I posted several weeks ago about an anomaly in my 18 year old daughter's ferritin results and received some really helpful advice from @humanbean and others. Her ferritin level from a Medichecks blood test was 75, however when her GP tested it a few weeks later it was just 15.4 and her Haemoglobin was 119 (range 120-155). The general consensus on here was we should ignore the Medichecks result, and also that my daughter was showing signs of iron deficient anemia.
My daughter did another CBC last week together with an iron panel, as we had provisionally arranged an iron infusion for next week, although this has now been cancelled as she wants to see whether she raise her iron levels through diet (for 3 months) before going ahead with the infusion. The CBC has again shown borderline low Haemglobin of 121 (range 120-155), RBC of 392 (range 390-520) and Haematocrit 365 (range 355 -455). All these levels have dropped quite considerably over the last couple of months.
However, the iron panel results are really baffling us, they are:
Ferritin - 12.9 (10-291)
Serum Iron - 9.1 (10-30.4)
Transferrin - 2.36 (2.50-3.80)
Saturation - 17% (16- 50)
We had assumed that she had iron deficient anemia but we're really confused as to why her transferrin is below range - from what we've read transferrin will be high/elevated in the presence of IDA. We understand that low levels of transferrin are generally caused by inflammation/anemia of chronic disease or liver issues. My daughter's inflammatory markers all came back negative a few weeks ago (CRP, ESR and ANA etc) and her liver function test was also normal. However, she does have elevated cholesterol levels which perhaps suggests that her liver function is not optimal.
We have already spoken to our GP who didn't understand what the issue was. If anyone on this forum has any thoughts on these results we would love to hear them. Thank you!
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Cookerybookaddict86
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suggest that the rules for Transferrin and TIBC are the same.
TIBC (total iron binding capacity) or Transferrin
• Low in range indicates lack of capacity for additional iron
• High in range indicates body's need for supplemental iron
Your daughter's results are very, very like mine were when I started treating my own low iron nearly 10 years ago. I was also baffled about why, despite being so low in iron and ferritin and saturation that my Total Iron Binding Capacity (TIBC) - I didn't know my transferrin - was below range.
In the end I decided I had no choice but to start supplementing iron. But I tested frequently to be sure that none of the low results (ferritin, iron, and saturation) increased dramatically.
I started feeling the benefit of the iron quite quickly, but it took me 22 months to get my ferritin to mid range because I absorbed it poorly. When it finally got there my other iron results were still not optimal, and have stayed that way most of the time. I continued to take iron at a maintenance level (for my ferritin) for years. I only stopped taking iron when my ferritin suddenly shot up for no obvious reason. I still test regularly (about twice a year now).
Personally - I have no proof of this - I think my family has some kind of genetic error involving iron. I have/had seven relatives on the maternal side of my family who all have low iron and anaemia pretty much all the time. But like me they have the problem that doctors rarely, if ever, test iron panels, and rarely keep prescribing iron for more than about 2 or 3 months. I only managed to help myself when I found out that iron could be tested privately and iron supplements could be bought over the counter without a prescription. I had to stop being at the mercy of doctors - and luckily, it worked for me.
Improving liver health might help iron/ferritin/saturation levels. The only way I've managed to improve my own is by giving up sugar, cakes, biscuits etc. But I relapse frequently!
Hi humanbean, thank you so much for your helpful reply. You wrote such a helpful reply last time I posted, so I was really hoping that you would reply to this thread too!
Have you ever considered an iron infusion to boost your Ferritin levels? I really thought this might be the answer to my daughter's problems, but she wasn't keen at all, and now that we know she has low transferrin too, I'm not sure whether it's even advisable. My understanding is that low transferrin indicates a lack of capacity for extra iron, so I'm wondering whether this would completely rule out an iron infusion. I've just queried this with the iron clinic and we're currently waiting to hear back from them.
Has you ever been given an explanation as to why your TIBC is low? I'm wondering whether my daughter's is somehow connected to low FT3 levels in her liver. I understand that transferrin is made in the liver, and as she already has abnormally high cholesterol levels, I'm wondering whether her liver doesn't have enough FT3 to work probably - however this is just my theory!
My understanding is that low transferrin indicates a lack of capacity for extra iron
That is my understanding too. The same is true of low TIBC.
But since my iron, ferritin and saturation were all low, and my TIBC just didn't fit with those results I decided I had no choice but to ignore the TIBC because there was no way my iron, ferritin and saturation would go up just by wishing it would, which seemed to be the only option I had left.
If I had my time over again and had realised that taking iron supplements would take soooo very, very long to raise my ferritin, while leaving iron and saturation still well under optimal, I would probably go for an iron infusion too.
I would hope that a reputable company doing iron infusions ought to tell patients whether they would benefit from doing this, otherwise they are causing harm which ought to be illegal (and probably is) but you would have to contact a company doing such infusions to ask what their service covers. They should be responsible for the outcomes they get from doing anything medical, they can't just evade all responsibility.
Has you ever been given an explanation as to why your TIBC is low?
I've never found out why my TIBC is always low. I've never discussed it with a doctor either. I have no faith in them whatsoever.
Many thanks for your reply. We have now been assured by the Iron Clinic that an infusion would be completely safe despite my daughter's low level of transferrin. The clinic is run by a doctor who has done extensive research into anemia, so I guess we have to assume he knows what he's talking about!
The only issue now is that my daughter isn't keen to go ahead which is frustrating as I think she would really benefit from an infusion. Your comments above about how long it took you to raise your Ferritin levels have confirmed my views about this, but ultimately I have to respect her decision if she doesn't want to go ahead for now.
Hi AS14, I think you had strange results from Medichecks too?
My daughter's most recent blood tests which came back with Ferritin of 15 and then 12.9 were done at our GPs surgery. The bloods are then sent to the lab at our local hospital which is a very large teaching hospital. I have far more confidence in these results than I do with the Medichecks results which I am now convinced were completely inaccurate! Are you able to have your Ferritin level rechecked by your GP?
I could try asking my gp but to be honest I just cant face them, lost any faith I had in them. I doubt they’d oblige anyway. Im sticking to private testing.
Im going to speak to medichecks to see if they’ll have future tests done by the doctors lab.
I had an iron transfusion and it was the best thing I did.
I don't tolerate tablets well and I was vegan for a number of years before hand. As my health has deteriorated I didn't have enough energy or strength to cook nutrious meals every day so went back to being veggie and since my transfusion have been eating beef once or twice a week.
Diet alone is going to be tricky to raise her ferritin when it's so low... teenagers always know best though don't they? 😉
Thanks Witchinghour, that's really good to know. My daughter had been veggie/pescatarian for 10 years until about 4 months ago when she decided to start eating meat again in the interests of her health. Ironically her iron levels seem to have deteriorated quite drastically since she started eating meat again which makes us think it must be a gut/absorption issue.
You're quite right, teenagers know everything, don't they! I'm hoping she'll come round to idea of an iron infusion very soon!
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