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My lab results yesterday shows that my iron saturation at 5% is quite low. I have been feeling like something that cat dragged in for a couple of years now but have only been minimally tested for iron with only CBCs in the past. My hematocrit and hemoglobin levels have been out of range for about a year but not enough to cause any concern. This week was the first time that anyone (a nurse at a doc-in-the-box; not my primary physician) thought to test my iron stores.

What I'm wondering is what are some important pointed questions that I should ask my PCP when I see him on Monday. Does this seem like anemia or iron deficiency... or are they one and the same? Is ferrous sulfate enough to correct these levels? Do I need to see a hematologist? I've always been concerned with my iron levels because my father passed away due to complications from untreated hemochromatosis but my doctors have always told me that my CBCs indicate that I don't have to worry about heriditary hemochromatosis. Kudos to the doc-in-the-box for testing me properly though! They told me that CBCs are only a small snapshot of what the real levels my iron might be, and not the whole picture. Can you think of any other questions that I should ask my PCP?

Below are the results from my blood work this week and a couple others from this past year, plus a bit of my health history:



[U]This week[/U]:

HGB = 11.5 [COLOR="Red"]Low[/COLOR] (Range = 11.7-15.5)
HCT = 34.8 [COLOR="red"]Low[/COLOR] (Range = 35.0-45.0)
RBC = 4.21 [COLOR="Green"]In Range[/COLOR](Range = 3.8-5.1)
MCV = 82.7 [COLOR="Green"]In Range[/COLOR](Range = 80.0-100.0)
MCH = 27.3 [COLOR="Green"]In Range[/COLOR] (Range = 27.0-33.0)
MCHC = 33.0 [COLOR="Green"]In Range[/COLOR] (Range = 32.0-36.0)
RDW = 17.8 [COLOR="Red"]High[/COLOR] (Range = 11.0-15.0)
[B]Total Iron = 24 [COLOR="Red"]Low[/COLOR] (Range = 40-175)
TIBC = 437 [COLOR="Green"]In Range[/COLOR] (Range = 250-450)
% Saturation = 5 [COLOR="Red"]Low[/COLOR] (Range = 15-50)[/B]


[U]6 months ago[/U]:

HGB = 8.8 [COLOR="Red"]Low[/COLOR] (Range = 12.0-16.0)
HCT = 27.6 [COLOR="Red"]Low[/COLOR] (Range = 37-47)
RBC = 3.59 [COLOR="Red"]Low[/COLOR] (Range = 4.2-5.4)
MCV = 76.9 [COLOR="Red"]Low[/COLOR] (Range = 81-101)
MCH = 24.4 [COLOR="Red"]Low[/COLOR] (Range = 26-34)
MCHC = 31.8 [COLOR="Red"]Low[/COLOR] (Range = 32-36)
RDW = 13.6 [COLOR="Green"]In Range[/COLOR] (Range = 11.5-14.5)


[U]7 months ago[/U]:

HGB = 10.0 [COLOR="Red"]Low[/COLOR] (Range = 11.5-15.2)
HCT = 29.9 [COLOR="Red"]Low[/COLOR] (Range = 33.5-45.2)
RBC = 3.67 [COLOR="Red"]Low[/COLOR] (Range = 3.84-5.04)
MCV = 81.4 [COLOR="Red"]Low[/COLOR] (Range = 82.0-99.0)
MCH = 27.2 [COLOR="Red"]Low[/COLOR] (Range = 27.4-33.0)
MCHC = 33.4 [COLOR="Green"]In Range[/COLOR] (Range = 31.6-35.5)
RDW = 12.3 [COLOR="Green"]In Range[/COLOR] (Range = 10.2-14.0)


[U]Health history[/U]:

Female, late 40's, have not entered menopause, not overweight, fairly active until as of late
Newly diagnosed w/ sleep apnea (using CPAP)
Newly diagnosed type II diabetes (diabetes under control) NO FAMILY HISTORY!
Kidney stones twice in the past two years
Undiagnosed joint pain and recent significant hair loss
Extreme fatigue
Medications: Metformin


Any comments would be so very appreciated. I'm feeling really lost about this iron stuff.:dizzy:
Hi, it looks like your hemoglobin is slightly low, and you mcv is within range so the cells themselves are alright, If it is that your not absorbing iron, then that could be from a stomach, intestine or bowel problem, medication, menstration. Ferrous sulphate would correct the levels but if its an absorbtion or keeping iron stores then you could look into underlying causes, maybe treat that problem if there is one, rather than being reliant on ferrous sulphate.
Heamochromatosis can cause joint pain, but i think that is in the hands. If you are having joint pain and hair loss has that been attributed to anemia?
could you ask for a full chemical work up including liver function tests and inflammatory tests like ESR ? it might give a clearer picture as i dont really know how diabetes affects the blood?
Wish you well
xxxx
If I didn't feel so absolutely drained and finding myself gasping for breath doing the most mundane things, I'd prefer to avoid iron supplementation. I've always erred on the side of caution, iron-wise, since my father passed away due to hemochromatosis. I'd read online many years ago (but can't seem to find it anymore) where you can be anemic and still have hemochromatosis so I guess that's the root of my fear.

I do hope that I am referred to a hematologist. While I really like my primary care physician, he's missed a few pretty big things here and there over the years that have left room for doubt now on occasion, this being one of them. Symptoms for diabetes, anemia, thyroid issues, lyme disease, lupus, etc., overlap a great deal and I'd like to put to rest some nagging questions I have such as why I have just developed diabetes. There is no family history whatsoever and I am a fairly active, normal weight-range person, although I do enjoy drinking colas daily. There again my fear of hemochromatosis seems more of a possibility since diabetes can be a consequence of hemochromatosis.

My unexplained joint pain is in my hands. No arthritis in the family either.:confused:
The hair loss became noticeable about a year ago. It's not patchy, but seems to be more evenly distributed throughout my head. Perhaps at the temples a little bit more but I'm not sure. It appears that I've lost nearly 50% of my hair and/or hair volume. The really weird thing is that my hair was always sort of baby-fine but I had a lot of it, but now the hair shaft itself is even much, much finer too.

I need to educate myself better on what tests might be beneficial in determining the cause of this anemia. I'll be looking up ESR for sure. I don't even know what MCV, MCH, MCHC means and how they relate to one another. It's so, so confusing to me.
Hi there,
its really hard to know what all the abbrieveations are, i got a medical dictionary to help with that.
Esr basically shows up inflammation in the blood, i have a higher count due to rheumatoid arthritis, they also do a crp which is c-reactive protein again an indicator for inflammation, most rheumatoids, lupus sufferes have high readings when having a flare up.
I have had blood tests come back where im anemic and have shown hemochromatosis, I havent had any problems though. Like myself i have no family history of blood or immune :)system illnesses only me it seems, I do drink loads of cola, and coffee but again no difference or pattern to my flare ups.
Hair loss and thinning could be anemia, but also medication can affect that.
MCV is the mean cell volume, basically how big the red blood cells are, i have little ones, due to medication, the other ones MCH MCHC are related to size and shape of the cells HGb is the important one really followed by MCV as this is the anemia tests.
I would ask to see a blood specialist, just to put your mind at rest if any thing, and if it was an absorbtion or retaining iron problem, it could be vitamin b12 shots or just a change of diet or medications that could help, without the need for long term iron meds.
I was looking at your blood results and wondered why the mcv mchc etc had suddenly picked up, are you taking anything different now or have changed diet or anything?
I hope it all goes well for you goldie
best wishes.
Thank you so much again for your responses.

I'd asked my primary care physician a couple of years back to test me for hemochromatosis -- the actual proper testing for it along with the necessary calculations. His reasoning for hesitating to test for me for it was because it could adversely affect me insurance-wise (i.e., always being on my record and perhaps my not being insurable in the future because of it). Hopefully nowadays that will no longer be an issue so I think he should properly test me for it. Up until just this past week, my iron levels had never been tested beyond a simple CBC.

I have the nodules on my joints indicating it could be osteoarthritis. Also blood tests came back negative on whatever could have indicated that it would be RA. It's so very weird having health issues that no one else in my immediate or extended family has... the joint issues, diabetes, hair loss, kidney stones/infections, etc.

I think some of my test results might have improved due to my continuing to stay on carbonyl iron during my cycles after having been told to take it back in June and July. I'm not sure if it could've made that much of a difference or not.

I'm wondering, since I've seen so many here listing their ferritin level, if maybe they have not checked my ferritin level yet? I thought maybe that was what my total iron result was but now I'm thinking it's not. I've been trying to figure out my results, and I'm not quite familiar with the proper terminology, but it looks like I'm not very anemic at all but my iron stores seem to be quite low. I'll be seeing my doctor tomorrow so hopefully I'll understand a little more then about how you can possibly not be anemic but also not have enough iron stores. :dizzy: I hate feeling like such a newbie.
I'm a bit irritated following my doctor's appointment yesterday.

My doctor does not want to refer me to a hematologist. He sees no need for it and seemed a bit at odds with the doc-in-a-box suggesting that I should see one. He says I'm barely anemic and that the daily iron tablets will improve my iron stores enough. He wants me retested in a month. That I can understand and I will take a wait and see approach. The rest of the appointment only went downhill from there though.

He sees no need to test me for hemochromatosis. If I am anemic, then I cannot have hemochromatosis. (Guess it doesn't matter that this is the direct cause of my father's death.)

He completely dismissed my request to be tested for vitamin b deficiency. He sees absolutely no need whatsoever for it. Even after I explained to him that I was told by the urgent care center that had originally prescribed my Metformin back in March, and also the pharmacist, that said I must be tested in about 6-12 months for vitamin b, and then again annually. I've read this too in several books about type II diabetes. After that rebuff, I didn't even have the nerve to ask about vitamin k or ferritin.

He had nothing at all to say about my drastic hair loss. He has never seemed overly concerned with the painful joints in my hands so I didn't even bring it up. I guess I am to assume that there is nothing that can be done for that and that it is a consequence of aging. (This makes me quite angry because I am a very young 48 in body, mind, and spirit.)

I'm feeling really down since my appointment. I will remain hopeful that the iron tablets will improve my blood results. I've been feeling like heck for a long time now, what's another couple of months?





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