QuestionQUESTION: Hi, I am a 31 year old female. I've had extremely low ferritin and low iron serum for the past couple of years. I've been taking OTC iron supplements and my doctor said it looked as if it was pure iron deficiency and nothing to worry about. My levels have been checked periodically and basically stayed the same with each test, but never affected my hematocrit or hemoglobin until my most recent test. My ferritin is now normal, but my iron serum is 48 which she said is low and now my hematocrit is low at 36.7 (said normal was 37). In March 2010 it was 40.8 on the same reference range (37.0-51.0). My doc is putting me on prescription iron/vitamins and will recheck again in 6 weeks. Is this anything to be worried about? What could the change in levels signify (simply menstruation, malignancy, chronic illness I'm unaware of, etc)?
Next is my FT4 level. I have suffered from anxiety and depression for many years but it's never been so bad I couldn't handle it. Until this past March when it seemed to spiral out of control. I've also lost over 39lbs in the past year without trying. The psych thinks it's due to the anxiety and depression but wanted me to have my thyroid checked just to be sure. In June of this year the FT4 level was 1.11 (reference 0.61-1.12) but two years ago in May of 2008 my FT4 was 0.85 with the same lab and same reference range. Could this change, and the fact that my level is now so close to the upper end of the range, be of any significance?
Thanks in advance!
ANSWER: Hi Wendy, I'd be glad to try and answer your question. First let's start with your iron/ferritin. Your current levels actually look good. Even though the hematocrit is slightly lower than the "normal" range, it's actually good for being female. Because of menstruation, of course, female normal range is typically lower than male normal range. Your iron of 48 is normal, also. For females, the normal range at the hospital I work at is 35-100. Ferritin is a good indicator of how well the iron your taking is being absorbed by your body. So, since your ferritin is normal, that's very good.
Now your Free T4 level. Free T4 is only one of several thyroid tests that can be checked to monitor thyroid function. Did your doctor do other thyroid tests? Were they also normal? The change from 0.85 to 1.11 is unlikely to be of any clinical significance. Values can change easily from day to day, both in your body and by the lab's measurement.
Hope this helps. Good luck!
Samantha
---------- FOLLOW-UP ----------
QUESTION: Hi Samantha,
I received a copy of my last labwork and I'm very concerned. Here are the abnormal results. I hope you can shed some light on this as my doctor simply said we'd recheck again in 6 weeks. Thanks!
IRON 48 L (50-170)
TRANSFERRIN SAT 15 L (20-50%)
WBC 3.9 L (4.8-10.8)
RBC 4.12 L (4.50-5.50)
HCT 36.7 L (37.0-47.0)
PLATELET 116 L (150-430)
AnswerHi again, Wendy. There's no need to be too concerned, since your doctor doesn't seem to be. All of the abnormal results you've listed are all part of your iron deficiency anemia. Also, the values are only slightly abnormal, which is of little clinical significance. Have you tried eating more iron rich/fortified foods? I know you're taking iron supplements, but iron from foods is more readily absorbed by the body and this may help more than the iron supplements.
Samantha
