Hi all
I have been off Iron tablets for about 8 months. I had my bloods done last weeks as per below;
They look all in range but I wonder if my iron panel results look good?
My ferritin is - Serum ferritin level 116 ug/L [23.0 - 300.0]
Serum Iron Status
Serum iron level 21.9 umol/L [9.0 - 30.4]
Serum transferrin level 2.21 g/L [2.0 - 3.2]
Transferrin saturation index 39 % [16.0 - 45.0]
Thank you
I'm not an expert in iron panels but your serum iron is good at 60% of range. Optimal is 55 to 70% of the range.
Ferritin should be around 90 - 100 for best use of thyroid hormone. Yours is slightly above that so as long as you dont currently have an inflammation which would cause a flse high for ferritin then your levels look good to me.
What have you been doing to maintain your level without supplements?
I have been on iron tablets from the age of about 27 to 39. I do have much lighter and shorter periods now so I am wondering if that has helped. I don’t take any supplements to help with my iron levels. I recently had a heart attacked caused by SCAD so I am now on heart medication for a while.
Lighter periods may well help iron levels.
Have you tested B12, folate & D3 and now supplementing to optimal?
What supplements do you take?
What are you recent thyroid results?
Sorry to hear about your heart attack.
I must admit that I haven’t had my Vit D, Vit B or folate tested for a while. I have also been really slack in taking my Vit B12 and Vit D. I will start them again.
I had my Thyroid tested in December 2023 and my TSH was undetectable, my FT4 and FT3 were in range. I take 100mg of T4 and 20mg of T3.
Most members also need folate so a B complex is preferable to a stand alone B12 supplement.
B complex suggestions: Slightly cheaper options with inactive B6:
amazon.co.uk/Liposomal-Soft...
Contains B6 as P5P an active form:
bigvits.co.uk/thorne-resear...
healf.com/products/basic-b-...
Explanation about the different forms of B6:
helvella.blogspot.com/p/hel...
B complex comparison spreadsheet:
healthunlocked.com/thyroidu...
Thank you.
I have bought Nature Provides Liquid Vitamin B12 and Pure Encapsulations b12 complex
Good stuff. Remember to stop the B complex 4-7 days maximum before a thyroid blood test as it contains biotin which can interfere with the results.
I was going to start taking them again but I’ve been in and out of Hospital the last 6 weeks. They seems to keep taking blood ( I don’t think I have any more left to take) so I was worried about starting them in case it interfered with the results. Things are settling down now so I should be okay to start taking them.
I'm a 72 year old male and now wonder how does the rest of the bodily systems cope with a thyroid hormone favourable Ferritin level of just around 90 - 100?
The reason I ask this is that when I recently saw a Consultant Endocrinologist and asked her what my optimal ferritin level should be, she stated "off the record" that if she were treating me in a hospital, that she would expect my ferritin level to be in order of 130 - 150 level.
Note: On since reviewing my 17 ferritin level blood test results since 2014, only 3 of them were in excess of 100 (and most likely post a recent iron infusion) and the remaining ones ranged between 8 & 80.
To complicate and perhaps confuse matters further, the website of The University of Rochester Medical Center in the USA, shows the normal range for ferritin in your blood serum as follows:
24 to 336 ng/mL for adult males
24 to 307 ng/mL for adult females
25 to 200 ng/mL for newborns
200 to 600 ng/mL at 1 month old
50 to 200 ng/mL at 2 to 5 months old
7 to 140 ng/mL for children 6 months to 15 years
Remember what "normal range" really means!
This is a link to a very good article in the British Medical Journal discussing what the 'normal range' really is. Very readable.
The normal range: it is not normal and it is not a range
helvella.blogspot.com/p/the...
My own ferritin is somewhere over 400 (from last test done). It appears that you are not consuming, or absorbing enough iron. Or that you are losing iron. Really should be looked at. If nothing else, consider changes to diet.
I'm not an expert in iron.
The range for males is higher than for females.
All body systems do better with the optimal range of iron, not just thyroid. I've attached a diagram of different symptoms at different ferritin levels.
Thanks for your reply and which is very informative.
Your results as high as I’d want to see them.
Are you saying you were, or were not, supplementing prior to this test.
If so, how much, and how frequently, and when was the last dose prior to this test.
Do you have a previous iron panel result you can also share, with the same info I’m asking above.
Hi
I think I stop iron tablets about November 2023.
These were my results in February 2024;
Serum ferritin level 109 ug/L |23.0 - 300.0]
Serum Iron Status
Serum iron level 18.9 umol/L 19.0 - 30.41
Serum transferrin level 2.08 g/L |2.0 - 3.2]
Transferrin saturation index 36 % [16.0 - 45.0]
If that was your panel after 2-3 months of not supplementing, then in my opinion you should not be supplementing.
Your ferritin is on the high side, and your saturation % is most concerning, you should aim for mid range and you do not want to be so close to top range.
Do you eat a lot of meat?
Why were you on iron supplements for so long, did you test regularly throughout that time, and what was the highest you’ve seen your ferritin, transferrin saturation percent and iron over that time?
Hi,
I have been vegan for 5 years.
I was on iron tablets for years because my ferritin was about 20 and I felt so so tired. They put my on iron tablets and I felt better. They would test my ferritin and it would be around the 80/90 mark. My new GP decided to take me off them to see if my levels would come down but they haven’t.
I think my ferritin was about 90 when I was on iron tablets. It’s the highest it’s been since I’ve being off iron tablets. I thought my levels was plummet but they haven’t.
They never tested my serum iron panel in the past. The first time they have ever tested was was in February 2024.
Did you get a CRP-hs test ever along with these ferritin results. You should.
Your saturation percent is high enough to be one vote against supplementing.
Your ferritin is and has been pretty good with slight room for improvement.
Iron is least reliable as a single number for action planning - and so that low number alone does not counteract the other high ones.
Yours is an interesting story here, still trying to figure out why you were supplementing so long?
I don’t think I did as this is all is says on my ferritin results;
Specimen
Specimen Type: SST Serum
Specimen Reference#: 1
Collected: 30 Jul 2024
Received: 30 Jul 2024
Provider Sample ID: 2461113088_ SST
Pathology Investigations
Ferritin
Serum ferritin level 116 ug/L [23.0 - 300.0]
Comment Ferritin < 15 ug/L may be indicative of iron deficiency.
Levels <30 ug/L can also be associated iron deficiency but are
less specific. Ferritin is an acute phase protein.
Levels may
be raised in inflammatory states, kidney or liver disease and
malignancy. In these states a level within the reference range
cannot exclude iron deficiency.
General Information
Service Type: New
Status: Unspecified
Provider Report ID: 2461113088 RM100
1542801
Report Date: 30 Jul 2024
I did try and come off the iron tables but my ferritin would plummet so the GP would put me back on them. I did use to have really heavy and long periods but in the last few years they have changed so maybe that’s why my levels are better now.
I haven’t taken any iron tablets since approx November 2023 and do not intent to start.
I would add CRP-hs to your next iron panel. As what you lasted above says:
Ferritin is an acute phase protein. Levels may be raised in inflammatory states, kidney or liver disease and malignancy.
.
That is measured by CRP-hs. And it will help you understand your ferritin results. It might very well be that your ferritin is low and it’s the inflammation impacting it. But you’ll need to test to know.
.
Also - it’s very hard as a vegan to ingest enough iron to maintain levels, which is why your good/high results are interesting.
You should of course eat as much iron rich foods as possible, paired with vitamin C.
I would then test again, adding CRP, and see where that leaves you.
Do you ever get a full blood count - like hemoglobin and the like?
This was on the 30th July 2024;
Full blood count
Total white blood count 6.0 10*9/L [4.0 - 10.0]
Red blood cell count 4.44 10*12/L [3.8 - 4.81
Haemoglobin concentration 135 g/L [120.0 - 150.0]
Haematocrit 0.394 |0.36 - 0.46]
Mean cell volume 89 fL 183.0 - 101.0]
Mean cell haemoglobin level 30.4 pg |27.0 - 32.01
Platelet count - observation 246 10*9/L [150.0 - 410.0]
Neutrophil count 3.73 10*9/L |2.0 - 7.01
Lymphocyte count 1.79 10*9/L [1.0 - 3.0]
Monocyte count - observation 0.33 10*9/L [0.2 - 1.0]
Eosinophil count - observation 0.12 10*9/L [0.02
- 0.51
Basophil count 0.02 10*9/L [0.0 - 0.1]
I have never asked the GP about CRP as it was hard to even get them to do a serum iron test as they only ever tested Ferritin. I know my kidneys are okay as they have been checking them.
What causes inflammation in the body?
I know that my GP will say everything is okay as it’s in their range. It’s a constant fight.
I am not a doctor : ) Just someone managing their own iron.
That being said - looking at your iron panel shows a couple areas of concern, so kind of OK but you must not push it higher:
- ferritin and sat% slightly too high. Saturation percent is really one you do NOT want to get top of range for. It means your transferrin (the ubers of iron tranport in your blood) are saturated with iron, bringing just a little too much iron all around your body. You want to avoid this. The changes in your ferritin need to be understood more by also testing CRP-hs at the same blood draw as the others. But at this point it's higher than we want to see.
- FYI - Inflammation is commonly caused by colds/flus/viruses - prob other things I'm not aware of because mine is always non-existent. It can push your ferritin up, since ferritin will sop up all the excess iron to starve bacteria and viruses that thrive on it.
Your full blood count gives comfort that other measures reflect good iron, and so even though the ones above are too high, you are generally OK.
Your hemoglobin is slightly above the midpoint of the reference range, suggesting you have enough iron to make enough hemoglobin - which is how oxygen gets carried about your body. This mid point does not indicate overload, so that's good.
Iron is needed to make red blood cells - so you're mid-range there which means this isn't flagging an issue.
One thing that could be an indicator of needing more iron - MCV. It's in range, but low - which only means it's a good idea to keep monitoring your iron overall. Sometimes low MCV could be an early indicator that iron is going in the wrong direction.
No one blood test can give you a complete picture of your iron. Keep in mind that iron itself is pretty volatile, and can easily move up or down in short periods of time.
That's why we do panels, and can augment with a few things from your full blood count, and a pretty nuanced assessment is needed especially when results are mixed or middling across all the measures.
as far as what to do - remember this:
- Unless you have a genetic disorder/some kind of hemochrosis, then it is impossible to eat too much iron. The body has an extremely sophisticated system of checks and balances and won't allow you to absorb too much.
- Supplementing on the other hand overwhelms those checks and balances. It is very easy to overload on iron with supplements even in a few months time.
- therefore, if you supplement, commit to regular testing and make sure you are not overloading. Your body has no way to excrete excess iron and it is toxic over time, causing permanent and irreversible organ damage.
Iron toxicity is no joke and not to be messed with!
If you don't supplement, eat iron rich foods, pair with vitamin C, and re-test in a month or two (with CRP-hs) you will start to build a better understanding of what's going on in your body.
EDIT - your full blood count was several months after the iron panel. So might be a mismatch, who knows. None of us here really get full blood counts as a rule esp if you need to pay for it. A full iron panel is what you need - maybe also in addition to the CRP-hs, adding TIBC and UIBC (although I don't always find those as helpful as the ones you already got anyway. But they are usually included.)
I’ll have a chat to my GP if they call with the results. I just found them on my NHS app so hopefully they will call to discuss. I’ll raise the concern that my levels are rising even though I have not been supplementing for about 9 months.
I was in bed for 5 days with the most awful virus about a week before my ferritin / iron bloods. Maybe that is why the inflammation is showing. I also had a heart attack about 6 weeks ago so maybe that hasn’t helped my inflammation markers. It’s not the traditional one, it’s a tear in my heart! I’m 39, slim, don’t drink or smoke and work out 4 times a week.
I have a good liquid vitamin C that I am going to start to take. Hopefully that will help bring the inflammation down.
If my GP isn’t helpful then I will see if I can find a private finger prick test that does CRP.
100% yes if you had an awful virus, then you should take that ferritin number with a grain of salt.
But you should take what I say with a grain of salt too : )
Seeing what you've just written, there is a lot going on. I know a bit about iron & hypo, but there are too many things in your story that I have no experience and no idea about at all!
Your numbers don't fit the usual stories/profile I see here most often. The above would apply to me if I had those numbers. But take care to modify based on your dynamic health situation. Learn up and consider the above might not make sense for your situation. I'm just not sure.
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