Vit D not done. I see Tesco are offering cheap tests for various vits. Thoughts ?
I am housebound so I take vit D. 25 ug daily. Also omega 3 fish oil and a multivitamin.
I was reading about dietary iron. One suggestion was to cook in a cast iron pan !
I’m confused about some foods which appear to be both high in iron but also inhibit iron absorption. Things like broccoli and nuts. Are they recommended or not ?
My diet is extremely high in dairy. I really depend on it as I find I can’t eat much meat. I wonder if part of the answer would be to take Pepsin or other digestive aids ? Perhaps that would enable me to eat more normally ?
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no reference ranges were given for any of these. These are bloods which my GP did at my request. She added them to my usual annual tests which I believe include an anaemia check : I will have to fillet out the iron panel results.
When I rang for results I was told that the only abnormal results were prediabetes as before and there was no action to be taken. So no, no treatment and not even picked up on my “ low iron stores “ as explicitly stated on the printout.
Folate range is sometimes 3-20 but can also be 8-60
You are legally entitled to printed copies of your blood test results and ranges.
Suggest you find out the range …..before making an appointment with GP
If folate is below range they should prescribe, though it will only be folic acid
If it’s within range down to you to self supplement
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Post discussing how biotin can affect test results
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
( In non-pregnant women aged over 15 years — Hb below 120 g/L. )
Mean CORPUSCULAR volume ( MCV ) 87.4 fL
( An MCV less than 95 femtolitres has a sensitivity of 97.6% for iron deficiency anaemia. )
To me this looks like haemoglobin is just above anaemia, but MCV level indicates anaemia ? It seems very complicated to the novice.
The medichecks test you link to seems to list tests that are different from the NICE formula above. Unless they are different names for the same thing ?
Are they different tests which I need to do in addition to haemoglobin and MCV ? Now or as monitoring while on supplements ?
( In non-pregnant women aged over 15 years — Hb below 120 g/L. )
To me this looks like haemoglobin is just above anaemia
My surgery has a range of 115-165 for haemoglobin estimation and a quick Google of some NHS hospital ranges give 120-160 and 120-150 as well as the same range as my surgery. If your range is similar then your result wouldn't be classed as "just above anaemia", it would be fine.
As for MCV, my surgery's range is 80-100 and again looking on Google for NHS hospital ranges 80-100 seems very common with the occasional 83-101. Your level of 87.4 again doesn't suggest anaemia if your range is similar.
Your folate is low at 4ug/L but doesn't confirm folate deficiency (also called folate deficiency anaemia) but does come within the "indeterminate" zone. According to
◦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.
I believe MCV is generally high or borderline high with folate deficiency anaemia.
An iron panel would determine if you have iron deficiency, and you can have iron deficiency with or without anaemia.I believe MCV would be low with iron deficiency anaemia.
Tests included in an iron panel to see if you have iron deficiency (but doesn't show if anaemia is present) are:
Serum iron
Transferrin saturation percentage
Total Iron Binding Capacity (or Transferrin)
Ferritin
You can have low ferritin without iron deficiency.
You shouldn't take iron supplements without doing an iron panel. This is because if you have good levels of serum iron and saturation percentage then taking iron tablets could take these over range and lead to toxicity or iron overload. If you have low ferritin without iron deficiency then it's suggested to try and raise ferritin through diet.
I need to test Vit D, so I will do a fingerprick for that and the four-iron panel you recommend.
I’m starting to wonder whether I should be testing for other nutritional issues too, just because I feel like my absorption may be poor in general. I feel really gutted that my ferritin must have been getting lower and lower while I imagined everything was ok. I often can’t eat meat and rely on dairy, but I was taking a supermarket multivitamin and I thought I’d ‘got away with it’. Now I find out that the calcium in that pill would cancel out the iron - and that my diet is basically Kryptonite for iron ! I’m obviously changing how I eat now.
My GP blood tests arrive as a printout without ranges ( apart from the odd result like cholesterol or diabetes which has a load of explanation attached. ) Do yours arrive with ranges or do you have to chase these ?
The GP receptionist just declined to give me any reference ranges so I have a phone appointment this afternoon with the GP. I sort of expected this !
Is the four iron panel you refer to something that the GP will routinely do with low ferritin ? If so I might try again to get that Vit D done with the GP too.
Is the four iron panel you refer to something that the GP will routinely do with low ferritin ?
Possibly not but may depend on your GP. When my ferritin was 39 with a GP test they didn't see a problem 🙄 let alone consider further testing.
The GP receptionist just declined to give me any reference ranges so I have a phone appointment this afternoon with the GP. I sort of expected this !
Ah, she has a god complex then and is wielding her power over you, good grief what's the matter with her! In the UK we are legally entitled to our results with ranges, results are meaningless without them. Hopefully the GP will be more amenable but if you have any further problems remind them that the law allows you to have them and put in a Subject Access Request which can be in writing or a verbal request is supposed to be enough but in writing is probably better (take a letter with you and be ready!) but they do have 30 days to respond.
The results thing is so silly. They have got some much more helpful receptionists down there now especially on the admin requests but I think if ‘computer says no’ etc haha !
So when your ferritin was 39 did they not test further because you were supposedly fine, or not test further and put you straight on iron tablets ?
I’m guessing the former. So I will need to make the case for a full iron panel, eg saying I don’t eat much meat , and symptoms …?. Not sure if saying ferritin at 100 is recommended by Thyroid UK will help or not !?
So when your ferritin was 39 did they not test further because you were supposedly fine, or not test further and put you straight on iron tablets ?
I can't remember why ferritin was tested as it's not something routinely done at my surgery. Anyway I pointed out that I was surprised that my level was 39 as it was previously 119 (I was already privately testing and the 119 was the result of a private test but I didn't mention that). So when I said that I was offered iron tablets which I declined and said I would try raising it by eating liver and they were happy to leave it at that. If I hadn't mentioned the previous level of 119 they would have been more than happy to leave things as they were as my result was in range therefore it was perfect 🙄.
Sorry to keep coming back on this one - I’m basically trying to work out whether the GP will agree with the advice on here NOT to begin iron tablets until the four iron panel has been done ?
Edit - sounds like your GP wanted to put you on iron tablets without further four iron testing ? End edit
Why didn’t you want to take iron ? I’d assume that would be the fastest way of raising ferritin along with diet.
sounds like your GP wanted to put you on iron tablets without further four iron testing ?
Yes, that's correct.
Why didn’t you want to take iron ? I’d assume that would be the fastest way of raising ferritin along with diet.
But did I need to raise my ferritin level?
Because I was already doing private tests which included the iron panel I knew that my private test 8 days before showed a ferritin level of 119 so there's no way on earth that a ferritin level would drop from 119 to 39 in that short amount of time. This does bring into question the disparity between ferritin results from different labs which has been discussed on the forum recently.
Also, my private test showed serum iron at 45%, saturation at 27.5%, both slightly lower than optimal but certainly not bad, and TIBC which was 41% through range so towards the lower end of it's range which suggests no supplementation needed.
Oh, your 119 was only 8 days prior ! Yeah, it does rather call into question which results to trust.
I think I will get some rest now before my phone call later and mull this over. And I will quit bombarding you with questions ! I really appreciate your input on this.
I’ll come back maybe tomorrow with the results of the GP appt.
Sorry to hear about you being housebound to low health. Can you pls further explain your difficulty in digesting meat? I've read that white meats(chicken, fish ) are more easily digestible. Maybe you can try ground chicken breasts. My doctor frequently mentions hcl, ox bile and digestive enzymes to help with digestion. Another option is taking apple cider vinegar with the mother. Avoid this if you have an active ulcer or gastritis.
Have you ever been tested for sibo? H plyori? Gut dysbiosis?
Are you on iron pills? If not , maybe you can combine heme iron with iron bisglycinate to help raise your levels
I had a quick look at your other posts and I think I will need to look into the digestive stuff a lot more in future.
First things first is to post about my GP appt and sort out more tests for iron etc. I will defo read over your iron thread as this is my first iron panel too !
I tend to find that when I have overall low energy, that’s when my appetite for meat goes. The thing I live on is milk , yoghurt and cheese. ‘Next one up’ is eggs and then pork sausages (which maybe you don’t eat ? ). I have to be feeling pretty energetic to face beef. Chicken is somewhere in the middle but maybe it doesn’t help that much with iron. Luckily I do like black pudding !
I’m glad you asked me about it because it reminds me that I actually have a problem with my digestive system. It’s easy to lose sight of this when you live alone because I can eat what I like, when I like. I also eat little and often.
Forgive me as I can’t chat back and forth at the moment as my energy is quite low and I need to reply to Susie above and get some tests sorted. I will definitely look into the issues you’ve raised - thanks for that .
No need to apologize for not having enough energy to reply back. I've been there and still have those days with my untreated sleep apnea. You are quite right in that I don't eat pork due to religious reasons. I've made an exception with my NDT med (Erfa) which is allowed for medical reasons.
Seems like you're on the right track since you're looking into testing etc. Wishing you all the best on your journey
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