Low Iron

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    Low Iron


    I have a friend with the following lab values. My question is, does this warrant supplementing iron? Since the Ferritin is normal, I'm not sure why the iron is low, unless this lab is incorrect.

    Erythrocite count 5.52 4.5-6.5
    Haemoglobin 16.2 13.8-18.8
    Haematocrit 0.49 0.40-0.56
    MCHC 33.1 32-36
    MCH 29.4 27-35
    Platelets 236 150-450

    Iron 2.1 11.6-31.3
    Transferrin 34.4 26.0-47.0
    % Saturation 3.1 20.0-55.0
    Ferritin 121 20-300

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    Quote Originally Posted by 1cc View Post
    I have a friend with the following lab values. My question is, does this warrant supplementing iron? Since the Ferritin is normal, I'm not sure why the iron is low, unless this lab is incorrect.

    Erythrocite count 5.52 4.5-6.5
    Haemoglobin 16.2 13.8-18.8
    Haematocrit 0.49 0.40-0.56
    MCHC 33.1 32-36
    MCH 29.4 27-35
    Platelets 236 150-450

    Iron 2.1 11.6-31.3
    Transferrin 34.4 26.0-47.0
    % Saturation 3.1 20.0-55.0
    Ferritin 121 20-300
    Wait a little then send PM to cpeil2
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    Quote Originally Posted by 1cc View Post
    I have a friend with the following lab values. My question is, does this warrant supplementing iron? Since the Ferritin is normal, I'm not sure why the iron is low, unless this lab is incorrect.

    Erythrocite count 5.52 4.5-6.5
    Haemoglobin 16.2 13.8-18.8
    Haematocrit 0.49 0.40-0.56
    MCHC 33.1 32-36
    MCH 29.4 27-35
    Platelets 236 150-450

    Iron 2.1 11.6-31.3
    Transferrin 34.4 26.0-47.0
    % Saturation 3.1 20.0-55.0
    Ferritin 121 20-300

    It could be uncomplicated iron deficiency - meaning that it is early enough so that it has not created any other blood abnormalities. MCV would help rule out anemia.

    Ferritin can remain normal in the presence of infection or inflammation.
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    Quote Originally Posted by cpeil2 View Post
    MCV would help rule out anemia.
    Thanks Cpeil. Here is the whole CBC including MCV. The neutrophils are just slightly elevated.

    ESR 2 1-30
    Erythrocite count 5.52 4.5-6.5
    Haemoglobin 16.2 13.8-18.8
    Haematocrit 0.49 0.40-0.56
    MCHC 33.1 32-36
    MCH 29.4 27-35
    MCV 88.8 79-100
    RDW 13.7 11.0-16.0
    Platelets 236 150-450

    Leucocyte Count 9.90 4.0-12.0
    Neutrophils 7.51 2.0-7.5
    Lymphocytes 1.47 1.0-4.0
    Monocytes 0.67 0.2-1.0
    Eosinophils 0.14 0.0-0.5
    Basophils 0.11 0.0-0.3
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    Quote Originally Posted by 1cc View Post
    Thanks Cpeil. Here is the whole CBC including MCV. The neutrophils are just slightly elevated.

    ESR 2 1-30
    Erythrocite count 5.52 4.5-6.5
    Haemoglobin 16.2 13.8-18.8
    Haematocrit 0.49 0.40-0.56
    MCHC 33.1 32-36
    MCH 29.4 27-35
    MCV 88.8 79-100
    RDW 13.7 11.0-16.0
    Platelets 236 150-450

    Leucocyte Count 9.90 4.0-12.0
    Neutrophils 7.51 2.0-7.5
    Lymphocytes 1.47 1.0-4.0
    Monocytes 0.67 0.2-1.0
    Eosinophils 0.14 0.0-0.5
    Basophils 0.11 0.0-0.3
    Neutrophils are usually increased with an infection and giving iron during infection will only feed it. Copper is also released during an infections this causes a rise in neutrophils. Copper will also cause a depeltion of iron as well because copper increases iron metabolism..you might have a little steph infection. I notice WBC are not given here
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    Quote Originally Posted by hardasnails1973 View Post
    I notice WBC are not given here
    I'm not sure why, but WBC was not on the CBC.
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    Quote Originally Posted by hardasnails1973 View Post
    Neutrophils are usually increased with an infection and giving iron during infection will only feed it. Copper is also released during an infections this causes a rise in neutrophils. Copper will also cause a depeltion of iron as well because copper increases iron metabolism..you might have a little steph infection. I notice WBC are not given here
    Leucocyte count = WBC
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    Quote Originally Posted by 1cc View Post
    Thanks Cpeil. Here is the whole CBC including MCV. The neutrophils are just slightly elevated.

    ESR 2 1-30
    Erythrocite count 5.52 4.5-6.5
    Haemoglobin 16.2 13.8-18.8
    Haematocrit 0.49 0.40-0.56
    MCHC 33.1 32-36
    MCH 29.4 27-35
    MCV 88.8 79-100
    RDW 13.7 11.0-16.0
    Platelets 236 150-450

    Leucocyte Count 9.90 4.0-12.0
    Neutrophils 7.51 2.0-7.5
    Lymphocytes 1.47 1.0-4.0
    Monocytes 0.67 0.2-1.0
    Eosinophils 0.14 0.0-0.5
    Basophils 0.11 0.0-0.3

    Yes, neutrophil count is SLIGHTLY (and I stress slightly) elevated. It is worth watching, but probably no cause for concern. ESR is a marker for inflammation. One as low as here indicates inflammation is not a problem. Although ESR is used to determine how active a condition such as Lupus or rheumatoid arthritis is, as a general marker for inflammation, it is considered old-fashioned. CRP would be much better.

    Red cell indices are textbook normal, iron-deficiency anemia is unlikely. I would say it is either lab error or an early iron deficiency that will respond well to dietary changes. Does friend eat plenty of meat, poultry and fish?

    I wouldn't supplement iron unless dietary changes don't work.
    Last edited by cpeil2; 08-22-2007 at 06:12 PM. Reason: Add content
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    Quote Originally Posted by cpeil2 View Post
    Does friend eat plenty of red meat?
    It's good that you picked that up Cpeil2. I just found out a couple days ago that he stopped eating red meat about 2 years ago. (I hope he hasn't been eating a ton of fish - mercury).

    Quote Originally Posted by cpeil2 View Post
    Red cell indices are textbook normal, iron-deficiency anemia is unlikely. I would say it is either lab error or an early iron deficiency that will respond will to dietary changes.
    I came to the same conclusion. In a case like this, I would have expected Ferritin to be low as well, or at least his hemoglobin or MCHC to be lower.
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    Quote Originally Posted by cpeil2 View Post
    Does friend eat plenty of meat, poultry and fish?
    He does not eat meat.

    I believe he does eat a lot of poultry. Not sure about the fish. Would these help in elevating iron?

    Thanks for your help Cpeil2.
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    I have been going through a similar situation, except my WBC's have been more elevated.

    My question is just what are the correlations between low iron and infection. How/why do these relate during infection?


    All of my results are in this thread.
    Any studies on TRT effecting WBC's
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    Quote Originally Posted by 1cc View Post
    He does not eat meat.

    I believe he does eat a lot of poultry. Not sure about the fish. Would these help in elevating iron?

    Thanks for your help Cpeil2.
    Heme iron is more easily absorbed than non-heme iron. Any kind of animal flesh - red meat, poultry fish is a good source of heme iron. Some are better than others - clams, oysters, mussels, shrimp, beef, turkey, pork liver, beef liver are all tip-top.


    Green vegetables and peppers are good sources of non-heme iron. Spinach, paradoxically, contains plenty of iron, but also inhibits iron absorption.
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