Opinions please on low ferritin.
Had a blood test last week to rule out CA and my ferritin level is 11. Range is 10 - 150.
I have several symptoms of iron deficiency and just wondering if it is actually too low. GP states that is still in range. Any thoughts please?
I'd suggest asking your GP for a full iron panel to see where your serum iron level is and if it's safe to supplement... I thought they'd changed the low range to 30!!
It has changed to below 30, Nice changed it in 2021 (I think) but lots of labs still use 10 as the lower limit, including mine. I had a discussion with my gp about this when requesting a blood panel test. She wasn’t aware of this.
TiggerMe. What does a full blood panel consist of please?
They seem to vary a bit but it should give you (serum) iron, tranferrin or TIBC, tranferrin saturation, UIBC
You just need to know that your levels aren't already high as it is possible to have high iron with low ferritin levels and too much iron is toxic
I can,t see any of that has been done. Just looked at the nice guidelines and it is correct that it should be over 30!
The haemaglobin has been ‘estmated’ between low and high levels of ‘Normal’?.
The Nice guidlines state MCV should be 95 upward. Mine is 90 but the normal range on my results state normal between 80 - 100?. Really puzzled. Nice state MCV of less than 90 has a sensitivity of 97.6 having Iron Deficiency Anaemia.
Just looking at MCH. Range 27 - 32. Mine is exactly 32.
This is the iron panel offered by Medichecks :
medichecks.com/products/iro...
I think it measures all the standard stuff.
This link is worth reading : labtestsonline.org.uk/tests...
Expand the + signs for more info.
The labtestsonline link does add this info but it would add hugely to the cost of the iron deficiency test linked above, and some of the tests mentioned are only relevant if iron overload is suspected. Deficiency is much more common than overload. Personally I wouldn't mind getting a zinc protoporphyrin test done but I've never seen it offered anywhere. Note that faecal occult blood tests (mentioned below) were renowned for giving false positives and false negatives, but I don't know if that problem has been overcome or not.
The following tests can be used to help recognise problems with iron status.
Haemoglobin and Haematocrit - These tests are performed as part of a Full Blood Count (FBC). A low value for either test indicates that a person has anaemia. Iron deficiency is a very common cause of anaemia. The average size of red cells (Mean Cell Volume or MCV) and the average amount of haemoglobin in red cells (Mean Cell Haemoglobin or MCH) are also measured in an FBC. In iron deficiency, insufficient haemoglobin is made, causing the red blood cells to be smaller and paler than normal. Both MCV and MCH are low.
Blood film/picture- this test looks at the size and shape of red blood cells under a microscope. This helps to differentiate iron deficiency anaemia from other different types of anaemias.
HFE gene test - Haemochromatosis is a genetic disease in Caucasians that causes the body to absorb too much iron. It is usually due to an inherited abnormality in a specific gene, called the HFE gene that affects the amount of iron absorbed from the gut. In people who have two copies of the abnormal gene too much iron can be absorbed and excess iron is deposited in many different organs, where it can cause damage and organ failure. The HFE gene test determines whether a person has the mutations that cause the disease. The most common mutation is called C282Y. Not everyone with this genetic mutation will develop haemochromatosis.
Zinc Protoporphyrin (ZPP) - Protoporphyrin is the precursor to the part of haemoglobin (haem) that contains iron. If there is not enough iron, another metal, such as zinc, will attach to the protoporphyrin instead. The amount of zinc protoporphyrin in red cells is increased in iron deficiency. Sometimes ZPP (and its ratio to haem levels) is used as an early indicator of iron deficiency in children. However, the test is not specific for iron deficiency, and elevated values must be confirmed by other tests. The test is therefore rarely used in the UK, but still has a role in developing countries.
Additional procedures such as testing the stool for blood (faecal occult blood [FOB] or faecal immunochemical test [FIT]), or endoscopy and colonoscopy may be used to find the cause of anaemia in cases of chronic bleeding from gut. Pelvic ultrasound scans are also used in women to look for the cause of excess menstrual bleeding.
Liver function tests- This panel of tests may help identify liver damage in iron over load conditions.
Liver biopsy- If liver damage is suspected following iron overload, a sample of tissue from the liver is removed, using a thin needle. The sample is sent to a laboratory to be checked for the presence of iron as well as for evidence of liver damage, especially scarring or cirrhosis.
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