Quoted post said:Originally posted by Insight Driver
She has normal iron in her tissue, but it is low in her blood.
Where my blood chemistry is normal, hers is not.
Blood tests done for "iron studies" are one of the most difficult tests to interpret even for senior doctors.
The most important result is ferritin which reflects the body's stores of iron. However, it can be hard to interpret in that the ferritin level goes up when you have any inflammation going on at the time (eg the 'flu or a skin infection). If the ferritin is greater than 100, then you can be sure that you are not iron deficient. If it is very low, then you are likely to be iron deficient.
Women generally have lower levels of ferritin than men because of menstrual losses (1mg iron loss per day) and losses associated with pregnancy & lactation.
The level of iron itself in the blood is not particularly important and should generally be ignored. Many things can affect the level and whether it is low or high does not accurately reflect iron stores. If your ferritin is above 100 and your iron level is low - don't worry as the low iron level is probably not relevant. If both are low then you are likely to be iron deficient.
The haemoglobin level & size of your red blood cells on a "full blood examination" or "complete blood count" are important. The haemoglobin level is what tells you that you really are anaemic. There are many causes of fatigue other than anaemia. If you are anaemic, then further evidence for iron deficiency is that the red blood cells are small (MCV or Mean Cell Volume below 80fl). If you have anaemia with normal or large red blood cells, then it is important to look for causes other than iron deficiency.
If, after all this, the diagnosis of iron deficiency anaemia is made, it is very important to look for the reason why and not just focus on replacing iron. Causes include:
*Blood loss (eg heavy periods, losses from the stomach or bowel due to things like stomach ulcers or diseases of the colon)
*Inadequate dietary intake
*Failure to absorb iron (eg celiac disease or chronic diarrhoea)
*Other rarer causes
With regards to iron replacement, remember that this is a slow process. You only absorb a small % of the iron you take in.
You can absorb up to 30% of the iron in meat, fish or poultry but only 10% or less of the iron in vegetables. It will take a long time to restore your stores fully, especially if losses such as heavy periods are ongoing.
Adding vitamin C will improve the absorption of iron if taken together. Iron tablets are good but some people get very constipated and others can become disconcerted by the way they make bowel motions black.
If you are successfully replacing iron, the haemoglobin should rise by ~2 g/dl in the first 3 weeks or so (that is if you were anaemic to start with).
