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    Old 01-29-2009, 07:20 AM   #1
    rdptamom
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    Unhappy Not sure what to do?

    Hi! I'm 48 y.o. female. I have been having some weird blood work/symptoms for over 6 months now and feel like I have to be my own doctor. I have been feeling extremely tired, nauseated, headaches, foggy, mild hair shedding.

    In a routine exam last Sept I had blood work done. My H/H was low (11.4/34.3 and RBC low at 3.81). My iron was 160 (>nl) and my ferritin was 6. My doctor initially said everything was fine and I wasnt anemic because my iron was high. I went to another doctor for something unrelated who suggested my doctor redo the tests since my ferritin was so low. The retest results a month later were:

    Iron 55 wnl, UIBC 334 wnl, TIBC 389 wnl, %iron sat 14 (low) and ferritin 7 (low); folate >20 (above nl), B12 normal, Hgb 11.9, Hct 35.2. This time the doctor called and said I was anemic and put me on 325 mg Fe each day and to be retested in 2 mos. It took me 3 months to take a 2 month dose (it made me nauseaus) and then I retested @

    Iron 189 (high)

    UIBC 98 (low)

    TIBC 287 (normal

    % iron sat 66 (high)

    Ferritin 11 (low)

    Another call from doctor's office saying my anemia is gone and to stop taking iron and be retested in 2 months.

    Everything I have read has told me that a ferritin at my level is extremely deficient. I don't think my doctor has a clue (I like him other than for this recent issue) and I have made an appointment with a hematologist on my own.

    Anyone with similar issues? The question is why the high iron levels with such a low ferritin. I feel like crap and I'd like to go to the hematologist informed. Thanks,

    Diane

     
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    Old 01-29-2009, 09:48 AM   #2
    FLFLOWERGIRL
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    Re: Not sure what to do?

    Diane--I don't know what to think about those tests and what you were told. It is my understanding that when one of the three or more; H & H and RBC counts are below range then you are anemic.

    I am no doctor by any means, just a patient. From my experience which is limited, I have never heard of a disease that would note a low ferritin along with high iron serum. Ferritin is the most specific/sensitive test for iron deficiency. And....you are looking pretty iron deficient to me.

    Get copies of all your labs for reference including your most current and post those if you like. Were your other tests done when you were taking supplements or not? The iron serum is the iron that is in circulation in the blood at the time of testing and is not real accurate. This can be changed by supplements, and food sources that are ingested.

    With all that being said, the amount of iron between your Serum iron and your T Sat% is way too high. It appears that you are absorbing iron, but not metabolizing it. What confuses me here is that you would store this iron in the ferritin, if it were truly happening. T Sat should be anywhere from 25-35% never more than 45% so that you don't overload. This would be reflected in your ferritin. Your ferritin does not compute for iron overload. I might want to retest with a FASTING iron panel and no supplements. Really, there are so many possibilities, this is where a specialist comes in. Best of luck to you. FLFLOWERGIRL

     
    Old 01-29-2009, 12:05 PM   #3
    rdptamom
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    Re: Not sure what to do?

    Thanks so much for getting back to me. These are all the tests I have for now. The first set was with no supplement; the second set was just with a multivitamin with iron; and the third set was after taking the iron supplement. I am at a loss (as is the doctor) as to why I have a high iron with a low ferritin. I agree that my next tests need to be fasting and without the supplement...I was not aware (none of the doctors ever told me to fast) of how fasting would affect these tests until reading about it on line.
    I did come across someone who was talking about the same thing--high iron levels, but low ferritin. Her gastroenterologist told her the serum iron can be affected by many things and that the ferritin was a more reliable indicator of iron status. She was told she was having malabsorption of Fe due to long term use of PPIs for GERD. I have been on PPIs for GERD for many years and am now wondering how this plays in to this. Anyone heard of this??
    I plan on discussing this with the hematologist. Thanks again...any insight is greatly appreciated!

     
    Old 01-29-2009, 02:50 PM   #4
    FLFLOWERGIRL
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    Re: Not sure what to do?

    You know I have never been told to fast with the iron panel either. My Hematologist never ran this test for me only the PCP several times. I was told that I was having malabsorption by my GI doc as well due to PPI use of 9 yrs., and I too have a low ferritin and have to stay on iron forever. But my iron numbers have never been what yours are, I'm extremely curious. Also, the PPI causes less acid that is needed for iron to break down, without this acid you absorb less or very little if any, this is the problem. From your serum iron you look like you have absorbed it into the blood, just not the ferritin. Some people have a hard time storing iron for different/many unknown reasons. There is another poster here and her Hematologist says that she does not think this is her reason for low iron levels so I don't know what to think anymore. Keep us posted. FLFLOWERGIRL

     
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