Hi everyone,
My doctor seemed rather unconcerned about my ferritin levels, and simply asked if I took iron tablets-- I didn't until I saw the results. This happened around the beginning of Feb.
What's your opinion? This result was from Quest Diagnostic
Ferritin Reference Range 10-232ng/ml
My result was 9, which was noted as being out of range.
I've had some very heavy, irregular periods lately (with spotting) and realize now how rubbery and weak I feel.
I'm going to a new doctor next week, and will show him the results. Am I extremely low? If so, can he do something in his office? Do I just need to continue with the over-the-counter tablets? Doctor 1 hardly blinked an eye, so I don't know if he missed something important, or if this is a "low but nothing to worry about" test result.
Thanks for your opinions.

I don't know if I will be any help as Im new to the whole Anemia thing. But your level is low. I dont think its seriously low as if it was the Doctor would of had no choice but to do something hun. However heavy periods can cause Anemia. Good idea about getting a 2nd opinion. Hopefully this Doctor will help you. Meanwhile keep taking Iron tablets and eat more food containing Iron such as Pulses, Lentils, Redmeat etc.

My ferritin level has been at 5 for awhile. While my doctor is not happy about it, he is not freaking out. We are "working" on it. I suppose that after some more time goes by and it doesn't go up, he will be sending me out to a specialist. I am taking iron and I no longer have anemia anymore, just the low ferritin which means that I have very little stored iron.

I agree with ChristineVA, that while you ferritin is definately below the range, at this point is not critical. i.e, requiring iv iron or transfusions.

Did you also have other bllod work done, such as a cbc? Take a look at your MCV, and see if it too is below level. You would then have more evidence that points toward a microcytic anemia.

I believe protocol is to have a month or a little more trial on iron supplements. You must get the ones that have the greater amount intended to resolve simple iron deificieny anemias. like between 45-65 mg elemental iron.

After this period, have your ferritin and Hgb alson with some other blood markers checked, as standard in cbc. And see if it has made any differnece. If not, then it is time to go see a specialist to properly diagnose you.:)

Sparkles,

Hi... with your knowledge, what does it mean (or indicate) when the MCV is low (67), ferritin is low (7) and the RDW is high (26)?

Hi MMR0719:

I am by no means an expert, but I do know there are a number of ways to look at nutritional anemia/deficiency/depletion. Most clinicians are only concerned with clinical anemia which means that you need to be below range in one or more lab values (e.g. Hemoglobin, serum ferritin, MCV (mean corpuscular volume -size of your red blood cells) and sometimes, MCH and hematocrit play a role in supporting a conlcusion of anemia etc.

If you look up microcytic anemia, the primary feature, which would cause a dr to look further, is the MCV. Most labs contain a low range that are high 70's low 80's, so 67 is likely below range. It would help if you could give the ranges along with the values. I found out the hard way, drs will not take low #'s seriously until you support them with the ranges...

Anyway. I believe that iron deficieny anemia is the most prevalent cause of a low MCV.

If your ferritin is low (again assuming you are belong range), this is usually the first indice to fall in an iron deficiency anemia situation (or prelude to it). Then a dr looks also to your hemoglobin, then to MCV if he is more thorough. In my case, I have a low, but normal Hgb, and very very low, but normal (i think the range is changing higher) so I am not anemic, just maybe deficient or depleted depending on definition.Unfortunately, I had to ask for my ferritin test - most practiciioners only glance at the Hgb, and if it is in the "range" you are "fine".

According to the literture, when a MCV drops, it is usually preceded by a drop in the Hgb (2 pts they say). Is your Hgb also below range?

The RDW, i am not too familiar with, but an RDW is increased in anemias, including nutritional anemias - it is also predicative of a deficiency anemia where the MCV and Hgb have not yet fallen below range. A high RDW also has an impact on how the dr interprets the MCV value (its accuracy since high RDW which means you have a high degree of size variation in your red blood cells.

Normally, all points to an iron deficieny anemia, if all your numbers are below range. Ordinarily a dr would give a trial period of iron to a patient to see if the ferritin etc comes up. If not, then you may have to go to a specialist.

However, no knowing your medical history, I would not take iron on my own, since it can be dangerous if you have certain conditions.

If your dr does not want to treat even for iron deficiency anemia, presuming iron is ok for you to take, I would get a second opinion.

Finally, anemia is a symptom, not a diagnosis. While many are nutritionally related, there are many causes and if the simple iron does not work, then you should pursue it further. :)

PS you can have a look at an article on the web on one of those big article sites - search for microcytic anemia and American Family Physician

Thanks so much for all your replies. I wrote a big reply here but it seems to have gotten lost- if not, sorry if I repeat myself.

My entire CBC seems to be within normal range. My MVV was 91.7 (reference range 80.0-100.0) My doctor gave me a good quality vitamin B-complex at the time, but didn't mention anything in particular about my blood work. My RDW is 13.4 (range 11.0-15.0)

I started taking Carbonyl Iron 25mg, 2 tablets daily = 278%.
Is there a point when I can OD on iron or over-correct low ferritin and cause problems the opposite way? Should I test my blood often, or just assume I need 3-6 months of supplements before thinking about it again? Or do menstruating women just need iron supplements, regardless?

Thanks again- your replies are much appreciated!

Thanks for the information. I got the actual diagnosis (ICD9) today and it is iron deficiency anemia. I have my 8th infusion tomorrow then re-test on Friday.

I currently have an abdominal mass (ovarian) that needs to come out, but the surgeon won't touch me until my blood levels are right.

They tried me on iron pills, but I have an absorption problem, so my numbers actually went down during those weeks.

I am hoping that my blood is now correct so I can get my surgery scheduled.

Thanks so much, again!

My ferritin level is 3 and I just started taking iron. I have had 2 colonoscopys, an EGD, a small bowel series and a liver biopsy because my liver enzymes are slighty elevated. I also swallowed the camera and it showed an area of bleeding but they can't determine where it is. Very upsetting to say the least. Every test including the biopsy didn't show the problem. I go back to the gastro doctor in 2 months for a recheck of labs. Depending on the results he will probably send me to a hematologist. He said my case is unusual so he was going to bring it to a conference he was going to so all the doctors could discuss it.

I started taking Carbonyl Iron 25mg, 2 tablets daily = 278%.
Is there a point when I can OD on iron or over-correct low ferritin and cause problems the opposite way? Should I test my blood often, or just assume I need 3-6 months of supplements before thinking about it again? Or do menstruating women just need iron supplements, regardless?

I am taking ferrous sulfate elxir,220mg, 44 mg elemental iron, which is 240% RDA. I don't know how long it takes to raise one's ferritin on average, since some people have contributory causes that prevent absorption etc. I think a month or 6 weeks would be a good time to recheck the levels in order to see if the supplementation is having an effect. If your ferritin has not increased, then you should check for other conditions that may be causing your problem...I saw a post from a celiac sufferer who had low ferritin.

You are definiately at the deficiency stage with a 9. It can at some point continue to anemia, tho how long this might take I don't know. As I wrote in another post elsewhere, the second measure to assess iron status after finding low ferritn, is serum iron (iron transported in the body) which may be low if the deficiency has progressed. As serum iron falls, transferrin increases. If these two markers are present, it shows an advanced deficiency.

Did your cbc measure serum iron and transferrin?

Yes, one should be cautious with iron...there are some good sites on the web containing info on vits and minerals ,their RDA, toxicity levels etc., like the National Institutes of Health Dietary Supplement Fact Sheets. Too much iron can result in hemachromatosis.:)

Sparkles,

Can you tell me the name of the iron elixier your are taking?

I am looking for another OTC iron supplement. I am currently on Spatone and it has certainly corrected the anemia (did that very quickly) but after 3 months on it, my iron stores are not replenishing. I think I need something stronger. The tablets kill my stomach and was hoping a liquid would do better.

Are you taking Floradix?

I went to one of the major drug store chains and asked at the pharmacy counter for a liquid ferrous sulphate preparation.

The told me the used to have an expensive name brand for 33$, but now carried some kind of generic for 10$.

It has the name "Ferrous Sulphate Elixir" by Qualitest.

I am sure if you ask around at the pharmacy counters, someone is bound to have the liquid preparation. So far, I seem to tolerate it well, I make sure I take it with meals, as on an empty stomach I feel a tiny bit of burning. I think you can mix it with juice if you want, sometimes I mix it with orange juice as the vit c helps abpsortion. :)