Hi,After testing via both usual companies and all failing for iron/ferritin have finally received some results through Monitormyheath,the NHS.
I'm a bit confused by results, & contact is very slow,so thought I'd ask here meanwhile please.
It said results wld be given as haemoglobin and transferrin as a percentage reading.
It's arrived saying
Iron 26.4 range 10.8-28,3 umol/L
Transferrin H
Transferrin Saturation H, presuming this means high until hear otherwise.
But on researching thus I've found conflicting answers as to whether this means I need to take iron or not? I used to be more familiar with TIBC,etc,but appreciate this is a different method.
I've been taking iron for 3 months due to experiencing my old symptoms of breathlessness, dizziness on rising, periods increasing to twice monthly, fatigue,aching limbs,pale skin,etc and some of these are starting to improve a bit.
I can't always go by ferritin as have various infections with ME/ thyroid issues/b12 defic & discovered yday I have absess forming at tooth root which could affect ferritin result,
Any thoughts much appreciated as always...many thanks.
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Jo5454
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There are several tests involved within an iron panel to measure the iron levels, how much is moving through the blood, how well the blood is carrying and how much iron is stored in our tissues.
- serum iron (S/I)
- serum ferritin (S/F)
- transferrin saturation (T/S)
- total iron binding capacity (TIBC)
- unsaturated iron binding capacity (UIBC)
T/S is a calculation of the other measurements to assess the percentage of transferrin (transport protein) that is saturated with iron, demonstrating how much iron is in transport, how much capacity is left to bind iron and move to appropriate sites (such as ferritin).
I guess the 'H' could relate to ‘high’ or 'haemoglobin'. There is also a ferritin type H but I haven't seen this used in labs before (iron is bound to both carrier proteins transferrin or H-ferritin.
Your serum iron is top of range so if T/S% is high also it will mean you will need to stop supplementing iron.
hi radd, thanks very much for your reply. Yes, I’ve usually done iron panels, so I can see the TIBC/UIBC as members on here had explained what to look for with those.
Just couldn’t get results from them this time around for some reason, kept haemolysing so tried this NHS one. I’ve contacted them a couple of times but they don’t seem to be able to answer what H is? Or why it’s given iron as a result and not haemoglobin which is what their test says it will provide.
Could I please ask, in the past I’ve often had good haemoglobin, but even with ferritin reading higher, the TIBC/UIBC have shown I still need supplemental iron. Are you saying with a high transferrin this cannot possibly be the case?
Transferrin is a protein carrier largely produced in the liver that helps regulate the transportation and absorption of iron into the blood. It binds two molecules of iron to transport it to tissues, organs, bone marrow, etc, or into storage attached to ferritin.
When it is high, it can be an indicative that iron levels need raising but this is a very simplistic view as all iron measurements should be viewed together.
Thanksfor your explanation. Oh no, please not an H for Haemolysing!!!ahhh, hadn’t considered that, and they didn’t inform me that that part of the test hadn’t worked, but I will keep asking them!! They requested the vial I did for folate be redone because of haemolysing, so I assume they’d have requested that one too? One can only hope!!
So can I ask, the iron measurement they’ve given me, is that similar to haemoglobin result? As in, I’ve never been low in haemoglobin, but have often been very low in ferritin or as I said, higher in ferritin, but still showing I needed to take iron with other levels within the iron panel.
So really, after 3 months attempting tests and a fair bit of money spent, I’m not much wiser!
Plus, I’ve just read on here that iron tests ideally taken after fasting, mine was just after midday meal so as to have less time in transit, so that may not have helped?
Symptoms are starting to improve on taking iron, so I don’t really know what to do!
This is serum iron, ie how much iron is in your blood, and yes it can elevate straight after an iron rich meal.
Haemoglobin gives RBC's their colour. It contains iron which draws oxygen to be transported to the cells and tissues. Low levels can indicate anaemia and high levels indicative of certain conditions such polycythaemia. I myself have haemochromotosis so a strong interest in the multiple workings of irons mechanisms.
Your serum iron level is a good level but without the rest of the iron panel it is impossible to ascertain if supplementing should be continued.
Thank you, I'd just had beef for lunch! I usually fast for tests,regardless,but due to previous tests haemolysing it'd been suggested I take it later in the day! Oh dear!
I've no idea why they state the results will be given as haemoglobin and provide ranges to check, then give it as iron?
I'll plod on getting to the bottom of H! And back to the drawing board with it all I think!
Thanks for the explanation on haemoglobin.youve obviously spent a lot of time researching, and trying to understand and resolve your own issues,and appreciate you sharing it,thank you.
There are other problems that can give puzzling results.
I had below range iron and low in range ferritin. This should have given me an extremely high TIBC. But it didn't. My TIBC was well below range. My TIBC has been at odds with the rest of my iron-related results for as long as I've been getting iron panels done.
I decided to ignore my TIBC and supplement with iron anyway. My TIBC actually rose with the iron supplementation which, theoretically, is the opposite of what should have happened, but I was happy about it.
I think my family has a genetic problem with iron absorption - anaemia or low iron is an issue for a lot of my close relatives.
Thanks humanbean, It says an H next to both Transferrin and transferrin saturation?
Thanks for the link, will have a read.
Glad you followed your thoughts and managed to raise yours, despite it being different to what thereotically should have happened?!
Can I ask if you’ve had any problems in obtaining iron panel results recently. I never had, but have tried 3 times with my usual, then did a thyroid test with another company I often use, and the ferritin haemolyside within that too.
Have tried the NHS pinprick test this time, but it’s very slow going communication wise!
I’m concerned at overdoing iron, but because the symptoms were fairly severe, I assumed I’d got pretty low in it again, and with periods increasing to twice monthly for few months, thought i would definitely be needing iron, as that’s usually a symptom for me. It usually takes me a long time of supplementation to raise levels. Very strange! Thank you…
I think like radd that the H must be for "haemolysed". There is no result or range so it would seem likely that the test wasn't actually done.
Can I ask if you’ve had any problems in obtaining iron panel results recently.
I haven't had any problems with getting iron panel results recently, but I haven't been doing them as often as I used to. I no longer take iron supplements because a little while ago my ferritin shot up practically overnight to top of range and has been going down very, very slowly ever since.
If you have problems with blood becoming haemolysed for a lot of tests perhaps your technique isn't working well for finger-prick tests? SeasideSusie is our expert on that particular issue. Also there have been quite a few complaints in the last year or so from people that think ferritin results are untrustworthy from some companies. Also, the reference ranges for post-menopausal women have become very weird, and frankly unbelievable very recently.
I sincerely hope its not H for haemolyised:)! I'd have hoped they'd offered me a second chance if thos was thr case,am awaiting a reply again from them,all so longwinded as they can take days it seems.
Strange thing is like ferritin,for instance,didn't work but all the other tests in the same vial did,so surely it was done correctly? I did an active b12 at same time ish,that was fine,it just seems to be iron related ones for me not working,and as I said they've sways fine so in past. But yes,maybe will have to consider private iron panel by vein.
That's strange yours shot up so quickly isn't it,but atvleast you can stop supplementing for a while they're not the greatest supplements to take are they. Thanks,I'll read up SeasideSuzies tips....
In case you can't find them (I don't think I've posted them for a while):
Tips for fingerprick test
* Be well hydrated, drink plenty of water the day before, and before you do the test.
* Some people take a shower before hand, some run up and down the stairs to get blood flowing. Personally, as I can't run up and down the stairs, I circle my arm round, windmill style.
* Have a bowl full of hot water, dip hand in and out, swish around, hand needs to go red. If blood flow stops, you can always swish round in the hot water again.
* Stand up to do the test. Make sure your arm is straight down when collecting the blood. Either use a small step stool to raise yourself well above the work surface, or put the collection tube on a lowish shelf or use an ironing board to get the perfect height.
* Prick finger on the side, not the tip. I find that half way between the nail bed and tip is about right, or maybe slightly nearer the nail bed rather than the tip. Middle finger seems to be best for me, if flow stops I then go on to ring finger.
* Do not squeeze your finger to get the blood out, it can damage the blood and it may not be usable
I've recently done 2 tests. The first one there was very little blood coming out which was unusual for me so I used a second finger and between the two I gradually filled the tube. However, when I checked the prick site for the first finger the actual cut was very small and as I've had some of these lancets fail before I put it down to that. When I did the second test this is what I did
* Prick my finger as usual, at the same time try and make a very slight twist with the lancet (the blade retracts very quickly so you have like a nano second to twist the lancet). I'm not talking 90 degrees or anything, just a very slight twist to make the cut just slightly bigger, it doesn't hurt or cause a blood bath! This made a big difference, 11 generous drops of blood filled the tube in less 2 minutes.
If you supplement with Biotin, or a B complex containing it (B7), leave it off for 7 days before doing any blood tests as it can give false results when biotin is used in the testing procedure, and most labs do use it.
Sometimes the sample has haemolysed, ie the red cells rupture. This may be due to:
* bacteria (so clean area thoroughly and allow to dry)
* intense exercise (so don't go mad trying to get the blood to flow prior to the test)
* squeezing the finger to get the blood out (you can gently "milk" the finger but don't squeeze)
* shaking the tube vigourously instead of gently inverting it.
* sample collection was prolonged
* if there was a long delay between sample collection and analysis
* there is too little blood in the tube and too much coagulant for the amount of blood
Thanks so much for giving me all this info SeasideSusie, much appreciated.
I’ve been through them all and to be honest, don’t know what I can improve on. Like you I drink plenty, windmill my arms, moved my hands in bowl of warm water for couple minutes beforehand so they were red, prick that same part, stand up, etc. I do have a bit of trouble catching it in the vial, so wouldn’t have thought of the ironing board idea thanks! I tend to hold the vial, arms length, under the finger.
Yes, I was like you recently, found that two fingers, nothing wanted to come out, so then gave the next lancets a harder old press, then I could fill it quicker than I could catch it😀
I do wonder how long to keep getting it from a fingertip before I stop, I worry it will clot if it starts to slow down, so would try another finger then. Maybe I’m doing that wrong?
I’ve tried hard not to keep scraping it in, and let it drop. I do the tests late afternoon now, pay for delivery by 1, but on most occasions, good old RM has had them there at 7.30am! To be fair, the folate result gave a fail, back to me by 5.30, the day the blood arrived there. So I’m assuming they tested the other vial at similar time? The b12 and iron got a result from that vial, so wouldn’t you tend to think the others should too?
That seems odd to me recently, all the thyroid, vit d, etc could be read from another pinprick I did, but not the ferritin.
I did a separate activeb12 another time, that was fine. Just these iron related ones?
I had high hopes it had worked this time when they only mentioned redoing the folate vial, but seems things are turning out otherwise!
'I decided to ignore my TIBC and supplement with iron anyway. My TIBC actually rose with the iron supplementation which, theoretically, is the opposite of what should have happened, but I was happy about it.'
It should increase as should correlate with serum iron levels to bind and transport that exact amount (with spare going into ferritin storage). Your body will increase transferrin to prevent the iron you supplemented from being free. This is a healthy reaction.
You are right that transferrin elevates in the presence of low iron but only as an encourager for the body to absorb more iron (like an invitation). This is because as said iron and transferrin should correlate to prevent free iron.
Go back to the low transferrins we have discussed numerous times and the anaemia of chronic disease (inflammation). This is when the body won't absorb iron because there is insufficient transferrin to bind it, It's a safety mechanism.
radd and humanbean, you were right! they’ve mailed to say it was H for haemolised!! And going to look into why no haemoglobin result! And as to why I wasn’t sent another vial to retry I guess! Doh!
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