Why is my ferritin level low, but transferrin saturation level is high?

Question

Hello doctor,

I was feeling fatigued, having headaches, difficulty concentrating at times, hair loss, and gaining weight quickly. So I took my blood test and found that my ferritin level was low (30 ng/mL; normal range 38 ng/mL to 380 ng/mL), but the transferrin saturation level was high (0.054 mg/dL; normal range 0.02mg/dL to 0.048mg/dL). It also showed high TSH levels (5.3 mIU/L; normal range 0.4 mIU/L to 4.5 mIU/L) and normal T4 (1.4 µg/dL; normal range 0.8 µg/dL to 1.8 µg/dL). Everything else, CBC, lipid levels, metabolic tests were normal. What could be the issue? I have read that a low ferritin level may indicate iron deficiency, but my transferrin saturation is high, which is not expected of iron deficiency. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

From the report attached (attachment removed to protect the patient’s identity), first, for ferritin, you got nothing to worry about as your hemoglobin (Hb) is normal, iron is normal, CBC (complete blood count) is normal, and ferritin level is only mildly low which does not signify anything. If all the reports were deranged, then it would mean you have some disease. So nothing to worry about.

Regarding TSH (Thyroid-stimulating hormone), thyroid treatment is started when TSH (Thyroid stimulating hormone) is above 12 mIU/L. However, if you face any hypothyroidism symptoms like constipation, lethargy, hair loss, abnormal menses, then you can take low dose of tablet Thyroxin 25 mcg once daily. If there are no symptoms, no treatment is required. Just get a repeat TSH level every three months and monitor for rising levels.

Hope this helps.

Kindly revert back in case of further queries.