Could I have help please with these results for my daughter?
What does the overall pattern seem to suggest?
Iron -good and no need to supplement?
TIBC and UIBC are a bit alarming, but that may be because I don't understand the implications.
Transferrin Saturation - seems high?
Ferritin
Feb 23 Blue Horizon blood test 66.7(13-150 ug/L)
May 23 GP blood test 29 (15-300 ug/L*) - deficient?
May 23 Medichecks 58.2 ug/L (13-150 ug/L) - not particularly low in range - but lower than first test.
*I believe this is the old measurement and NICE guidelines now (since 2021) state 30-300 range. She is low in Ferritin according to the new range.
I am confused as to how to interpret her ferritin. Is it low or ok? My husband tells me that if the ranges are very different as they are here, you will not be able to calculate a percentage through the range. Is this correct?
Supplements
My daughter has been supplementing according to the suggestions here for about 2.5 months. Here is what she has been taking for the last 6 weeks:
Methylfolate - 1600mcg (since her initial folate test was very low at 8.81 (8.83-60 nmol/L)
Methyl B12 - 500mcg (as part of b complex)
Vit D - 10 000 IU (since initial result was 38 nmol/L)
Magnesium elemental - 200mg
Vit K M7 twice weekly - 100mcg
She will have new thyroid and vitamin results hopefully by the end of next week (first test since starting to supplement).
Which symptoms would someone be likely to have with the low TIBC and UIBC?
She has a GP appointment at the end of June, I think I will send in a copy of the iron results by post as I think they need to see it?
She has a comprehensive set of bloods from GP taken two weeks ago if that will help the picture, but I didn't want to overload with info - there is already a lot!
Thank you very much.
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Sneedle
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Iron is complicated, as are the different ranges. I don't believe you can compare the results if you use a different lab with a different range so you can't really compare the ones with the 13-150 range with the GP one with the 15-300 range.
With the Blue Horizon and the Medichecks ones, were both tests processed by County Pathology? If so they ought to be comparable.
*I believe this is the old measurement and NICE guidelines now (since 2021) state 30-300 range. She is low in Ferritin according to the new range.
You have to use the range that comes with the result, you can't take her latest result from Medichecks and use the range NICE is quoting.
If Medichecks had sent the test to INUVI to process they use the following ranges:
Males: 16-60: 30-400 ug/L
Females: 16-60: 30-150
Both over 60: 30-650
I tend to stick to Medichecks now and do the full iron panel.
Serum iron: This test measures the amount of iron in your blood.
Serum ferritin: This test measures how much iron is stored in your body. When your iron level is low, your body will pull iron out of “storage” to use.
Total iron-binding capacity (TIBC): This test tells how much transferrin (a protein) is free to carry iron through your blood. If your TIBC level is high, it means more transferrin is free because you have low iron.
Unsaturated iron-binding capacity (UIBC): This test measures how much transferrin isn’t attached to iron.
Transferrin saturation: This test measures the percentage of transferrin that is attached to iron.
I tend to take more notice of serum iron and saturation when I do my iron panel.
Interpreting her Medichecks iron panel results, optimal iron panel levels according to rt3-adrenals.org/Iron_test_... are:
Serum iron: 55 to 70% of the range, higher end for men - hers is 54.70% through range so that's pretty good.
Saturation: optimal is 35 to 45%, higher end for men - hers is 47.9% so on the higher side.
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 - hers is bottom of range.
So those three results show she doesn't have iron deficiency and don't suggest supplementing, if she took iron tablets then her serum iron and saturation would very likely rise too high and could lead to toxicity.
Her current ferritin level of 58.2 is on the low side, some experts say the optimal ferritin level for thyroid function is 90-110ug/L, some say it should be half way through range - personally I'd aim for the 90-110ug/L and be happy with that as long as CRP is nice and low (ferritin rises with inflammation and CRP is an inflammation marker). What was the CRP result that came with this test?
She can help raise her level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Vit D - 10 000 IU (since initial result was 38 nmol/L)
Magnesium elemental - 200mg
Vit K M7 twice weekly - 100mcg
Is she taking the 10,000iu Vit D every day? If so she should be taking the Vit K2-MK7 every day too, it's 90-110mcg for up to 10,000iu D3. Presumably the magnesium is daily?
With her GP tests, are any borderline or out of range?
The iron test was done by County so Ferritin is the same test and range as BH. ie a reliable comparison.
You have to use the range that comes with the result, you can't take her latest result from Medichecks and use the range NICE is quoting.
What I was trying to say (not very clearly!) is that she has two very different results.
Medichecks with reasonable levels of 55 and 66. As you point out this could be higher (she isn't diagnosed UAT as yet).
NHS GP lab which indicates by its own guidelines (the NICE bit) that she is just under the lower end of the range at 29 ( NICE range changed in 2021 to 30-300). However - the GP test result has not been updated to the new NICE range and is still at 15-300. Elsewhere on the forum I think SlowDragon may have mentioned this but I can't find the post right now.
So the upshot is that the Medichecks result indicates a reasonable level and definitely no deficiency, whereas the NHS lab result indicates a deficiency. Regardless of ranges these are two completely different results.
I'm open to views!
Which leads on to increasing ferritin - iron is indeed really complicated! You're suggesting my daughter needs to increase her ferritin, but will this not send iron level upwards which I think she doesn't need to do? Does eating liver etc increase the iron level, or only the ferritin level?
Re low TIBC and UIBC I've checked a DNA test she had and she doesn't have the mutation for haemochromatosis/iron overload which is good to know.
But in this case then, is there any reason for concern about these out of range results?
Her CRP is 0.3 mg/L in range of 0-5.
Vit D etc - yes vits are daily apart from K, I will look increasing K but am wondering about blood clotting - we could hardly get any blood out of three fingers for the test which was worse than the last time when it was also difficult.
GP other blood tests - all were with range but some were bottom of range:
Liver Function
Serum Globulin 23 (22-43g/L)
Serum alkaline phosphatase 55 (54-143u/L)
These two also came up in the Bone Profile, I don;t know if that means anything.
I think that's everything let me know if things aren't clear!
What I was trying to say (not very clearly!) is that she has two very different results.
Medichecks with reasonable levels of 55 and 66. As you point out this could be higher (she isn't diagnosed UAT as yet).
NHS GP lab which indicates by its own guidelines (the NICE bit) that she is just under the lower end of the range at 29 ( NICE range changed in 2021 to 30-300). However - the GP test result has not been updated to the new NICE range and is still at 15-300
Yes, I get what you're saying (I'll mention below my experience with NHS v Medichecks).
Each lab has their own range which, as we can see from Medichecks, INUVI, NHS, and NICE guidelines. Even though NICE has announced their new range it doesn't mean that every lab has changed theirs, recalibrated their testing equipment, etc, so as far as I'm concerned we just use the range that comes with the result as that is what that particular lab is using at that time.
I don't think there will ever be a standard range for ferritin. At the moment there is a different range for males and females and for pre and post menopausal females with some labs yet my NHS range, like yours, is 15-300 for everyone regardless of sex or age. It does make you wonder how can that be.
Feb 23 Blue Horizon blood test 66.7 (13-150 ug/L)
May 23 GP blood test 29 (15-300 ug/L*) - deficient?
So the above shows the difference between Blue Horizon (County Pathology) and your GP. Below are my results from tests done 4 days apart:
Medichecks (County Pathology): 73.8 (13-150)
GP: 49 (15-300)
So like your daughter's a much lower GP result that has a wider range, and a higher County Pathology result with a narrower range. It doesn't make much sense.
I remember one of our members took this up with Medichecks because she had the same problem, this is one of the posts she made about it (there are others, there were two private labs and NHS lab being compared so it became quite involved).
and note in particular in their reply Medichecks say
In summary ferritin is one of the results which varies quite widely when we try to compare results between laboratories, and so it is important to be consistent and rely on results from one laboratory when you are tracking results over time.
This is what I now do, I just use Medichecks (CP) for my iron panel and even though ferritin is rarely tested by my GP I would disregard it.
I would also say that ferritin and iron can be influenced by things we don't realise. My ferritin level has been very high recently, firstly with a serious illness at the beginning of the year and latterly with a bad case of Covid. When I had Covid I was given Co-Codamol, second time of using this and both times I've used it I noticed that my serum iron and saturation levels fell. Looking into this I discovered that the body converts the codeine contained in Co-Codamol to morphine and morphine affects iron levels. So currently my iron and saturation are trashed and I have to now work on building those both back up again to what is my usual reasonably good levels yet my ferritin is still raised due to my recent illnesses and this false raised ferritin is borne out by my still high CRP caused by said illnesses.
[Apparently penicillin can also lower iron levels so it makes you wonder what else affects them.]
As your daughter's CRP result was 0.3 (<5) then there is no evidence of inflammation so her ferritin is not falsely raised, it would be a true measure of her normal level.
You're suggesting my daughter needs to increase her ferritin, but will this not send iron level upwards which I think she doesn't need to do? Does eating liver etc increase the iron level, or only the ferritin level?
When I had reasonably good iron/saturation levels and low ferritin I ate liver regularly, my ferritin level slowly improved but it made very little difference to serum iron and saturation. That was my experience, I can't vouch for anyone else.
Re low TIBC and UIBC I've checked a DNA test she had and she doesn't have the mutation for haemochromatosis/iron overload which is good to know.
But in this case then, is there any reason for concern about these out of range results?
I haven't done any further research into these two tests other than that quoted in my reply above.
Vit D etc - yes vits are daily apart from K, I will look increasing K but am wondering about blood clotting - we could hardly get any blood out of three fingers for the test which was worse than the last time when it was also difficult.
There are two types of Vit K - K1 and K2. Vit K1 is the blood clotting form which is given to new born babies to prevent a now rare bleeding disorder called 'vitamin K deficiency bleeding' (or 'haemorrhagic disease of the newborn'.)
Vit K2 is the form that directs calcium to bones and teeth and away from soft tissues and arteries
Some articles say that K2 aids blood clotting, some say it's only K1. If you are concerned then maybe do further research.
I can't comment on the liver test results, it's not something I've looked into but Labtestsonline is good for finding out about different tests. Here is the page for liver functon tests, click on all the + signs for detailed information
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