I recently got a bunch of lab tests done by a functional medicine doctor. I thought I had too much iron. My UIBC was lab low at 91(range 131-425), my iron was lab high at 204(range 27-159), and iron saturation was lab high at 69%(range 15-55%).But ferritin was somewhat low, though not lab low. It was 44 with a range of 15-150. The doctor said he wants menstruating women, which I am, to be at least 50ng/mL, which I'm not.
Any thoughts about how my iron levels can be both high and low?
will flag this for humanbean to comment on
Iron and ferritin are complex
If iron is high but ferritin is low you can’t take iron supplements
You can only help improve ferritin levels by increasing iron rich foods in your diet
What’s your diet like
Have you tested TSH, Ft4 and Ft3 recently
Or vitamin D, folate and B12
See from previous post you’re in USA
(please add country on your profile)
healthunlocked.com/thyroidu...
I am currently, grain, dairy, and soy free. I have been eating this way for 2-3 months.My thyroid levels were tested at the same time as my iron levels. TSH was 2.1; FT4 was 1.38; FT3 was 2.7
Vitamin D was 64.1. I am currently on a high dose of sublingual vitamin D to keep it in range. Folate was not tested. Vitamin B12 should be in range - I take massive amounts of B12 as part of another supplement the doctor recommended
TSH was 2.1;
FT4 was 1.38;
FT3 was 2.7
Please add ranges on these results
Vitamin D is unit of measurement ng/mL or nmol
Exactly what vitamin supplements are you taking
TSH = 2.1uIU/mL (range 0.45-4.5)
FT4=1.38ng/dL (range 0.82-1.77)
FT3=2.7pg/mL (range 2-4.4)
Vitamin D= 64.1ng/mL (range 30-100)
I had been taking an adaptogen herbal supplement with vitamin C, asian ginseng, ashwagandha, holy basil, rhodiola, eleuthero, pantethine, boerhavia, peptidase, and betaine HCI
Also a vitamin supplement with vitamin A (50mcg), vitamin C (150mg), vitamin D (200IU), Vitamin E (30IU), Vitamin K (5mcg), thiamin (15mg), riboflavin (10mg), Niacin (25 mg NE), B6 (5mg), Folate (400mcg DFE), B12 (100 mcg), pantiothenic acid (25mg), choline (25mg), magnesium (35mg), zinc (5mg), copper (0.5mg), manganese (5mg).
I was taking 6 times the serving size per day (2 capsules every meal) so every ingredient amount listed times 6.
FT4: 1.38 pmol/l (Range 0.82 - 1.77)
Ft4 58.95% through range
FT3: 2.7 pmol/l (Range 2 - 4.4)
Ft3 only 29.17% through range
Helpful calculator for working out percentage through range
I was taking 6 times the serving size per day (2 capsules every meal) so every ingredient amount listed times 6.
Why ? ….That would be very high dose vitamin A
Copper and zinc should be tested before supplementing
CraftyGamer19,
‘Any thoughts about how my iron levels can be both high and low?’
A common reason on the forum is chronic inflammation caused by factors such as Hashi antibodies, poor gut health, being over weight, etc.
Iron is intrinsically connected to the immune system and inflammation can impair how iron works by reducing iron transporters proteins (transferrin). When full blown this presents as anaemia of chronic inflammation/disease but can occur in many different stages.
UIBC refers to the amount of unbound iron you have. Yours is under-range which has allowed too much free iron seen as over-range serum iron. This is the reverse to TIBC that refers to the amount bound and being carried around the body. These measurements have to be looked at in context with other iron measurements.
You have enough iron in your blood stream but are also low in ferritin which is another protein for iron storage. It is commonly known to elevate as part of a healthy immune response to infections or a cut (to withhold iron from feeding pathogens) but again can be negatively influenced by chronic inflammation. Many members on the forum find it difficult to raise their ferritin levels.
Low ferritin can be viewed as a strong indicator of iron deficiency even in the presence of high serum iron levels. This is because serum iron can be so variable, it is difficult to maintain adequate ongoing levels on a day to day basis, eg as soon as iron consumption drops, there are no reserves to draw from.
However, until iron mechanisms are encouraged to work better, you can not supplement iron as this risks taking serum iron levels even higher.
What are you RBC’s looking like?
My RBC was 4.33x10e6/uL (range 3.77-5.28)
Oh good, so you are not anaemic yet.
I am in a similar position. I managed to raise my ferritin from 25 to 71 but kept my iron at the top of range but no higher. I eat chicken liver once a week (ugh) and sometimes one sachet of Spatone (with vit c powder to aid absorption).
First of all, I'm not a doctor.
However...
With an iron saturation of 69%, you should exclude the possibility of haemochromatosis which you can have even with in range ferritin. Not sure how that squares with a low UIBC though.
I have had the same issue - ferritin was as low as 7 but haemoglobin at top of normal range. I had private infusion - my haemotologist disagrees that you can’t have iron supplementation (oral or intravenous) in this situation.
The outcome was my ferritin has gone up to a good level and my haemoglobin has fallen slightly. I’m very happy with the outcome and feeling much better. My ferritin is likely to drop again as I still have heavy regular periods (even at 52) so the advice I have been given is to supplement via one ferrous fumarate tab every second day when that happens. Regular bloods to check levels are a bit of a pain but so be it!
The diet approach did not work for me btw.
csj113,
Interesting, so was your serum iron low?
Serum iron is always at top of range even when ferritin v low - unchanged after infusion.
csj113,
So you had an iron transfusion when serum iron and haemoglobin were top of range, you were not anaemic but ferritin was low.
They usually advise against it as there’s no guarantee that serum iron wouldn’t raise further annd become toxic. When we receive or accumulate too much iron, the body has no way to rid itself of excess which then settles in body tissues causing damage.
Anyway, I’m pleased it worked for you. Perhaps hemo knows some new research available because you went private. Did he provide any new data for this protocol?
Who usually advises against it? The clinic I went to is currently conducting research (incidentally the medics there work primarily in NHS). Will be published in due course but their belief is the body will top up ferritin if it’s sufficiently low and protective mechanisms will prevent iron going over range. That was certainly borne out in my case - in fact haemoglobin and iron fell slightly. I was pretty unwell with ferritin 7.
I was not anaemic but I was iron deficient - diagnosis was IDWA
Also, there are some published studies - here is one as an example. Note no change in haemoglobin in the study group.
doi.org/10.1182/blood-2011-...
csj113,
Thank you, I will have a read. The mechanisms of iron are so immensely complex, it is an interesting subject.
Can I ask if you are slim?
One cause (of several possibilities) of high iron and low ferritin occurring together is an MTHFR gene problem. It's very common - about 50% of the world's population has a less than optimal version of the MTHFR gene. In this situation someone taking iron supplements will end up with iron getting even higher than before and ferritin hardly changing.
The main problem with having a dodgy MTHFR gene is that it affects methylation. My knowledge of MTHFR and methylation is extremely rudimentary to put it mildly.
One thing that helps some people deal with their methylation problem and improve their iron and ferritin status at the same time is to take supplements that contain "methyl groups", usually methylfolate but there are other possibilities.
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/m...
There have been members on the forum who have dealt with high iron / low ferritin by optimising their B12 and their folate with the right supplements.
1) If B12 is too low for good health, start supplementing B12 with methylcobalamin which is easily sourced online on sites that sell supplements. Avoid any other forms of B12. For more info on the forms of B12 available and the levels of B12 to aim for :
perniciousanemia.org/b12/fo...
perniciousanemia.org/b12/le...
Note that B12 is not toxic in high doses or at high levels.
stichtingb12tekort.nl/weten...
2) After a week of being on methylcobalamin (if you need it) add in a second supplement - methylfolate, also easily sourced online. Avoid folic acid.
Some people who have been short of methyl groups for a long time have bad reactions to methylfolate. If this happens then the solution is to start on a small dose and increase it over a few weeks. For more help if this happens :
dramyneuzil.com/methylfolat...
mthfr.net/methylfolate-side...
3) If you get to a dose of B12 and folate that you are comfortable with you could then add in a B Complex. Eventually, if levels get high for B12 and folate you may be able to drop the separate supplements and just stick with the B Complex. The B Complex has to be one that includes methylfolate and methylcobalamin. One of the popular ones is this one :
uk.thorne.com/products/dp/b...
...
Regarding methylation, and MTHFR gene issues, be aware that the solution I've described above is safe for people with or without MTHFR problems. Personally, I can't see the benefit of paying to get tested for MTHFR problems. The solution above will raise levels of B12 and folate in most people (except possibly those with Pernicious Anaemia who can't absorb B12 via tablets and need injections - but they might need specifically methylcobalamin injections). If it improves iron and ferritin levels as well then it is likely you have MTHFR problems, and you can make a guess about this without testing.
Just in this, if your B12 levels are ok, do you skip straight to point 2?
Am I right in thinking you can’t accurately test for B12 if you’re already supplementing or have I dreamt that?
ps Do you need to add in stage 2 supplements even if folate levels are ok?
labtestsonline.org.uk/tests...
They have a chart which shows how to interpret the combination of test result levels. As Humanbean points out this isn't cut and dried. In the US, your PCP would most likely send you to a hematologist to determine cause and a treatment plan.
Patti in AZ
High Ferritin & more weird symptoms
Iron overload
Iron/ferritin - journal articles
Continuous low ferritin levels
Low Ferritin High Serum Iron
