.00) 58% of the way through range

Trans Sat = 40 (20.00 - 55.00) 57% of the way through range

Ferritin (BH) = 249 (20-150) Over range

Ferritin (NHS) = 110 (20-291) 33% of the way through range

****

I wanted to ask a couple of questions about your results...

Nov 2016 and Mar 2016 - actual dates for the ferritin results?

22 Oct 2016 - Do you have a ferritin result? Were the tests done on this day done by the NHS or BH or MC?

24 Aug 2016 - Same questions as for 22 Oct 2016.

11 Nov 2015 - Which ferritin result belongs with the Iron, TIBC and Trans Sat results, and were the Iron, TIBC and Trans Sat results produced by NHS or BH or MC?

When you have any testing done which involves iron testing what circumstances are the test done under? Time of day? Fasting or non-fasting?

(Even if you answer all these questions, I'm still not promising to come up with the answer to anything. There is no doubt your results are strange.)

shambles profile image
shambles

Hi Humanbean

Apologies for the delay in getting back to you. Called back to work!

Firstly can I say how impressed I am by your input and detail. Secondly you shall be known as forensic Humanbean. :-) Thank you.

November ferritin dates were 3 Nov and 14 Nov.

Test October ferritin was 194.1 (MC)

No August test but July 220 (MC)

No ferritin tests done on 11 Nov, just iron panel as part of an essential health screen with MC. All iron panels done by MC, none by NHS

For iron tests I always fast min 12 hours, except for thyroid meds at 6am and water. Take the test around 7am ish. Always finger prick.

Hope I have answered what you needed?

Appreciate your take on it.

humanbean profile image
humanbean in reply to shambles

Nov 2016

Tests done 3/11/2016 and 14/11/2016 i.e. 11 days apart.

Ferritin (MC) = 199.8 (13-150) Over range

Ferritin (NHS) = 113 (20-291) 34% of the way through range

****

22 Oct 2016 (MC)

Iron = 24.1 (6.60 - 26.00) 90% of the way through range

TIBC = 57.4 (41.00 - 77.00) 46% of the way through range

Trans Sat = 41.99 (20.00 - 55.00) 63% of the way through range

Ferritin = 194.1 (13 - 150?) Over range

****

24 Aug 2016 (MC)

Iron = 37.0 (6.60 - 26.00) Over range but taken vitamin C

TIBC = 59 (41.00 - 77.00) 50% of the way through range

Trans Sat = 63 (20.00 - 55.00) Over range

****

July 2016

Ferritin (MC) 220 (13 - 150?) Over range

****

May 2016

Ferritin (MC) = 234.5 (13-150) Over range

****

Apr 2016

Ferritin (BH) = 137.2 (20-150) 90% of the way through range

****

Mar 2016

Ferritin (MC) = 194 (13-150) Over range

Ferritin (NHS) = 124 (20-291) 38% of the way through the range

****

11 Nov 2015 (MC)

Iron = 24.5 (6.60 - 26.00) 92% of the way through range

TIBC = 62 (41.00 - 77.00) 58% of the way through range

Trans Sat = 40 (20.00 - 55.00) 57% of the way through range

Ferritin (BH) = 249 (20-150) Over range

Ferritin (NHS) = 110 (20-291) 33% of the way through range

****

Some comments and links

1) The table at the bottom of this page is very helpful and gives useful info on several different kinds of anaemia :

irondisorders.org/Websites/...

2) For info on optimal iron results - be aware when looking for info on any test results that reference ranges and units of measurement might differ from country to country and lab to lab :

rt3-adrenals.org/Iron_test_...

3) It is possible to have more than one kind of anaemia. When this happens it can make sorting out what is going on very difficult and may disguise the anaemia altogether. So, for example, someone may have anaemia caused by a vitamin B12 deficiency which (amongst other things) may show up with high ferritin. Someone with iron deficiency anaemia has low ferritin. Put both in the same body and you could have perfectly normal ferritin levels and be told everything is fine, your results are normal, go away. This is why having just a ferritin level is often not helpful and cannot be assumed to be reliable.

4) Some useful info on iron tests generally :

labtestsonline.org.uk/under...

****

To summarise what you've got :

Low RBC

High MCV

Would like to see results for Haemoglobin, B12 and folate if possible.

All other inflammations markers are normal, low in fact.

Ferritin : Over range x 6 results, High in range x 1 result, Lower in range x 3 results

Iron : Over range x 1 result, High in range x 2 results

TIBC : Mid range x 3 results

Transferrin Saturation : Over range x 1 result, Mid-range x 2 results

Okay, I'll bite the bullet on your odd results and waffle on about it for a bit. ;)

I have read that Blue Horizon and Medichecks will sometimes (?) often (?) use the same laboratory in London - The Doctors' Laboratory.

tdlpathology.com/home

But you'd obviously have to check with both BH and MC to find out which lab they used for your ferritin results.

If BH and MC are using different labs then it would seem likely that the NHS is the odd one out and that the very high results are the correct ones. But if BH and MC are using the same lab then you have one private lab producing high results and one (NHS) lab producing lower ferritin results and we are no further forward.

****

Quote from you : RBC constantly below range, MCV constantly above range. Have checked all levels related PA and B12 and negative. Folate does drop low if I don't supplement. Haemoglobin is fine.

****

Low RBC :

Quote from labtestsonline.org.uk/under...

A low RBC count may indicate anaemia, bleeding, kidney disease, bone marrow failure (for instance, from radiation or a tumour), malnutrition, or other causes. A low count may also indicate nutritional deficiencies of iron, folate and vitamin B12.

****

High MCV :

Quote from labtestsonline.org.uk/under...

The MCV is elevated when your RBCs are larger than normal (macrocytic), for example in anaemia caused by vitamin B12 deficiency or folic acid deficiency.

****

The low RBC and high MCV both suggest Vitamin B12 deficiency and/or low folate, so if you've had these tested could you post the results, please.

If you do have anaemia caused by low vitamin B12 or folate then it would push up your serum iron (yours is high in range or over the range), push up your ferritin (from the private tests yours is high in range or over the range), push up your Transferrin saturation (you have two mid-range and one over the range result), lower your haemoglobin (I'd like to see this result).

****

I think, on the balance of probabilities, that you have high ferritin rather than ferritin in the lower half of the range. I think the NHS is wrong. There are patients galore doing the private tests from BH and MC under lots of different circumstances. I suspect that an error in the testing protocol is more likely to be caught in a busy private lab than from the NHS. The vast majority of people being tested by the NHS won't get tests done elsewhere so getting it checked or odd results picked up is less likely.

Although I'm not knowledgeable on the subject of B12, I am aware of the fact that people can have functional deficiencies of B12. Blood test results might look good, but in fact there might be a problem with the B12 getting into the cells and so the person is nevertheless suffering from B12 deficiency, despite there being lots of B12 in the blood. I wonder if this is what you have.

You might find this link interesting :

academic.oup.com/qjmed/arti...

There is a link to a PDF of the above article, just below the Published Date near the top of the page.

Please realise that I am not a doctor and I'm just trying to put together the evidence to suggest what your results are actually showing. I think that you have a B12 problem of some kind.

Please don't blame me if I've got it wrong!

shambles profile image
shambles in reply to humanbean

I am completely overwhelmed by your time and effort.

Would like to digest everything you've written and the attached links and give a decent reply if that's OK.

Thank you, really good of you.

humanbean profile image
humanbean in reply to shambles

Your post triggered my curiosity and my hidden desire to be a detective. It was also a challenge. ;)

I don't usually put as much effort into following up a post. :D

shambles profile image
shambles in reply to humanbean

Hi Humanbean

I just want to say thanks again for taking the interest.

I read all the links thank you and all were helpful.

I do believe like you that it just not that simple and that there is more than one think occurring with my results.

My iron is high across the board and does suggest iron overload at times but I do not carry the HYE gene.

I thought my results indicated B12 deficiency but I have run all the tests and I can’t find it. I have posted and been well looked after on the PA site. Their thoughts were that it is not unusual to see low RBC in people that are hypo and especially with no thyroid.

So I have been focusing on now is the homocysteine and the ferritin, two inflammation markers.

I have posted pretty much everything I have, feels a little exposing 

HS CRP

14 Feb 20170.40.00 - 5.00

22 Oct 20160.90.00 - 5.00

20 May 20160.70.00 - 5.00

23 May 20131.50.00 - 5.00

Folate

14 Feb 201719.983.89 - 26.80

22 Oct 20168.583.89 - 26.80 not supp

20 May 20169.13.89 - 26.80 not supp

Haemoglobin

24 Aug 2016129115.00 - 155.00

11 Nov 2015128115.00 - 155.00

08 Jan 2014127115.00 - 155.00

30 Aug 2013122115.00 - 155.00

RBC

24 Aug 20163.913.95 - 5.15

11 Nov 20153.983.95 - 5.15

08 Jan 20143.793.95 - 5.15

30 Aug 20133.753.95 - 5.15

MCV

24 Aug 2016100.080.00 - 99.00

11 Nov 2015103.380.00 - 99.00

08 Jan 2014101.880.00 - 99.00

30 Aug 2013108.080.00 - 99.00

All the above are MC but they concur with NHS tests. NHS also tested PCV and it is low out of range.

B12

31 Jan 14 497 (211-911) NHS supplementing but off for 4 weeks

09 July 15 728 (142-725) BH Not supplementing

27 Nov 15 466 (140-725) BH Not supplementing

20 Oct 16 485.7 (191-663) MC not supplementing

Active B12

17 Jan 2014 118.7 (25-165) BH supplementing but off for 4 weeks

13 Dec 2015 193 (25-165) BH not supplementing

08 Jul 2016 100(25.10 - 165.00 Not supplementing

Homocysteine

17 Sep 2015 12 Range given for at risk with this company 10-15 Highlighted as at risk. Not supplementing with any B vitamins.

9 March 2016 10 same range so still high, still not supplementing as my B12 is showing over range In active B12 test.

18 Nov 2016 18.4 (0.0-15.0)

Looking for PA myself I then test IF antibodies and MMA, both negative. Also test for candida and that’s negative too.

I test then some B vitamins because of the high homocysteine

B1 1.08 <1.15 normal

B2 1.38 <1.20 deficient

B6 1.65 < 1.75 normal

RBC B9 Folate 5.8 (3.1-20.5) not supplementing, all folate tests low in range.

Also deficient in vitamin A alpha carotene and vitamin E gamma-tocopherol.

I’ve started supplementing with B12, B complex and B2 to see if that is the reason for the high homocysteine. As far as the ferritin is concerned, I’m not sure. I only had been tested by the NHS prior to 2015 and it well in range sitting at around 85 (20-291). In April 2015 I introduced some T3 into my regime and although initially felt much better I ended up with a bunch of problems and eventually stopped in November of the same year. It was during that period that I saw the ferritin increase with both private checks and the NHS.

I don’t want high iron/iron stores, it is not a good thing, Alzheimer’s and I do have that gene. I need to know if I should consider donating blood to reduce my iron stores or in fact even if I can with low RBC.

If you have the time I am happy to be a recipient of your forensic skills .

Have fun!

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