Last year thanks to some good advice from radd and others, I was able to have an iron infusion which really improved my life.
A year on, I have had the full iron panel again and my iron has dropped back to 22 from 33, and my ferritin is still way high. My GP has summoned me by email as he has seen the ferritin. Has anyone got any comments on my results please ?
CRP HS 1.01 ( 0-50
IRON 22.3 ( 5.8 - 34.5)
TIBC 49.2 (45-81)
UIBC 26.9 (24.2-70.01)
TRANS SAT 45.5 (20-50)
FERRITIN 628 (13-150)
Thank you
Written by
Daffers123
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You can not exactly decipher what is going on from your results because even though CPR is within range there are many forms of bodily inflammation which could cause not only ferritin to raise but contribute to dysfunctional iron mechanisms (& how well thyroid hormones are utilised). Therefore, if this were me I would be considering possible causes and the most likely on this forum being unmanaged Hashi.
I would adopt a g/f but iron rich diet, ensure Vit D is optimal and supplement fish oils, possibly Vit C & turmeric, and just keep monitoring iron and thyroid antibodies which may be an indication of unwanted bodily inflammation.
Serum iron may have just dropped to a more realistic and workable level for your body and the great thing is it is still well within range and able to feed through to VitB12 & folate making RBC’s to carry haemoglobin, and this will no doubt be making thyroid hormones work better which will hopefully improve iron utilisation in a positive cycle.
CRP-HS - I'm assuming the range is a typo for (0 - 5)?
Optimal for CRP and CRP-HS is less than 1. It's an inflammation marker, so the lower the better. Yours is so close to optimal I would consider it a very good result.
Iron
Serum iron
• 55 to 70% of the range
• higher end for men
Your result is already optimal.
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
Result is well in range but your blood lacks capacity for additional iron which is what you would expect with over range ferritin and optimal serum iron. You don't need any more iron at the moment.
UIBC (Unsaturated iron binding capacity)
This shows you that the unused sites in blood which can bind iron are quite low in number. This also ties in with your high ferritin and optimal iron. There is little capacity for your blood to "soak up" more iron., which is not an issue since you have enough.
Transferrin Saturation
• optimal is 35 to 45%
• higher end for men
• to calculate divide serum iron by TIBC
• minimum saturation of 30% required to successfully treat with T3
• Low, beginning doses of T3 can be started with saturation at 25%
According to Medichecks :
Transferrin is made in the liver and is the major protein in the blood which binds to iron and transports it round the body. This test measures how much this protein is 'saturated' by iron.
Your transferrin saturation is a little high for a woman, but only by a very small amount. It suggests your iron level is a smidgen high, but I wouldn't worry about this result if it was mine.
Ferritin
According to this link (my emphasis) from Izabella Wentz, who has Hashi's herself :
Normal ferritin levels for women are between 20 and 200 ng/mL. According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.
So, generally speaking your only problem is the high ferritin - the rest of your results are quite acceptable with only a few small variations from optimal.
What has (probably) happened is that something called "The Iron Withholding Defense System" (which you should google for more information) has kicked in and is storing excess iron in ferritin to prevent pathogens getting hold of it. Iron is required by pathogens to help them reproduce and you really don't want that to happen.
Read Page 8 in this document for a description of what has happened :
I'm assuming that you aren't taking iron in any way at the moment, and you definitely shouldn't take any until your ferritin has reduced. But it could take a while. I would suggest that you do an iron deficiency test roughly every three - four months, just to see what is happening and how fast it is dropping (if it is dropping). As you are someone who has ended up low in iron in the past it could easily happen again in the future.But it isn't a good idea to wait until your levels drop too low. At some point you may have to take iron supplements to prevent your iron dropping as low as it was before your iron transfusion.
But you would only need what is known as a "prophylactic dose".
I assume you had an infusion because your iron was very low. If you don't know why it was low it might easily go low again, and if it does it should start using up your excess ferritin.
The only way I know of to reduce ferritin is to have phlebotomy i.e. getting blood removed and then the blood would be disposed of because it has too much iron in it. But doing that would make all your iron-related levels worse, not just lower your ferritin. Since you have had low iron results before I wouldn't recommend you have phlebotomy to reduce iron again.
A couple of links you might find helpful in the future :
Dear Human Bean I can't thank you enough for your very clear explanation of iron. It was so kind of you. I was told by consultant that I would need infusions for life, but still finding it how often.
I feel I understand it more now and will regularly test as your recommend
The 'Iron Withholding Defense System' kicks in to prevent pathogens feeding on iron, but ferritin also raises in the presence of bodily inflammation caused by high levels of Hashi auto-antibodies.
It reduces with reduction of inflammation, and/or with improved iron mechanisms (possibly through improved thyroid hormone levels) meaning ferritin will reduce enough to become in line with serum iron as per ratio. Ferritin is only reduced by phlebotomy if T/S is also over-range.
Apologies hb, I don’t think I explained my thoughts clearly regarding the iron withholding mechanisms.
We can see serum ferritin shooting up in response to the O/P’s iron infusion and it’s true iron does have roles in controlling pathogenic infection but I think the cause is more likely to be due to overload preventions kicking in.
The body has many mechanisms to prevent free & toxic iron and as serum iron levels were initially full safely bound to a good amount of transferrin, the excess invited large amounts of ferritin (& most likely hemosiderin) to keep iron safe.
And then sometimes when ferritin systems starts rising due to a large unnatural iron dump it can be difficult to initially reverse until other mechanisms catch up. The serum iron drop could be to a level better tolerated for utilising rather than the unfamiliar initial top of range. Hopefully ferritin will eventually drop and serum iron levels maintained.
Transferrin should self adjust to match serum iron or inflate to encourage higher serum iron levels but we often see low transferrin levels on this forum due to conditions such as Disease of Chronic Aenemia common in Hashimotos sufferers.
If we talk about inflammation induced ferritin again I think it more likely to be the result of autoimmune inflammation rather than pathogens. This will also negatively alter thyroid hormone conversion to inactive forms.
Have you seen other results besides these ones? Because I've only seen the one set.
...
I think that anyone who has an iron infusion will always end up with high ferritin because, as you say, the body has various ways of dealing with large quantities of iron, and I think that storing it in ferritin is the safest way for the body to cope with it. The other option the body must have is to store excess iron in serum iron which I think would be a much more dangerous place to keep it.
I haven't seen earlier results from before the iron transfusion. If ferritin was high then (suggesting inflammation or a problem with pathogens or both), then it would very much increase the likelihood of further iron being stored in ferritin when a large quantity came along. If the body is already inflamed before transfusion it would likely make the the iron withholding defense system more likely to kick in with a transfusion.
I suspect that iron transfusions might often increase inflammation, and this is probably unavoidable. But Daffers' CRP is currently at a very good level, so her body is coping very well with the large amount of iron for now and it is unlikely she has any dramatic infection keeping her ferritin high.
I have no idea whether ferritin will stay high, and for the moment I don't think she should try and get rid of any because that would disturb the other results she has which are very good under the circumstances.
Okay. I think the current iron level is good. Whether it will continue to drop while ferritin stays high is something none of us can forecast, so repeat testing is the only option.
I will continue to test every 3 months and can get in touch with consultant again if things get low. Your explained everything far better than he did, and he was a very kind consultant although I was paying nearly£1,000 for the infusion
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