Low ferritin and high total iron

[HealthMan]

I have been donating blood every 2/3 months and my ferritin levels are low (11 - range 20-345) but my total iron is high (216 - range 50-180). Other test results below:
Iron binding capacity 482 - range 250-425
% saturation 45 - range 15-60

Any comments why is that? If dangerous and how to fix it?

 

[Saul]

Interesting. Your numbers don't match up with a typical situation. Your very low ferritin indicates that your iron storage in your body's organs is low. And your Iron Binding Capacity (TBIC - bloods ability to bind iron) is also high. These both indicate that you are anemic and should stop or cut back on blood donations and eat some food that is iron rich.
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But, the other numbers don't match up. Your Total iron or serum iron is the amount of iron in your blood and is high. Your blood stores very little iron (beyond RBCs) and is mostly a transport mechanism. I find it odd that this is high. Did you eat iron rich foods before your blood work or take iron supplement (something to spike your blood iron levels)? Your % saturation is in the normal range - but this is just a ratio related to your iron binding capacity.
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I am not a doctor but I would say you are anemic and should cut back on blood donations. Any other health issues or blood work out of range? When you say total iron at 216 - are your referring to transferrin or serum iron? How was your hemoglobin?
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The following is a helpful link. See the table on the last page.
https://static1.squarespace.com/sta...4b057f9e38bfadf/1420054370996/HHC_ALL2011.pdf

 

[HealthMan]

Tks for the reply Paul. I dont think I am anemic. My HCT, hemoglobin and RBC are all normal.
My theory is that you need ferritin to store iron and given my ferritin is low the iron freely circulating in my blood is not being stored. Dont know if that makes sense.
I dont take any iron supplements. I ate a 20 oz steak approximately 16 hours before drawing blood.
Also how eating more iron will help given i am not anemic and my iron in the blood is high?
The test only says total iron (quest Diagnostics)

Interesting. Your numbers don't match up with a typical situation. Your very low ferritin indicates that your iron storage in your body's organs is low. And your Iron Binding Capacity (TBIC - bloods ability to bind iron) is also high. These both indicate that you are anemic and should stop or cut back on blood donations and eat some food that is iron rich.
.
But, the other numbers don't match up. Your Total iron or serum iron is the amount of iron in your blood and is high. Your blood stores very little iron (beyond RBCs) and is mostly a transport mechanism. I find it odd that this is high. Did you eat iron rich foods before your blood work or take iron supplement (something to spike your blood iron levels)? Your % saturation is in the normal range - but this is just a ratio related to your iron binding capacity.
.
I am not a doctor but I would say you are anemic and should cut back on blood donations. Any other health issues or blood work out of range? When you say total iron at 216 - are your referring to transferrin or serum iron? How was your hemoglobin?
.
The following is a helpful link. See the table on the last page.
https://static1.squarespace.com/sta...4b057f9e38bfadf/1420054370996/HHC_ALL2011.pdf

 

[Saul]

Tks for the reply Paul. I dont think I am anemic. My HCT, hemoglobin and RBC are all normal.
My theory is that you need ferritin to store iron and given my ferritin is low the iron freely circulating in my blood is not being stored. Dont know if that makes sense.
I dont take any iron supplements. I ate a 20 oz steak approximately 16 hours before drawing blood.
Also how eating more iron will help given i am not anemic and my iron in the blood is high?
The test only says total iron (quest Diagnostics)

I am not a doctor but I suppose there could be something wrong with your body's iron storage system or its ability to make ferritin. Ferritin is a protein that the body uses to store iron. Ferritin binds to iron and stores iron in your body, typically in organs for when you need iron to make RBC. I agree, with your other BW input you are not anemic, but given your low ferritin level and continual blood donation, you may be headed in that direction. Typically when your ferritin gets that low, your body emits less hepcidin thereby allowing your body to absorb more iron from the food you eat. This in turn allows your body to store more iron. You may be donating blood too often, not eating enough iron, or both.

I admit I don't understand your high blood iron, but that big fat steak could have jacked up your blood iron, but it would not have much effect on your ferritin. Your iron serum amount of iron is very small compared to typical ferritin iron stores. So you can have high blood iron and low ferritin. I admit I don't fully understand blood iron levels in relatino to ferritin values beyond this. My ferritin was high, but is coming down nicely, yet my iron serum levels are still very high. I have my own theory on why, but is just my speculation.

Your call on what to do next. What does your Dr say? Might be good to get checked out. In any event, your iron stores, indicated by the low ferritin values, are low so it would be good to get those back in range.

 

[HealthMan]

Do you think it can be vitamin b12 supplementation? I recently started supplementing with 1000mcg daily (long story why).
I have a follow up with my doctor in 3 weeks. I was donating blood because my HCT was elevated. Given my donation schedule he order the iron and ferritin tests. And here I am. Confused about what is going on.

I am not a doctor but I suppose there could be something wrong with your body's iron storage system or its ability to make ferritin. Ferritin is a protein that the body uses to store iron. Ferritin binds to iron and stores iron in your body, typically in organs for when you need iron to make RBC. I agree, with your other BW input you are not anemic, but given your low ferritin level and continual blood donation, you may be headed in that direction. Typically when your ferritin gets that low, your body emits less hepcidin thereby allowing your body to absorb more iron from the food you eat. This in turn allows your body to store more iron. You may be donating blood too often, not eating enough iron, or both.

I admit I don't understand your high blood iron, but that big fat steak could have jacked up your blood iron, but it would not have much effect on your ferritin. Your iron serum amount of iron is very small compared to typical ferritin iron stores. So you can have high blood iron and low ferritin. I admit I don't fully understand blood iron levels in relatino to ferritin values beyond this. My ferritin was high, but is coming down nicely, yet my iron serum levels are still very high. I have my own theory on why, but is just my speculation.

Your call on what to do next. What does your Dr say? Might be good to get checked out. In any event, your iron stores, indicated by the low ferritin values, are low so it would be good to get those back in range.

 

[ratbag]

I have a similar problem. I donated blood a few times and I had a heck of a time getting my ferritin back into range I was down to 7. But my % sat and serum were above range... I'm waiting to be checked for hematomachrosis but only a hematologist can do that where I am so it's another wait period for me.

When my ferritin was below range my entire body was cold if it was any colder than 85 degrees outside. I literally would get the shakes and have to take a very hot shower.

 

[HealthMan]

Odly enough i have no symptoms. How long did it take for your ferritin levels to recover? I thought that hematomachrosis was also accompanied by high ferritin levels

I have a similar problem. I donated blood a few times and I had a heck of a time getting my ferritin back into range I was down to 7. But my % sat and serum were above range... I'm waiting to be checked for hematomachrosis but only a hematologist can do that where I am so it's another wait period for me.

When my ferritin was below range my entire body was cold if it was any colder than 85 degrees outside. I literally would get the shakes and have to take a very hot shower.

 

[ratbag]

If you google hemachromatosis you will learn that most MD's don't catch it... and they go on until suddenly their liver is fried and they need a transplant. It's scary because most MD's only look at ferritin. You can have perfectly normal ferritin levels and have hemachromatosis. Have a quick read here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657669/

I had to take iron supps and it took about 2 months and when I got retested my ferritin was at 217. Where I live I cannot get a full iron panel, the labs/hospitals won't do it unless the Rx'ing MD is a hematologist. Here it's complicated but it shouldn't be like this. The real problem for you lies in getting a full iron panel and there are other labs they also use to help diagnose this as well. The problem being the average MD doesn't know how to diagnose it properly even with all the correct labs... so a hematologist is really necessary. And for that you would have to get a referral I suspect.

 

[HealthMan]

Can hemachromatosis be caused by TRT? I am also wondering if it is due to my b12 supplementation

 

[ratbag]

No TRT has nothing to do with it. Read that article.... it says:

SUMMARY

Hemochromatosis is a common and relatively simple genetic disease to diagnose and treat. It can be diagnosed and treated by family physicians using transferrin saturation, serum ferritin and C282Y genetic testing. Physicians who are not comfortable with interpretation of the genetic test and subsequent family counselling should refer to local specialists and try to avoid any perpetration of misinformation.

 

[Saul]

Can hemachromatosis be caused by TRT? I am also wondering if it is due to my b12 supplementation

Hemochromatosis is a build up of iron in the body. There are many causes. If due to a gene anomaly, it is called hereditary because you inherit a gene from each parent that results in the person absorbing too much iron from the food they eat. I don't know about B12. As far as I know TRT does not cause high iron or hemochromatosis. Nothing to do with TRT. OP, you do not have hemochromatosis.
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Iron test were on the standard blood panel based in the 70's maybe 80's I think, but then they took it off due to fraud and cost cutting. It affects about 1 in 200 European background people. My GP spotted it easily but he ran the right test and confirmed with genetic testing. I have never heard of someone with low ferritin having hemochromatosis. It takes months to increase or decrease iron stores (and thus ferritin value) because it is a slow process to pull the iron from the organs by repeated blood donations or increase stores through diet and supplements. My doctor told me that ferritin will drop 30 to 50 points per blood donation due to creation of new red blood cells.

 

[HealthMan]

Maybe Dr Saya or Nelson can shed some light. My theory is given ferritin is very low the iron stays in the blood stream instead of getting stored. When ferritin goes back to normal levels the serum iron levels should go back to normal

 

[ratbag]

Your forgetting the reason your ferritin is low is because you've been donating blood. This is self-induced. The crux of that article is that just because your ferritin is low doesn't mean you don't have hemachromatosis. That's all I was trying to say.

 

[HealthMan]

Agree. My ferritin is low because of blood donation. But given ferritin is the protein that binds to iron in the blood to be stored a low level of ferritin could in theory raise iron serum levels for a short period of time. Again. Just speculating.

 

[HealthMan]

What was your % saturation and serum iron?
My % saturation is 45% and looks like hemochromatosis patients have % saturation of 50-55%+

I have a similar problem. I donated blood a few times and I had a heck of a time getting my ferritin back into range I was down to 7. But my % sat and serum were above range... I'm waiting to be checked for hematomachrosis but only a hematologist can do that where I am so it's another wait period for me.

When my ferritin was below range my entire body was cold if it was any colder than 85 degrees outside. I literally would get the shakes and have to take a very hot shower.

 

[HealthMan]

Normal ferritin and hemochromatosis seens plausible but not low ferritin from what i have read. Did u test serum iron and % saturation after having your ferritin levels return to normal?

If you google hemachromatosis you will learn that most MD's don't catch it... and they go on until suddenly their liver is fried and they need a transplant. It's scary because most MD's only look at ferritin. You can have perfectly normal ferritin levels and have hemachromatosis. Have a quick read here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657669/

I had to take iron supps and it took about 2 months and when I got retested my ferritin was at 217. Where I live I cannot get a full iron panel, the labs/hospitals won't do it unless the Rx'ing MD is a hematologist. Here it's complicated but it shouldn't be like this. The real problem for you lies in getting a full iron panel and there are other labs they also use to help diagnose this as well. The problem being the average MD doesn't know how to diagnose it properly even with all the correct labs... so a hematologist is really necessary. And for that you would have to get a referral I suspect.

 

[HealthMan]

I am looking at my blood work before starting TRT and both serum iron and ferritin were well within range. So if I had hemochromatosis I would think that this blood results should have high serum iron but they do not

 

[ratbag]

I think your attaching too much relevance to your pre TRT labs. Currently you have above range Serum Iron and TIBC and % Sat. Are you aware that Symptoms of hemochromatosis usually appear in men between the ages of 30 and 50 years of age? (oops that was a cut and paste with out of control formatting) We are ignoring your ferritin because of your blood donations.

 

[HealthMan]

% sat is within range (not high). I agree that symptoms can start late from what i have read but if you have hemochromatosis your iron levels will be high during your life regardless of symptoms according to my searches in the internet.
Agree that ferritin is low because of blood donation. But the blood donation should also decrease iron serum levels (therapeutic phelobotomy is used to treat hemochromatosis). I asked my doctor to restest (to rule out the big steak i ate before the blood test).

 

[HealthMan]

Testes again. Ferritin back to normal ~ 50. Serum iron still elevated and now % saturation a bit elevated as well. Iron binding capacity normal now. I guess i will pay a visit to a hematologist