Hi everyome, just looking for some feedback on my Iron Blood Test results
Serum ferritin level 34 ng/ml [30 - 150]
Serum C reactive protein level 11 mg/L [0-5]
Serum transferrin level 3.13 g/L [2 - 3.6]
Serum iron level 11.5 umol/l [5.8 - 34.5]
Transferrin saturation index 15% [15 - 50]
clatow23
Did you fast for 12 hours before your test and no iron supplements (if you take them) for a few days and no high iron food (liver, pate, red meat, etc) the day before? If so then:
When discussion an iron panel we often refer to the optimal iron panel levels according to rt3-adrenals.org/Iron_test_... which are:
Serum iron: 55 to 70% of the range, higher end for men
Saturation: optimal is 35 to 45%, higher end for men
Total Iron Binding Capacity (TIBC) or Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron
Ferritin: Low level virtually always indicates need for iron supplementation; High level with low serum iron/low saturation indicates inflammation or infection; High level with high serum iron and low TIBC indicates excess iron; Over range with saturation above 45% suggests hemochromatosis - yours is
Serum C reactive protein level 11 mg/L [0-5]
This is over range and indicates inflammation or infection. As it's a non-specific inflammation marker it can't tell you where the inflammation is.
Serum ferritin level 34 ng/ml [30 - 150]
Inflammation causes elevated ferritin level so as your CRP is high then it's reasonable to think that your ferritin level is showing higher than it normall would in which case it's very likely that your ferritin level is suggesting iron deficiency. Even if it wasn't raised due to inflammation it is extremely low, NICE guidelines say <30 is iron deficiency.
Serum transferrin level 3.13 g/L [2 - 3.6]
This is 70.63% through range so is at the higher end and according to the optimal levels above suggests the need for supplementing.
Serum iron level 11.5 umol/l [5.8 - 34.5]
This is 19.86% through range and according to the optimal levels above is very low suggesting the need for supplementing.
Transferrin saturation index 15% [15 - 50]
As the optimal level is said to be 35-45% your is very low and on the bottom limit of your range so again suggests the need for supplementing.
All your results suggest deficiency so you need to discuss with your GP, he should ideally prescribe iron tablets and regularly monitor your levels with a full iron panel every two or three moths.
Hi SeasideSusie thanks for your reply. Would the GP take any notice? They have marked the results as satisfactory, no further action. So not sure what I would say to change his mind?
Would he be aware of CRP and elevated ferritin?
clatow23
Would the GP take any notice? They have marked the results as satisfactory, no further action.
So this was a GP test?
They have marked the results as satisfactory and no further action purely because the results are within range, albeit the saturation % is rock bottom they still class it as in range. They don't care about the patient, symptoms or anything else, we have been dehumanised, we are just numbers and your numbers are in range so nothing else matters. Sad but true in most cases where doctors are concerned.
Would he be aware of CRP and elevated ferritin?
Your CRP is elevated, your GP will be aware that this is caused by infammation but probably not, in his eyes, high enough to be a problem. He should be aware that inflammation causes elevated ferritin.
Would the GP take any notice?
Impossible for me to answer, I don't know your GP. Many wouldn't, some would if you advocate for your self well enough.
Do you have any symptoms of either low ferritin or iron deficiency:
Symptoms of low ferritin include:
◾Weakness
◾Fatigue
◾Difficulty concentrating
◾Poor work productivity
◾Cold hands and feet
◾Poor short-term memory
◾Difficulty remembering names
◾Dizziness
◾Pounding in the ears
◾Shortness of breath
◾Brittle nails
◾Headaches
◾Restless legs
**
Symptoms of iron deficiency include:
◾Persistent fatigue
◾Pale skin
◾Shortness of breath
◾Headaches
◾Dizziness
◾Heart palpitations
◾Dry skin
◾Brittle hair and hair loss
◾Swelling or soreness of the tongue or mouth
◾Restless legs
◾Brittle or ridged nails
If so then list them and emphasise them. If GP says your iron panel is in range then challenge him - "what are my symptoms caused by then?".
You need testing for anaemia, an iron panel can only show iron deficiency, to show anaemia you need a full blood count. You can have iron deficiency with or without anaemia.
Familiarise yourself with NICE guidelines, read through every section and particularly those under Diagnosis and use the information when discussing with your GP:
cks.nice.org.uk/topics/anae...
It's not a good idea to self treat iron deficiency (it is very important that regular testing is done) but if GP still refuses to take any notice maybe suggest that you are considering buying your own iron tablets so will he monitor you with regular blood tests.
Hi SeasideSusie , there is a full blood count too. Herr is what it says on my online results
Full blood count This patient sample had to be warmed due to presence of cold aggs
Please note this test is not UKAS accredited
RBC agglutination in film, ? Cold agglutinins. Please repeat in 6
weeks or sooner if raised reticulocytes/symptoms of anaemia.
DK
Film sent for medical review.
Haemoglobin concentration 145 g/L [115.0 - 165.0]
Platelet count - observation 406 x10^9/L [150.0 - 450.0]
Red blood cell count 5.03 x10^12/L [3.9 - 5.4]
Haematocrit 0.444 L/L [0.36 - 0.47]
Mean cell volume 88 fL [80.0 - 100.0]
Mean cell haemoglobin level 28.8 pg [27.0 - 32.0]
Total white blood count 6.9 x10^9/L [4.0 - 11.0]
Neutrophil count 4.0 x10^9/L [2.0 - 8.0]
Lymphocyte count 2.1 x10^9/L [0.5 - 4.0]
Monocyte count - observation 0.5 x10^9/L [0.2 - 1.2]
Eosinophil count - observation 0.2 x10^9/L [0.1 - 0.5]
Basophil count 0.1 x10^9/L [0.0 - 0.1]
Immature granulocyte 0.0 x10^9/L [0.0 - 0.2]
I don't know anything about the comment regarding your sample had to be warmed, but assuming it didn't affect the results in any way, and that your FBC was done at the same time as your iron panel, your FBC doesn't show anaemia, the haemoglobin and haematocrit would be below range if you had anaemia, the white blood cell count doesn't show infection so I think your raised CRP is very likely to be due to inflammation.
Is your hypothyroidism autoimmune (Hashimoto's)? If so this can cause inflammation, as can many other conditions.
SsS,
The warming was considering autoimmune haemolytic anaemia (AIHA) due to cold agglutinins (CAs). Once we have one autoimmune disease we are more prone to others.
Hi SeasideSusie not sure if it is Hashimotos or not
I also had some Reticuloxyte results above the reference limit
Percentage reticulocyte count 3.0 % [0.5 - 2.5]
Above high reference limit
Reticulocyte count - observation 150.0 x10^9/L [20.0 - 100.0]
Above high reference limit
They have been reported satisfactory though
Sorry I have no understanding of those blood tests, perhaps contact your GP and say you've noticed they're out of range and would be please explain what they mean.
Next time you have a thyroid test or do a private one, I would make sure thyroid antibodies are included as this should tell you if you have Hashi's.
clatow23
This test is part of an assessment to help determine if the bone marrow is responding adequately to the body's need for RBC's and identify what type of anaemia you have should you be diagnosed.
Even though your result is high indicating hemolytic anaemia, your iron panel evidences iron deficiency as already explained by SsS, and your elevated CRP indicates bodily inflammation which can also inhibit the iron you have from working properly, your haemoglobin levels although low remain within range which is likely why your GP is ignoring results.
If these were my results I would be questioning GP as you have several indicators of anaemia developing. If they are still resistant to prescribing iron, SsS’s idea of asking them to monitor you is good if you were to supplement yourself.
Supplementing iron requires monitoring to prevent over load and the trouble with results are like yours is they need monitoring more frequently as can't be sure where the additional iron is going to go. Obviously you would like serum iron to raise a little together with the corresponding transporter proteins to take them safely around the body and then ferritin to raise by storing the additional, but because mechanisms aren't working as they should this may not happen.
If you don’t supplement and serum iron levels continue to drop, then eventually haemoglobin will drop also and then you will be ‘officially’ anaemic. Why wait?
Taking Vit C with iron is good for absorption and also goes towards reducing inflammation. Ensure other nutrients are adequate too as deficiencies are generally seen across the board.
To confirm Hashi you will need thyroid antibodies TPOAb & TGAb testing.
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