Update on County Labs and Ferritin tests

[jsy_girl]

hello everyone, just wanted to share an update...

this is because I have been querying with Medichecks the variation in ferritin results between NHS, County and TDL. You can read my last post on this here:

healthunlocked.com/thyroidu...

and specifically in relation to a post from Buddy195 which highlighted that County lost its UKAS accreditation:

healthunlocked.com/thyroidu...

Off the back of this post I followed up with Medichecks to chase their response to me about the variation in results and ask whether they knew why County had had their accreditation removed.

They essentially say this is because their documentation wasn't up to scratch on their quality management system and not because of any concerns with accuracy of results. He goes on to say that he doesn't think I should worry about my own ferritin results and that I don't have enough data points to imply a correlation. I'm not sure this fully assures me and will continue to use TDL as a preference of laboratory but I understand from his perspective, for whatever reason, they accept that ferritin results do have a variation between platform analysers. I guess that is why it is good to aim to be within a range and not an exact number. Issue is that I can get a swing of around 40 with ferritin testing between tests - I guess 100 +/- 40 is what I should aim for therefore! Anyway hope that helps! Make of it what you will...

I did also email UKAS. No response from them as yet.

Reply from medichecks:

We have been in discussion with both County Pathology and UKAS about the withdrawal of their accredited status. County Pathology has confirmed that the accreditation was withdrawn because of an issue with how documentation had been recorded on their quality management system. This will be fixed in the coming 2-3 weeks and does not in any way impact the quality of the results they are returning. Medichecks' standards for the laboratories we use include a requirement that they be UKAS accredited, and so we took the decision to pause our usage of them whilst they await reinstatement of their accreditation.

They have confirmed to us that at no point have there been concerns about the accuracy of any of their tests and that they are continuing to provide testing services to other organisations throughout this period, albeit without UKAS accreditation.

I understand that recent events have caused concern for you about your ferritin results and would like to reassure you that for the reasons outlined above I do not believe it will have any implications for the accuracy of results issued by County Pathology. As I outlined in previous responses the accuracy and consistency of results from both TDL and County is assessed by the teams who run the External Quality Assurance schemes and by UKAS as part of their ongoing programme of assessments. They are assessed in a systematic and objective way, with strict criteria that are used to warn laboratories when their performance for a given assay is outside the acceptable range. The outcome of these assessments is not required to be placed in the public domain, however, the UKAS registration is. So there is a means for the public to check that laboratories are meeting the quality requirements for the assays that they perform. County have assured me that neither UKAS nor the External Quality Assurance Scheme have raised any concerns about their ferritin testing.

When we are looking at trends in results, and comparing between laboratories, it is important to have enough data points to be confident in the statistical power of the results that we based our conclusions upon. A small number of results can suggest a relationship or trend that does not hold up when more data is gathered. Consequently, I would advise caution about concluding that there is a significant difference between the results that you have received from TDL and County. Both laboratories use the Roche analyser system, and there is nothing that has been identified in discussions with the laboratories, UKAS, or the chair of our Clinical Governance Board that has given me cause for concern about the accuracy of ferritin results.

Ranges will vary between laboratories, sometimes this is because of how the range is calculated and the population that is being tested. Ferritin ranges for women are particularly variable because some laboratories use a lower range more suited to women who are still having periods and therefore losing iron during each period. Some laboratories will set a higher limit to the range so that it is less likely to return an abnormal result in women who have been through the menopause, and whose iron levels are higher because they are no longer losing iron every month.

I hope this provides some reassurance about your results and would like to apologise for any concern that the withdrawal of County's UKAS accreditation has caused.

SeasideSusie humanbean SlowDragon bluebug helvella RedApple tattybogle CatsofCatford Wate

[SeasideSusie Remembering]

Thanks for the update jsy_girl it's much appreciated, as is your persistence in trying to get an acceptable explanation.

[jsy_girl in reply to SeasideSusie]

You’re very welcome. Thanks for all your help on this forum!

[helvella Administrator Thyroid UK]

Thank you so much for coming back with that. It is very interesting.

[jsy_girl in reply to helvella]

You’re also very welcome. Thanks for all your help on this forum!

[Star13]

Hmmm Interesting! Thanks for posting. County are my local Lab which is a concern. Recently I had a test done by them and then an unexpected test done at a Hospital visit which were very different so I just ignored it but now I don’t know what to think!

[jsy_girl in reply to Star13]

That’s the thing isn’t it, really makes you question it... was your variation to do with ferritin or was it thyroid? Because I guess with the latter timing / eating / dosing all comes in to play which does not help with surprise tests!

[Hay2016 in reply to Star13]

I have been tested at two labs using Roche systems and a lab using beckman. All bloods taken in same draw. Good correlation with Roche but huge variation with beckman. I gave up trying to get to the bottom of it. Now I just accept unfortunately my endo is working off the weird results.

[jsy_girl in reply to Hay2016]

That is interesting as my experience would indicate the reverse with them both being Roche. I believe the NHS ones use beckman.

Yeah to medichecks point consistency helps with this.

[Buddy195 Administrator]

Thankyou so much for researching & posting!

[jsy_girl in reply to Buddy195]

You’re very welcome 😊

[Serendipitious]

I appreciate your perseverance with this. So I’ve had another iron panel done through Medichecks as they offered to do another one free of charge. Processed at Eurofins County Pathology because they told me that TDL don’t do this test. Hard to believe but anyway.

It’s not as high as last time but now Ferritin is 80. NHS result was 52 in December. The hard to believe Medichecks result in February was 100. Still not sure if I believe it.

[jsy_girl in reply to Serendipitious]

Well that is surprising given one of my medichecks iron panels was done at TDL. Maybe they don’t routinely do it but I certainly have one from that lab.

I can’t say what your results tell you but I would think if that was my result, that I was somewhere between 40-120. Unhelpful I know. What was your serum iron? Maybe use that as a guide for supplementation anyway.

[london81]

i’ve just posted about a disparity in my daughters results- totally different iron results from thriva vs nhs. very confusing. thanks for looking into this i’ll read up on it a bit more tomorrow