iCliniq logo

Ask a Doctor Online Now

HomeAnswersHematologyanaemiaPlease help me understand my blood results.

Can you help me understand my blood results?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At May 16, 2016
Reviewed AtJune 5, 2023

Patient's Query

Hi doctor,

I was diagnosed with anemia due to heavy periods. I was told to double up on my iron supplements. My iron is already high and my ferritin is low. My binding is not even registering. My results are as follows. Ferritin 8.0 ng/mL, iron 333 ug/dL, iron-binding capacity and transferrin saturation were not calculated due to an unsaturated iron binding capacity of less than 55 ug/dL. Can you help me understand my results?

Thank you.

Answered by Dr. Prakash. H. M.

Hi,

Welcome to icliniq.com.

Based on your query my opinion is as follows:

  1. The values are very rare. However, I will try to help you to the best of my knowledge.
  2. Ferritin is the storage form of iron. Serum iron is high, as you are on iron supplements.
  3. The body will take a longer period of time, usually up to three to six months for storing iron in the form of ferritin, hence ferritin is low.
  4. The body usually regulates serum iron by reducing the absorption of iron, however, if infusion is taken, iron can be high in serum.
  5. If oral intake is during the initial phase then increased serum iron may be found as more receptors are activated to absorb iron in the view of severe iron deficiency.
  6. The unsaturated iron binding capacity is the total iron binding capacity (TIBC) minus serum iron. As the serum iron is high, the unsaturated iron binding capacity falls and hence it cannot be calculated.
  7. Transferrin transports circulating ferrous molecules (Fe3). Normally only about one-third of iron-binding sites are occupied; the remainder is called unsaturated iron-binding capacity.
  8. Serum transferrin saturation is obtained by dividing serum iron by TIBC. This also could not be calculated as it is dependent on unsaturated iron binding capacity.
  9. At present, not sure, how long iron supplements are being taken, however, as heavy periods are causing blood loss, iron supplements are essential.
  10. MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin), and MCHC (mean corpuscular hemoglobin concentration) should be low with increased RDW (red cell distribution width) to make a diagnosis of anemia on complete blood counts. These values are usually secondary to iron deficiency.
  11. A better indicator of your body responding to improving iron status is a reticulocyte count. It will start increasing within two weeks of the start of therapy.
  12. Due to increased serum iron and its importance in the calculation of other results, other data was not calculated. Do continue with iron supplements, as the iron storage (ferritin) needs to be filled. Once serum ferritin is normal, you can reduce iron supplements to a regular dose.

Treatment plan

1. Continue iron supplements, until ferritin becomes normal. 2. Repeat biochemical tests after three months. If early tests needed, reticulocyte count will be more helpful.

Regarding follow up

Revert back after three months.

Patient's Query

Thank you doctor,

I have attached the rest of my blood work. My blood work has never been this strange compared to my other test over the years. I am suffering with anemia for the last 16 years after birth of daughter. I just started treatment before six years after it had got extremely bad.

Answered by Dr. Prakash. H. M.

Hi,

Welcome back to icliniq.com.

Based on your query and attached reports (attachment removed to protect patient identity), my opinion is as follows:

  1. The hemoglobin is mildly reduced and all others do not signify iron deficiency in any way. I can think of two possible explanations based on the data available.
  2. In partially treated iron deficiency anemia, serum ferritin remains low when hemoglobin and serum iron have returned to normal. Ferritin returns to normal when iron stores get repleted with further iron therapy.
  3. Besides iron deficiency, there are two other conditions that are associated with low serum ferritin. One is hypothyroidism and the other is scurvy.
  4. Always serum ferritin falls first, then serum iron. The correction also occurs, first in serum iron and then ferritin. Serum iron goes up following the ingestion of iron-containing foods, but serum ferritin does not. It will take time.
  5. If you are not having any fatigue, cold sensitivity, constipation, dry skin, and unexplained weight gain then probably no hypothyroidism. Thyroid hormone profile can confirm.
  6. Vitamin C deficiency causes scurvy and gum bleeding or small red spots in skin are usual findings.
  7. If both are not present then it is getting corrected. Do continue with supplements.
  8. The attached report is almost normal. Serum ferritin will get corrected, as hemoglobin returns to normal and serum iron will go to storage at that point.
  9. Maintaining hemoglobin within the normal range will improve the quality of life and is essential. Continue the same, as of now.

Investigations to be done

If necessary then get thyroid hormone profile.

Treatment plan

1. Doubling the dose may not be necessary. Continuing the same dose should be adequate. 2. Repeat complete blood count after three months along with serum ferritin.

Regarding follow up

Revert back after three months.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Prakash. H. M.
Dr. Prakash. H. M.

Hematology

Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Ask your health query to a doctor online

Hematology

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy