Iron panel and full blood count test results - is it safe to supplement?

[Purple_Green]

Hi there again. I've been looking into my low ferritin, and recently did both the iron panel and FBC.

Could someone please comment on them? is it safe to start supplementing? Anything to watch out for?

[Purple_Green]

More here

[humanbean in reply to Purple_Green]

Iron 10.8 (5.8 - 34.5) 17.4% of the way through the range

TIBC 56.9 (45 - 72) 57% of the way through the range

UIBC 46.1 (24.2- 70.1) 48% of the way through the range

Transferrin Saturation 18.98 (20 - 50) Below range

Ferritin 28.7 (13 - 150) 11.5% of the way through the range

Optimal levels of iron are shown in this link :

rt3-adrenals.org/Iron_test_...

Serum iron • 55 to 70% of the range • higher end for men

Your level is only 17.4% of the way through the range, suggesting you would benefit from extra iron.

TIBC (total iron binding capacity) • Low in range indicates lack of capacity for additional iron • High in range indicates body's need for supplemental iron

Your level is pretty close to mid-range suggesting your iron is not that bad.

Saturation • optimal is 35 to 45% • higher end for men

Your level is actually below range, suggesting that you need extra iron.

Ferritin • Low level virtually always indicates need for iron supplementation

Your level is very low in range, suggesting that you need extra iron.

It is quite common to have inconsistent results in an iron panel. The only inconsistent result you have with your iron panel is the TIBC suggesting your iron is not bad. I think the rest of your iron panel results are dire, and in your shoes I would suggest that you take iron supplements. Depending on how well you absorb iron you could be taking a therapeutic dose for several months. From very low levels, it can take 6 months to a year or two to replenish iron. Because absorption is so variable between individuals, and because nobody knows (until they try) how well they will absorb iron it is essential to test regularly. Excessive levels of iron are poisonous.

...

Your Full Blood Count (FBC)

Haemoglobin 150 (120 - 160) 75% of the way through the range

Haematocrit 0.437 (0.35 - 0.47)

Red Cell Count 4.74 (3.8 - 5.8)

MCV 92.3 (81 - 98) 66.5% of the way through the range

MCH 31.6 (27 - 33)

is not suggesting that you are anaemic. For that you would have to have a haemoglobin level that was below range.

MCV is a helpful measure to know.

If your MCV is low in range or below range it tells you that your red blood cells are small. Small red blood cells are indicative of low iron.

If your MCV is high in range or over the range it tells you that your red blood cells are large. Large red blood cells are indicative of low vitamin B12 and/or low folate.

If you have low iron AND low B12 and/or low folate then your MCV might be quite close to mid-range.

We already know from your iron panel that your iron is low. But your MCV is well into the upper half of the range, suggesting that you should also do a vitamin B12 test and a folate test too, because one or both might be low.

...

A link that you should read, including the replies...

healthunlocked.com/thyroidu...

And with regard to supplementing iron, this reply I wrote to someone else describes how to supplement in the UK - you don't need a prescription.

healthunlocked.com/thyroidu...

Personally, I use ferrous fumarate 210mg. They can be bought in packets of 84 which is enough for one tablet, three times a day for 28 days, which is the maximum safe dose.

There a lot of people who have problems tolerating iron supplements. So, it is a good policy to start at one tablet per day, then increase to two after a week, then test to see what is happening to your levels after 4 - 6 weeks on one tablet twice a day. If you absolutely have to you could increase to three tablets a day. And if you can't tolerate iron at all you can switch to a supplement with lower levels of iron in per tablet. The ferrous fumarate 210mg that I take contains 69mg pure iron per pill. If you switched to ferrous gluconate 300mg, each pill contains about 35mg of pure iron i.e. about half the amount in the ferrous fumarate pills I take.

Because tolerance is an issue, taking iron tablets with food might help, but it will slow down absorption. I take iron tablets with food because it is the only way I can tolerate them.

I have optimised my ferritin now, although my iron is still a bit low. I try to keep my ferritin as close to optimal as I can, and I let my iron do its own thing. I still test every few months. I take a maintenance dose of one tablet five days a week. I reduce to four, or increase to six, depending on my test results.

[Purple_Green in reply to humanbean]

Thanks a lot humanbean for your reply! I think it all slowly starts to make sense in my head. I'm soo glad I found this brilliant forum 🤗

I tested Folate and B12 last month, these were not dreadful but could still be better I guess.

Folate 13.38 (3.89 - 19.45)

B12 active 132 (37.5 - 187.5)

I'll try ferrous fumarate for next few weeks and see how it goes. One thing keeps puzzling me. So iron supps should be away from any other supps, and we need to take quite a few of them when working on our levels. Any tips on how to better schedule the vitamins when taking iron twice a day?

[humanbean in reply to Purple_Green]

How many doses of thyroid hormones do you take per day, and when do you normally take them now?

...

Your folate could be a bit better - upper half of the reference range is usually suggested as optimal i.e. approx 12 - 20. You could try and get your level a bit higher in range with folate-rich foods - but don't go over range. If you want to know more about folate and what supplements to use to raise it :

chriskresser.com/folate-vs-...

...

Your active B12 is already optimal - it is usually suggested to be between 100 and top of range. There is nothing wrong with taking your level a bit higher than it is now, if you want to try the experiment. Vitamin B12 is the only nutrient I know of with no known ill effects if it goes over range as a result of supplementing.

stichtingb12tekort.nl/weten...

If you want to supplement B12, go for an active B12 supplement. These are ones which contain methylcobalamin.

[Purple_Green in reply to humanbean]

I'm on 75mg Levo, taken at bedtime. I also take vit D, K2, magnesium, B complex with Folate and methylcobalamin in it, omega3, now got ferrous fumarate and vit C to add to it. The plan is to start with one iron pill a day for a week, and then try twice a day but I'm struggling to wrap my head around what should be combined with what once you start taking 2 iron pills.

[humanbean in reply to Purple_Green]

Okay, this is just a suggested timetable. Many people feel best when taking vitamins early in the day and minerals later in the day.

After breakfast

Make sure to include some fat in your breakfast to help the absorption of any fat soluble vitamins.

Vitamin D

Vitamin K2

B Complex

Omega 3

Mid/late afternoon

Ferrous fumarate

Magnesium

Vitamin C

At bedtime

Levothyroxine

There must be at least a four hour gap between taking iron and taking Levo.

[Purple_Green in reply to humanbean]

That's really helpful, thanks so much! 🙏

[humanbean]

One other comment...

If you have posted and haven't had any replies after, say, a day and a half or two days you could reply to your own post asking again if someone could help you, or you could post again.

Sometimes posts get overlooked - it isn't personal, it just happens.