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I'm a bit confused by some recent test results. I've been anemic a few times before: several times as a kid, once before I was diagnosed with celiac, about a year ago (while I had some severe period bleeding), and now (not bleeding so much anymore).

A year ago my lab results were:

RBC: 3.87 (4.2-5.10) L
Hemoglobin: 12.6 (11.7-17.1)
Hematocrit: 36.8 (38.5-45.0) L
MCV: 95 (80-98)
Ferritin: 22 (13-150)

I stopped my bleeding problem, supplemented with about 100mg of elemental iron each day (heme/liver based iron) and felt better within about 3-4 months (I didn't get new labs though...).

So I fell off the iron wagon about 4 months ago and recently started getting symptoms of high pulse, headaches, dizziness, fatigue, loss of stamina, etc. all those not fun iron deficiency symptoms : ( So I went in for a new blood test. Looks like I'm anemic (low RBC) but my ferritin is the best I've ever seen it:

RBC: 3.82 (4.2-5.10) L
Hemoglobin: 11.9 (11.7-17.1)
Hematocrit: 36.5 (38.5-45.0) L
MCV: 96 (80-98)
Ferritin: 47 (13-150)
Vitamin B12: 959 (211-946) H
Folate (Folic Acid): 15.7 (>3.0)

I'm confused; I thought that your body lost its ability to make enough red blood cells only after it used up most of your ferritin. It seems like I have enough ferritin (not a ton, but enough) but my body isn't using it? I've heard that ferritin is an "acute phase reactant" if I had some sort of cold or flu when the blood was drawn, would that artificially raise my ferritin?

I'm just trying to figure out whether I should supplement with iron again. My doctor is not worried about it because my numbers "aren't that bad"; she just told me to take a multi-vitamin with iron.

Any help greatly appreciated! Thanks!
Any immune or inflamatory reaction can give a deceptively high ferretin reading, colf, flu, arthritis, etc, even if it was so mild that you werent aware you were ill.

Given your history, supplementing with iron would seem wise, and indeed, it may be worth taking iron supplements every day until you cease mensturating (perhaps at a lower dose than initialy)

Say 2 x 65mg iron pills per day initialy for 3-4 months, then say 1 x 27mg tablet per day on an ongoing basis to keep your levels up.

Taking your iron with a vitamin c tablet can greatly increase the uptake of iron from the gut

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