Advice on Medichecks and GP iron results please

[Eton]

On 21st June I had some tests done by GP early morning and fasting. Results were:

IRON = 13 umol/l (6-35)

SERUM TRANSFERRIN =2.52g/l (2-3.6)

TRANSFERRIN SATURATION= 21% No range given

FERRITIN = 69ug/l (13-150 or 13-300 if post meno) I am past meno

My GP said I would benefit from iron supplements but before I started supplements I completed an iron panel test (on 4 July) which I had already bought. The results are very different to the GP results. The Medichecks test however was done at 4pm but all I had eaten that day was porridge with milk and Tea.

IRON = 22.4 (5.8-34.5)

TIBC = 54.9 (45-81)

UIBC = 32.5 (24.2-70.1)

TRANSFERRIN SATURATION =40.8% (20-50)

FERRITIN = 89.3 (13-150)

Can anyone( @HumanBean @SeasideSusie )advise on why the results are so differnet and whether I should take the iron supplements recommended by GP. She has asked me to retest in 3 months.

Many thanks.

[StPetes]

Iron management is difficult Eton. I'll be interested to find out what suggestions and advice come in for you. Have you been particularly tired lately or have you had any new symptoms ?

[Eton in reply to StPetes]

No new symptoms recently but I have been tired for last15 years! I think that's when my thyroid problems probably began but I knew nothing about them for many years as Gp always said all was good.... And I hadn't the knowledge to say otherwise at that time. More on my profileNo replies yet unfortunately. I expect people are busy watching Wimbledon!

[SeasideSusie Remembering]

Can anyone( @HumanBean @SeasideSusie )advise on why the results are so differnet

This is because basically you can't compare iron tests done by different labs. There have been posts on the forum before about the disparity between NHS and private lab results for iron tests and one member took this up with Medichecks. You can read about it in this post (and follow any links to other posts)

healthunlocked.com/thyroidu...

Optimal levels for an iron panel according to rt3-adrenals.org/Iron_test_... are:

Serum iron

• 55 to 70% of the range

• higher end for men

TIBC (total iron binding capacity) or Transferrin

• Low in range indicates lack of capacity for additional iron

• High in range indicates body's need for supplemental iron

Saturation

• optimal is 35 to 45%

• higher end for men

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

Some experts say the optimal ferritin level for thyroid function is 90-110ug/L.

Your Medichecks results do not show the need for iron supplements.

[Eton in reply to SeasideSusie]

Thank you Seaside Susie. I will check previous posts. Take care.

[Spangle15]

I had exactly the same thing recently:

NHS test -

ferritin - 37

iron - 28.5(5.8-34.5)

transferrin saturation - 44%

Medichecks -

ferritin - 45.4

Iron - 38.2 (10-30)

transferring saturation - 65.74%

This is not the first time that they have been different but this is the first time I have retested within a matter of a couple of weeks. The same protocol was followed for each.

I am inclined to trust the NHS results as I wonder if a finger prick test can be contaminated possibly or the way they are taken can damage red blood cells

[Eton in reply to Spangle15]

I think I will go with the NHS tests also. Thank you for your reply.

[SeasideSusie Remembering in reply to Spangle15]

I wonder if a finger prick test can be contaminated possibly or the way they are taken can damage red blood cells

Yes, things can go wrong with fingerprick tests which is why it's important to follow guidance when doing them as the blood can haemolyse or be spoiled in different ways including

* 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) - this will damage the blood cells

* 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

Even the HCAs or nurses at our surgery don't follow the old protocol for venous blood collection any more. The area is not cleaned at all, needle straight into the vein so if there's any bacteria on the skin this may contaminate the sample, whereas it always used to be cleaned with an alcohol wipe to ensure the area was sterile. I mentioned this once to the HCA about cleaning the area and she just wiped it with a dry cotton ball, not sure how that makes the area sterile 🤷‍♀️ so I take my own alcohol wipes now, last time I did this I was told I could ask them the clean it with one of their wipes (but they don't do it automatically). When I was in hospital for surgery recently, a doctor took blood and spent quite a long time thoroughly cleaning the area around where the needle was to be inserted which made me wonder why doctors do it in hospital but the HCAs or nurses don't at the surgery.

Also, at the surgery and in hospital they tend to use a tourniquet all the time yet there are some tests where a tourniquet shouldn't be used. I had a bone profile blood test the other day and the nurse used a tourniquet and I checked when I got home and it's one of the tests where you shouldn't in order to get accurate assessment of calcium and proteins. They don't need a tourniquet to find my vein, mine are very easy to see!

[Spangle15 in reply to SeasideSusie]

Yes, that's true, I have noticed they don't clean at the surgery anymore. I am going to ask them next time. Also I regularly have bone profile tests done and they always use a tourniquet, mind you my veins are tricky so I'm not sure of a way round that.

[SeasideSusie Remembering in reply to Spangle15]

When I read about it apparently using a tourniquet can raise calcium level (not sure about the proteins). With a bone profile test one would assume that the calcium level is important and needs to be accurate!