Low Iron

1cc

Member
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
 
1cc said:
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
Click to expand...

Wait a little then send PM to cpeil2
 
1cc said:
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
Click to expand...


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.
 
cpeil2 said:
MCV would help rule out anemia.
Click to expand...

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
 
1cc said:
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
Click to expand...

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
 
hardasnails1973 said:
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
Click to expand...

Leucocyte count = WBC
 
1cc said:
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
Click to expand...


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:
cpeil2 said:
Does friend eat plenty of red meat?
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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).

cpeil2 said:
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.
Click to expand...

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.
 
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.
Invalid Link Removed
 
1cc said:
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.
Click to expand...

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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