I got my recent blood test back, haven’t yet posted all results to my profile, but my ferritin was rock bottom (7 out of 7-271 range) so I’m going to get a full iron test before I share all the numbers here and decide my next med change.
What should I ask for:
Iron
Total iron-binding capacity (TIBC)
Transferrin saturation
Ferritin
High Sensitivity CRP (CRP-hs)
What about hemoglobin? Any other from the CBC panel or whatever that part of a blood test is called?
ps, just reread some other posts and one SD linked to from Seaside Susie says: “More likely you were advised to have an iron panel to see if you have iron deficiency and a full blood count to see if you have anaemia.” So do I need a full blood count at the same time? I got one in July, is that good enough or do I need it simultaneously like with my thyroid bloods?
Anything else helpful to add?
tagging humanbean SlowDragon and greygoose as I’ve seen your wise iron- related posts in the past and hoping you can eyeball the above? As always, very grateful.
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What you need to ask for is an iron panel or iron studies. They do vary in what is covered but this private test only needs a finger-prick blood sample (no doctor's permission required) and is the best one I know of :
If you create an account with Medichecks you will get notified by email of other discount codes throughout the years for their sales, and they will usually be higher than 10%, but discount codes can't be combined.
This is true for several testing companies, although possibly not all - creating an account with them will mean you get notified of any sales and special offers by email with temporary discount codes.
I forgot to mention Haemoglobin which is measured as part of a Full (or Complete) Blood Count (FBC in the UK or CBC in the USA)
Under range Haemoglobin (Hb) is used in the UK to indicate "official" anaemia, although here the lower end of the range is lower than that given by the World Health Organisation (WHO) where, for women, the lower limit is 120 g/L or 12.0 g/dL. For men the lower limit is 130 g/L or 13.0 g/dL.
In the UK the lower limit for haemoglobin is usually given as 115 g/L or 11.5 g/dL (probably to save money and to cut the number of people being treated for anaemia as a money-saving thing).
The parameters of an FBC that I find most useful in checking for anaemia are Hb, Mean Cell Volume (MCV), and to a lesser extent RDW.
For the WHO info, go to this link and click on Download, then go to page 3 in the report that opens :
About 10 years ago I had a chronic GI bleed which went on for a long time. I also had problems with inflammation which keeps ferritin levels higher than justified by the amount of iron in the body. My ferritin dropped very slowly despite the bleed. I didn't know it had dropped so much until I got a copy of my medical records after the bleed had been fixed. I also found out (after the fix) that my serum iron had been under range for several years. My haemoglobin had been bottom of the range but never went below it.
This was a serious issue for me under the circumstances because doctors are far more likely , in the UK, to do a Full Blood Count than an iron panel. They will sometimes add a ferritin test to an FBC, But they won't do an iron panel very often. I've only ever had one done by the NHS that I'm aware of and I wasn't told that my serum iron was under range. I've done lots of private tests since then. So, I was never diagnosed as being anaemic despite the chronic bleed because my haemoglobin never went below the bottom of the range.
As a result, for myself, I would never pay for a separate FBC because it doesn't reflect my own situation. I've seen various people listing iron panel results and (rarely) a haemoglobin level, and they don't always seem to agree - low iron/ferritin doesn't always lead to low haemoglobin and therefore a prescription for iron. This seems weird to me. It takes absolutely AGES in some cases for people to become officially anaemic while their iron can be trundling along the bottom of the iron panel ranges.
...
In the UK iron supplements can be bought over-the-counter without prescription, and online. There are a limited number of supplements available on US Amazon too for the people from the USA. It wasn't until I found out that I could buy my own iron supplements without prescription that I had a chance to repair the damage from the chronic bleed I had. But it is important once iron supplements are started for people to get regular proper testing to be sure they aren't taking their iron and/or ferritin and/or transferrin saturation too high for good health, because iron is poisonous in overdose.
It is also worth noting that serum iron can be low while ferritin can be sky high. Also ferritin can be low while serum iron is sky high. And in both cases having anything iron-related being sky-high is really bad for one's health.
I am in the US, so although I don’t fully understand the UK system, I think everything here is “private” so generally I can ask for bloods and get what I want.
So the original post does indeed list out exactly the medichecks list. So I will include those.
Maybe my final question then is:
Do I request a new full blood count (cbc) or are my July 2023 ones good enough as indicators ?
FWIW in July:
hemoglobin 12.7 (12-16)
MCV 89.9 (80-100)
RDW 14.9 (11.5-14.5) the only one “officially” out of range on my cbc
Do you think I should retest - or knowing the above will be good enough with a new full iron panel?
THANK YOU humanbean very grateful to you for sharing your knowledge!
generally I can ask for bloods and get what I want.
If your healthcare system wasn't so shockingly expensive I could almost be jealous,
I think you could get away with just the iron panel.
I wouldn't bother with the CBC, I'd ask for the iron panel or iron studies.
I would also suggest asking for a vitamin B12 and a folate test if you can get one. In some cases where people are anemic or have low iron/ferritin they can struggle to raise their levels. But it has been found that if folate and B12 are low then improving those can help with raising iron/ferritin. If low, both B12 and ferritin would have to be raised with the right supplements in order to help with the iron/ferritin - they aren't all the same. So if you can get those results we can suggest the right kind of supplements and the levels you should be aiming at.
To be fair, patients can do that here within reason, but patients often don’t ask or know their rights around this to fully advocate for themself, let alone have the strength to do so. Not that they should have to advocate for it. And, of course, some GPs are incredibly scrupulous and deny them anyway, some usually able to cite legitimate ethical or cost reason, and none really advertise the fact that patients can have this right.
I’m UK based, and thus far I have never been refused any test I want. Even though expensive ones like B6. Twice!
Then again, GPs are used to me being of their more arkward patients.
I love hearing these stories and learning about this. Question-how common is it for people to avoid the NIH and use a non-NIH private doctor?
And when you can say you can get what you want, how does that work when appointments seem to take so long to get. Or do they? Or can you email/call and request prescriptions for bloods or meds without an appointment?
Shockingly expensive … all depends on the insurance you have. And depends on what is considered shockingly expensive. So much to ponder!
Similar. All depends on what we call post code lottery, as well as any means to treat privately which many can not. As for getting what you want, again, this is within reason, and some things can only be requested by a consultant which requires a consultant not a GP and that requires a referral.
Waiting times… again a post code lottery. Smaller demographic areas have less of this issue. Of course, depends on the service required too. Also, a caring GP practice can push through a referral quicker with a phone call. I’ve experienced this when my problems were getting more severe while waiting.
Prescription refills are easy when they are based electronically by GP or consultants, except for supply chains issue. And, there are various ways to attain emergency scripts.
I’ve got too add a BIG but often under appreciated fact comes down health inequalities also. That is to say, your age, sex, race, other characteristics all play a part in the service received.
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