Hi Could anyone give me some clarity on my anaemia test results received today. Test was done by Monitor My Health but no reference ranges included so all components just say "normal" which is very uninformative and irritating. I know from this forum results need to be optimal.
Results:
Haemoglobin 128g/L
Ferritin 70 ug/L
TSats 18%
Active B12 44pmol/L
Folate 3.2 ug/L
I had previously had a ferritin test done by medichecks on 5th June (bit of accidental overlapping of tests)
but I did note that medichecks ferritin result was 85.9ug/L which is quite a bit higher than today's result from Monitor my Health. ( Only 10 days between tests)
Both tests were done under same conditions i.e. fasting at 8am. Im a bit concerned about this result. Any guidance would be much appreciated
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I've done this test and the ranges are there. You just have to look at the coloured graph, there are numbers on the left hand side, you look at the bottom and top numbers of the green band and that is the range.
Haemoglobin 128g/L (125-270 is showing on the green part of the graph)
Your HB is within range but at the low end.
Ferritin 70 ug/L (approx 15 to approx 410 is showing)
Interpreting ferritin is difficult. Firstly it's best to have an inflammation marker (eg CRP) done at the same time. If CRP is raised then that means you have some inflammation, and ferritin rises with inflammation. So we don't know, because no CRP was done, if yours is a true measure or if it's elevated due to inflammation.
Some experts say the optimal ferritin level for thyroid function is 90-110ug/L.
but I did note that medichecks ferritin result was 85.9ug/L which is quite a bit higher than today's result from Monitor my Health. ( Only 10 days between tests)
Ferritin tests from different labs can't be compared. A couple of members have had disparity between Medichecks ferritin result and another lab or GP test and this has been brought up with Medichecks before but no satisfactory answer has been received. Check out this post and the links within it to see previous queries about ferritin test differences
According to rt3-adrenals.org/Iron_test_... the optimal level for Saturation is 35-45% (higher end for males) so yours is low.
This suggests that getting a full iron panel to include serum iron, saturation, total iron binding capacity and ferritin plus CRP should be carried out to see if you have iron deficiency. A full blood count would also be useful as this would show if you have anaemia (you can have iron deficiency with or without anaemia). Your HB with this test is just within range but close enough to the bottom to check other parts of a full blood count. Your GP might do FBC and iron panel, if he wont then Medichecks do a home iron test (£49) which is the iron panel.
Active B12 44pmol/L (40-210 is showing)
This is a poor result. Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency and it is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.
Folate 3.2 ug/L (looks like approx 3.5 to approx 20)
This is likely to be folate deficiency or suggestive of it according to NICE, SEE
◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.
◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.
You should see your GP about this as well as B12.
No folate supplement/folic acid should be started before B12 injections or supplementation. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency and it is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.
These poor nutrient levels are often seen when Hashimoto's is present. I see from your first post on the forum that you do indeed have Hashi's according to your TPO antibody result
Thanks for your replies. I've just had a medichecks iron test come through literally 2 mins ago ( I know more overlapping tests....have made quite a few mistakes with ordering tests)
Medichecks result:
CRP 0.55mg/L (0-5)
Iron 17.1umol/L (5.8-34.5)
TIBC 61.1umol/L (45-81)
TransferrinSats 28%
Ferritin 70.2 ug/L
(Even ferritin level this time is different from level on 5th June with medichecks????)
Previous b12 on 5th June with medichecks was 48.1pmol/L (37.5-150)
No folate done then
Mum had pernicious anaemia and was on b12 injections
There is little difference in your B12 level, probably just natural fluctuation with such a minimal difference, so it shows your level is poor. If mum had PA then definitely push to get tested for that and definitely get started on injections (or supplements) before starting folic acid or folate supplement.
I really wouldn't compare results from two different labs. Different testing machines, calibrated differently, there's always going to be some difference, so let's look at your iron panel from Medichecks and I think the lab this time was County Pathology.
CRP 0.55mg/L (0-5)
No inflammation so that's good and tells us that your ferritin result will be a true measure.
Iron 17.1umol/L (5.8-34.5)
TIBC 61.1umol/L (45-81)
TransferrinSats 28% (20-50)
Ferritin 70.2 ug/L (13-150)
I do this test so have added the ranges for Saturation and Ferritin.
Serum iron: 55 to 70% of the range, higher end for men - yours is 39.37%
Saturation: optimal is 35 to 45%, higher end for men - yours is 28%.
Total Iron Binding Capacity (TIBC) Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 44.44% so fairly close to mid range, neither high nor low.
Your serum iron and saturation are on the lowish side, certainly not iron deficiency. Your ferritin isn't too bad but as mentioned above optimal is said by some experts to be 90-110ug/L. It's difficult because ferritin would benefit from increasing and serum iron and saturation fall short of optimal but don't scream out that iron supplements are needed.
I suppose what you could do, and this would be your decision, I'm not telling you that you should do it, is perhaps have a course of iron, something like Gentle Iron which is usually about 20mg elemental iron per capsule. Maybe finish one bottle then repeat the iron panel, you just want to boost your levels not take them to the top of the range, optimal levels are given above.
When I've needed to give mine a boost this is the one I use:
The rose hips provide some Vit C to help absorption but it wouldn't hurt to take more Vit C with them.
Alternatively, lots of iron rich foods such as 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
Thank you so much SeasideSusie for your very helpful info. I will order that iron supplement.I'm just so eager to get my vits sorted out as I have a first private endocrinologist appt on 14th July so want to go prepared and get as much as possible out my appt. He has excellent reviews and apparently treats patients and their symptoms rather than relying on blood results which is reassuring
Thank you so much Slowdragon...yes definitely going to chase up the b12 + folate with GP. I certainly do have alot of the symptoms of PAThis forum has been a godsend for me.
If I started supplementing with iron would it skew further GP testing for B12 and folate or should I hold off on the iron until GP does further bloods for PA?
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