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Taking Oral Iron Supplements. Suggested For Iron Infusions. Cause Of Iron Deficiency?

Posted on Tue, 26 Feb 2013

Question: Hi, I am on oral Iron suppliments but can never get my Ferritin above 25ng/ml, the latest iron profile was; Iron 11.4 umol/L, transferrin 30.2 umol/L, %saturation 18.9%, Hb 12.5 g/dL. My endocrinologist (treats my CFS) suggested Iron infusions as he wants my Ferritin above 60, but doesn't do the IV treatments, so went to GP who does but when he looked at these results says my iron is fine! Please can you tell me what you think? Thank you!

Answered by Dr. Robert Galamaga (7 hours later)

Hello and thank you for sending your question.

Your question is a good one and I will work on providing with some information and recommendations.

First I want to make sure that you have had a thorough gastroenterology evaluation to look for possible gastrointestinal bleeding. This is the most common cause of iron deficiency. This would include a colonoscopy and upper endoscopy.

At this time I see that you are not anemic. This is important when considering iron supplementation. At this time again with no anemia and a certain level which is within the normal range even though it is at the low range of normal I do not see indications here for iron infusions.

I do not necessarily think that a certain level above 60 is necessary for you. I do think however that you need regular laboratory evaluations to watch the level of your hemoglobin as well as iron and ferritin. Again I cannot underestimate the importance of having a full gastroenterology evaluation to look for possible sources of bleeding.

If you do develop some type of anemia in the future I think a consultation with a hematologist would be necessary.

Thanks again for sending your question. Please let me know if you have any additional concerns regarding this matter.

Sincerely,

Dr. Robert

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (12 hours later)

Hi Thank you so much for your answer! I will request the endoscopies as I've not had them yet. My endocrinologist was of the opinion that I have an absorption problem not a bleeding problem. I've had 3 or 4 Iron injections in the past which have not helped to increase my levels at all; just left me with very sore injection sites :)

Answered by Dr. Robert Galamaga (24 hours later)

Hello again.

It is possible you may have some issue with absorption of iron but it is absolutely necessary to rule out any form of bleeding which could be contributing to your problem.

One last thing that I did not mention is that if you have veryheavy menstrual bleeding this could certainly cause you to have a iron deficiency.

Thanks again for your question. Please let me know if you have any additional concerns you would like to discuss.

Dr. Robert

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (16 minutes later)

Hi Dr XXXXXXX thank you for getting back to me again! Yes, my bleeding used to be very heaving but is alot better now that i'm on natural hormones. Although it is difficult to judge what is too heavy for me or not? One last thing I forgot to mention was that I have to go in for an incisional hernia repair, which was one of the reasons I wanted my iron to be ok. Do you think it would be ok to have the surgery with my levels as they are or should i have the scopes first? Thank you so much!

Answered by Dr. Robert Galamaga (19 hours later)

Hello again.

At this time it is absolutely safe for you to have your hernia repair. There is no concern related to your iron level or blood count in the setting of your planned surgery.

Thanks again for discussing your health concerns with me. I remain available if you have additional points of discussion.

Sincerely,

Dr. Robert

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar