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  • Confused- low ferritin, high HCT

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    Old 06-07-2007, 11:12 PM   #1
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    Confused- low ferritin, high HCT

    I have been giving blood regularly at the Red Cross, and the last time I went in to give whole blood, the nurse was surprised at how high my hematocrit was, and asked if I had a family history of hemochromotosis. It turns out that my aunt has consistently high iron (but has not been specifically tested for hemochromotosis), so I called my doctor and asked for him to check it out. I got the results of my blood tests back, and the doctor has assured me that everything is normal, including the iron. But, the ferritin is pretty low.

    The thing that I am confused about is that the other things that are normally altered with anemia are actually on the opposite end of the range (high hematocrit, etc.).

    It seems like my ferritin should be higher, and I think my doctor is off on this. But why aren't the other results indicative of anemia as well? Is my ferritin so low that I need to have my doctor treating me for this, or can I just take stuff OTC?

    I'll be taking a year off from donating blood because I'm going to Costa Rica, so no need to lecture about that...

    RBC 4.30 (3.50-5.55)
    HGB 13.9 (12.0-15.0)
    HCT 41.2 (36.0-45.0) -was 46.0 before blood donation
    MCV 96 (80-100)
    MCHC 33.7 (31.0-37.0)
    platelets 288 (150-400)

    TSH 0.32 (0.35-5.50) -on 0.75 mcg levothyroxine

    B12 935 (211-911) -getting 1000 mg shots every 3 weeks, up from low 300's
    RBC folate 793 (280-791)

    Ferritin 8 (10-291)
    Transferrin 317 (200-400)
    Total iron 127 (50-150)
    TIBC 419 (270-440)
    % saturation 30 (20-50)

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    Old 06-08-2007, 08:16 PM   #2
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    Re: Confused- low ferritin, high HCT

    Your blood results look good, esp as you are hypothyroid. Out of curiousity I looked up elevated Hct and saw that it can be due to dehydation. The only other alternative is Polycythemia vera. I would not worry about it at this point, unless you get another strange lab with elevated Hct. Apparently, it can be asymptomatic, and most drs have patients tested for it when an elevated Hct is seen on labs. I would just keep an eye on it.

    As to the ferritin, it is considered to be at a deficient range. Have you asked your dr about it? He may consider having you supplement with iron, but not all drs do until one has reached an anemic state, that is Hgb below 12 (or 12.3 according to some).

    If you are not feeling any symptoms of fatigue, etc, it may not be a big issue at the moment, however.

    Finally, the only reservation I would have about supplementing with iron at this point is that your Hgb and RBC etc all look so good, so perhaps I would look further and have some other tests to confirm that it is in fact an iron deficiency problem causing the low ferritin, and not something else complicating it.

    Sorry I can't be of more help. Bottom line, I would retest the Hct (you did not say how recent your test was) and then discuss with my dr the question as to whether it was a good idea to supplement

    Last edited by sparkles916; 06-08-2007 at 08:18 PM.

    Old 06-08-2007, 08:19 PM   #3
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    Re: Confused- low ferritin, high HCT

    I had the bloodwork drawn 2 weeks ago. The HCT of 46 was about 6 weeks ago, then I immediately gave a pint of blood.

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