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I'm trying to figure out a mystery of why I

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Pathologist and Microbiologist
Practicing since : 2006
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I'm trying to figure out a mystery of why I have an elevated ferratin level. Obviously upon research their are some rather ominous causes for this elevation.

I've presented with ferratin levels of 575, 448, 535 and most recently 340 (different lab) over the past two months.

I thought the first two tests were due to inflammation from a sports injury but when I took the 3rd test when I thought the injury was healed it came back at 535. When I took the third test my doctor also ran a CRP and ESR which both came back normal. Crp <.4mg/dec (reference <.5mg/dec), ESR was 2. Another test also revealed I don't have hereditiary hemachromotosis. All other CBC, Metabolic tests came back normal.

Any idea of what is going on or what we can likely exclude? I do have osteoarthritis and bone spurs, not sure if that is a factor, I also consume a high meat, beans, brocolli diet so not sure if that can contribute. I am 41, 6'3, 198lbs, athletic and never drink or smoke.
Wed, 7 Feb 2018 in Blood Disorders
 
 
Answered by Dr. Shailja Puri 20 minutes later
Brief Answer:
Inflammation is ruled out, kindly post CHG, iron, % sat and TIBC reports.

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

High levels of ferritin are seen in disorders of iron metabolism, iron overload, inflammation, hereditary conditions like hemochromatosis to name a few.
A possibility of underlying inflammatory condition is ruled out due to normal ESR and normal CRP.
For further interpretation of lab result of ferritin, I request you to kindly post the entire iron profile - serum iron, % saturation, TIBC along with complete hemogram (CHG) reports.
In case any other investigation like bone marrow aspiration has been done, then please post this report also.

Thanks and take care
Dr Shailja Puri
Above answer was peer-reviewed by
 
Follow-up: I'm trying to figure out a mystery of why I 49 minutes later
Hi, the hematologist I was I referred to said my iron count was a little high but in normal range, my tibc % was 38, and other iron labs were in normal range that's all I remember. Sorry for not having more detail. I didn't have a bone marrow aspiration done, hematologist didn't seem concerned about malignancy and seemed to imply normal blood counts/tests, esr and crp as well as lack of classic symptoms ruled this out. Do you see this differently? Could I just have genetically high ferratin ?
 
 
Answered by Dr. Shailja Puri 12 minutes later
Brief Answer:
Low TIBC suggests iron overload. I suggest HFE gene analysis.

Detailed Answer:
Hello and welcome again,
A low TIBC suggests that your body has excess amounts of iron and thus excess of ferritin - storage form of iron.
Due to high levels of iron in body, the capacity of body to imbibe iron is reduced.
This happens due to negative feedback mechanism.
I would suggest you to go for HFE gene analysis after consulting with your hematologist.
There is possibility that accumulation of iron over a period of time may lead to damage to organs since iron is injurious to various organs in our body.

Thanks and take care
Dr Shailja Puri
Above answer was peer-reviewed by
 
Follow-up: I'm trying to figure out a mystery of why I 52 minutes later
Hi, I was told I tested negative for heriditary hemachromotosis. I made a mistake in my email before. My iron profile was as follows

Iron 128 ug/DL
TIBC 328 ug/DL
% saturation 39.0%
UOBC 200 ug/DL

Being that this is ruled out and I have normal acute phase values of crp and esr I'm not sure what's left. My last value of 340 was not very high.

Any thoughts besides just continues follow up with my hematologist ?

Thank you
 
 
Answered by Dr. Shailja Puri 16 hours later
Brief Answer:
Hematological follow up, LFT and blood glucose tests are recommended.

Detailed Answer:
Hello and welcome again,
Thanks for posting the values of iron profile.
All the values are normal, however, ferritin is high.
Ferritin is most sensitive parameter for iron overload.
Hemachromatosis is caused by mutation of various genes other than HFE.
With this blood picture, hematological follow up is most rational approach with regular monitoring of iron and ferritin levels.
I addition, I would suggest you to get liver function test (LFT) and blood glucose to rule out any damage to liver and pancreas since liver and pancreas are most amenable to damage by iron deposition.

Thanks and take care
Dr Shailja Puri
Above answer was peer-reviewed by
 
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