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What Is Ferritin?
Question: What is ferritin. ?
Brief Answer:
The ferrritin is a protein that stores iron in the body
Detailed Answer:
Hi XXXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Ferritin is a protein molecule in cells that stores iron in the body temporarily. The level of ferritin in the blood depends on the amount of iron stored in our body.
2. The ferritin test gives us a value that can be measured. Normal values are
Male: 12-300 ng/mL (nanograms per millilter)
Female: 12-150 ng/mL (nanograms per millilter)
3. Low ferritin means less iron stores and a possible anemia that has to be treated.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
The ferrritin is a protein that stores iron in the body
Detailed Answer:
Hi XXXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Ferritin is a protein molecule in cells that stores iron in the body temporarily. The level of ferritin in the blood depends on the amount of iron stored in our body.
2. The ferritin test gives us a value that can be measured. Normal values are
Male: 12-300 ng/mL (nanograms per millilter)
Female: 12-150 ng/mL (nanograms per millilter)
3. Low ferritin means less iron stores and a possible anemia that has to be treated.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My was 9 but heamoglobin was fine so what could b reason why ?
Brief Answer:
Early stage of iron deficiency anemia
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. Possibility of early iron deficiency anemia might be there. In this phase of anemia, the ferritin or transferrin saturation are low and the hemoglobin is normal.
2. The ferritin is just below normal at 9 and this might reflect that your anemia is of recent onset where the iron stores are depleted first. Supplement therapy with iron and folic acid usually brings back the values within normal levels.
3. It is a good thought to get a peripheral blood smear test done to evaluate the appearance of red blood cells in detail under the microscope and have a complete blood picture.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Early stage of iron deficiency anemia
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. Possibility of early iron deficiency anemia might be there. In this phase of anemia, the ferritin or transferrin saturation are low and the hemoglobin is normal.
2. The ferritin is just below normal at 9 and this might reflect that your anemia is of recent onset where the iron stores are depleted first. Supplement therapy with iron and folic acid usually brings back the values within normal levels.
3. It is a good thought to get a peripheral blood smear test done to evaluate the appearance of red blood cells in detail under the microscope and have a complete blood picture.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So it would b diet related yea and not really illness related ?
Brief Answer:
Iron deficiency can occur due to dietary deficiency and disease
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. Iron deficiency anemia can be caused due to dietary deficiency and illnesses.
2. It can happen due to the following
(i) Less intake of iron in diet
(ii) Excessive blood loss due to menstrual flow and associated diseases
(iii) Decreased iron absorption in the gut
(iv) Pregnancy causes increased iron demand and can lead to a deficiency state.
(v) Other causes of blood loss
(vi) chronic kidney conditions
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Iron deficiency can occur due to dietary deficiency and disease
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. Iron deficiency anemia can be caused due to dietary deficiency and illnesses.
2. It can happen due to the following
(i) Less intake of iron in diet
(ii) Excessive blood loss due to menstrual flow and associated diseases
(iii) Decreased iron absorption in the gut
(iv) Pregnancy causes increased iron demand and can lead to a deficiency state.
(v) Other causes of blood loss
(vi) chronic kidney conditions
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My menstrual
Cycle is fine not heavy .i had a baby XXXXXXX 2014 .
But I have noticed my bowel patterns have changed recently ie some days constipation etc and I fell very tierd and breathless at times .
My diet with vegetarian
But all other bloods are ok so must be diet right ?
Cycle is fine not heavy .i had a baby XXXXXXX 2014 .
But I have noticed my bowel patterns have changed recently ie some days constipation etc and I fell very tierd and breathless at times .
My diet with vegetarian
But all other bloods are ok so must be diet right ?
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. Your tiredness and weakness might be due to caring for your child.
2. However if you are feeling excessively tired then a thyroid function test might be of help.
3. A peripheral blood smear will give the exact picture of anemia should you have it.
4. Should you feel that your diet intake is not adequate then please include nutritious diet and take vitamins, iron and folic acid supplements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. Your tiredness and weakness might be due to caring for your child.
2. However if you are feeling excessively tired then a thyroid function test might be of help.
3. A peripheral blood smear will give the exact picture of anemia should you have it.
4. Should you feel that your diet intake is not adequate then please include nutritious diet and take vitamins, iron and folic acid supplements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Patient survival is extended by few months in most patients taking Avastin.
Detailed Answer:
Hi XXXXXX,
Thanks for writing in with an update.
1. The medicine Avastin is a anti-angiogenic in function. Avastin is designed to block a protein called vascular endothelial growth factor, or VEGF and the tumor is supposed to be derived of adequate blood supply. The amount of VGEF found in cancer cells is high and this medicine works by reducing the formation of new blood vessels by preventing formation of VGEF in the cancer cells.
2. Therefore medicines like Avastin can add few months to the survival in many patients of metastatic colon cancer and is worth.
3. Few people might have cancer metastasis that will not respond to Avastin. This is seen more in patients of pancreatic cancer in whom the cancer is refractory or less responsive to avastin.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Patient survival is extended by few months in most patients taking Avastin.
Detailed Answer:
Hi XXXXXX,
Thanks for writing in with an update.
1. The medicine Avastin is a anti-angiogenic in function. Avastin is designed to block a protein called vascular endothelial growth factor, or VEGF and the tumor is supposed to be derived of adequate blood supply. The amount of VGEF found in cancer cells is high and this medicine works by reducing the formation of new blood vessels by preventing formation of VGEF in the cancer cells.
2. Therefore medicines like Avastin can add few months to the survival in many patients of metastatic colon cancer and is worth.
3. Few people might have cancer metastasis that will not respond to Avastin. This is seen more in patients of pancreatic cancer in whom the cancer is refractory or less responsive to avastin.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
We r stuck as my father has metastic colon cancer . He was a stage 3 but now 4.
Irinotecan had not worked and now started oxy and raltitrexed , is this a good combination ?
Is avastin likely to work in him if irinotecan failed already ?he has liver mets and now 4 small peritoneal nodules (7mm).
Irinotecan had not worked and now started oxy and raltitrexed , is this a good combination ?
Is avastin likely to work in him if irinotecan failed already ?he has liver mets and now 4 small peritoneal nodules (7mm).
Brief Answer:
Avastin shows marginal improvement in survival in most patients
Detailed Answer:
Hi XXXXXX,
Thanks for writing back with an update.
1. I remember having discussed about irinotecan having failed and aborted radiofrequency ablation for your father in an earlier query last month.
2. Clinical studies suggest that this combination of Raltitrexed plus oxaliplatin, because of its favorable toxicity profile, high response rate and convenient schedule of administration, can be administered successfully.
3. The above combination has shown to improve survival rates by an average duration of about 10 months or more. The median time to response was 2.5 months (range 2–4) for this choice of medicine.
4. Avastin when given to a patient who is refractory to irinotecan, usually always works but the overall survival in such a case shows marginal improvement.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Avastin shows marginal improvement in survival in most patients
Detailed Answer:
Hi XXXXXX,
Thanks for writing back with an update.
1. I remember having discussed about irinotecan having failed and aborted radiofrequency ablation for your father in an earlier query last month.
2. Clinical studies suggest that this combination of Raltitrexed plus oxaliplatin, because of its favorable toxicity profile, high response rate and convenient schedule of administration, can be administered successfully.
3. The above combination has shown to improve survival rates by an average duration of about 10 months or more. The median time to response was 2.5 months (range 2–4) for this choice of medicine.
4. Avastin when given to a patient who is refractory to irinotecan, usually always works but the overall survival in such a case shows marginal improvement.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Avastin should be given carefully in those with tendency of lung clots
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. The chances of Raltitrexed plus oxaliplatin failing are less as it has shown good response rate in research studies.
2. Avastin can cause problems in those who have tendency to develop lung clots or pulmonary embolism. Please discuss the benefit to risk issue with your doctor if there was lung clot in 2013.
3. Avastin can cause a slight improvement in survival but giving it in lung clots needs to be discussed with your doctor.
4. SIRT is difficult in patients who have multiple spread of disease. As your father has metastasis to liver and peritoneum therefore SIRT will not help much.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Avastin should be given carefully in those with tendency of lung clots
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. The chances of Raltitrexed plus oxaliplatin failing are less as it has shown good response rate in research studies.
2. Avastin can cause problems in those who have tendency to develop lung clots or pulmonary embolism. Please discuss the benefit to risk issue with your doctor if there was lung clot in 2013.
3. Avastin can cause a slight improvement in survival but giving it in lung clots needs to be discussed with your doctor.
4. SIRT is difficult in patients who have multiple spread of disease. As your father has metastasis to liver and peritoneum therefore SIRT will not help much.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Liver is what kills right so if most mets there , wouldn't it be reasonable to do SIRT ?
Also is there any reason y irinotecan alone failed ?
Could
The cancer just be chemo resistant ?
M
Also is there any reason y irinotecan alone failed ?
Could
The cancer just be chemo resistant ?
M
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. SIRT can be given in patients with extensive metastatic colon cancer but it should be confirmed that any arteriovenous shunting through the liver or the tumor should not exceed 13 percent. This is important ans it can cause serious side effects for the patient as the radiation can harm the lungs. Final decision of SIRT is to be taken depending on facilities available at the hospital.
2. Following reasons have been found for irinotecan restistance
(i) variable levels of the enzymes involved in the conversion of irinotecan;
(ii) reduced cellular accumulation from active drug efflux;
(iii) reduced levels of Topo I expression;
(iv) alterations in the structure of Topo I from different mutations;
(v) alterations in the cellular response to camptothecin-Topo I-DNA complex formation, which involves proteasome degradation of Topo I and/or enhanced DNA repair; and
(vi) activation of the transcription factor nuclear factor kappa B by DNA damage and subsequent suppression of apoptosis.
The above mechanisms are mainly to do with blocks in the pathway of mechanism of action of irinotecan.
Cancers are due to uncontrolled multiplication of cells. Giving chemotherapy causes a break in the cell cycle and prevents the cell growth form taking place. However in some patients the cancer multiplication continues as the chemotherapy medicine is not able to effectively block the cell proliferation. In these patients, giving a chemotherapy with a combination of medicines to act at more than one point of cell proliferation process usually controls the cancer.
Treatment with avastin causes reduced new blood vessel formation and sort of starves the cancer and then reduces its size.
Therefore chemotherapy medicines work at different levels and a cancer cannot be completely resistant like a superbug. If not one medicine then a combination can be used to get results.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. SIRT can be given in patients with extensive metastatic colon cancer but it should be confirmed that any arteriovenous shunting through the liver or the tumor should not exceed 13 percent. This is important ans it can cause serious side effects for the patient as the radiation can harm the lungs. Final decision of SIRT is to be taken depending on facilities available at the hospital.
2. Following reasons have been found for irinotecan restistance
(i) variable levels of the enzymes involved in the conversion of irinotecan;
(ii) reduced cellular accumulation from active drug efflux;
(iii) reduced levels of Topo I expression;
(iv) alterations in the structure of Topo I from different mutations;
(v) alterations in the cellular response to camptothecin-Topo I-DNA complex formation, which involves proteasome degradation of Topo I and/or enhanced DNA repair; and
(vi) activation of the transcription factor nuclear factor kappa B by DNA damage and subsequent suppression of apoptosis.
The above mechanisms are mainly to do with blocks in the pathway of mechanism of action of irinotecan.
Cancers are due to uncontrolled multiplication of cells. Giving chemotherapy causes a break in the cell cycle and prevents the cell growth form taking place. However in some patients the cancer multiplication continues as the chemotherapy medicine is not able to effectively block the cell proliferation. In these patients, giving a chemotherapy with a combination of medicines to act at more than one point of cell proliferation process usually controls the cancer.
Treatment with avastin causes reduced new blood vessel formation and sort of starves the cancer and then reduces its size.
Therefore chemotherapy medicines work at different levels and a cancer cannot be completely resistant like a superbug. If not one medicine then a combination can be used to get results.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
U explained so so well thx.
I was getting worried that none will work . I hope this one does .
Is irinotecan alone not effective enough would u say ?
And finally is SIRT can be done should we go for it ? There are approx 1o liver mets
I was getting worried that none will work . I hope this one does .
Is irinotecan alone not effective enough would u say ?
And finally is SIRT can be done should we go for it ? There are approx 1o liver mets
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXXX,
Welcome and thanks for writing back with an update.
1. It is hoped that this combination will work for your father. Since it has good results in many patients, I certainly hope that this treatment will act in controlling the cancer.
2. Irinotecan alone is not effective enough for your father as seen from earlier scans. In the situation irinotecan can be combined with other chemotherapy agents or completely different set of drugs can be given.
3. SIRT has got a list of conditions when not to do it. The list of contraindications to SIRT includes those who have
(i) had previous external beam radiation therapy to the liver,
(ii) ascites or are in clinical liver failure,
(iii) markedly abnormal synthetic and excretory liver function tests (LTFs),
(iv) greater than 13 to 20% lung shunting of the hepatic artery blood flow determined by Technetium MAA scan,
(v) pre-assessment angiogram that demonstrates abnormal vascular anatomy that would result in significant reflux of hepatic arterial blood to the stomach, pancreas or bowel,
(vi) disseminated extra-hepatic malignant disease,
(vii) been treated with capecitabine within the two previous months, or who will be treated with capecitabine at any time following treatment with SIR-Spheres@,
(viii) portal vein thrombosis.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXXX,
Welcome and thanks for writing back with an update.
1. It is hoped that this combination will work for your father. Since it has good results in many patients, I certainly hope that this treatment will act in controlling the cancer.
2. Irinotecan alone is not effective enough for your father as seen from earlier scans. In the situation irinotecan can be combined with other chemotherapy agents or completely different set of drugs can be given.
3. SIRT has got a list of conditions when not to do it. The list of contraindications to SIRT includes those who have
(i) had previous external beam radiation therapy to the liver,
(ii) ascites or are in clinical liver failure,
(iii) markedly abnormal synthetic and excretory liver function tests (LTFs),
(iv) greater than 13 to 20% lung shunting of the hepatic artery blood flow determined by Technetium MAA scan,
(v) pre-assessment angiogram that demonstrates abnormal vascular anatomy that would result in significant reflux of hepatic arterial blood to the stomach, pancreas or bowel,
(vi) disseminated extra-hepatic malignant disease,
(vii) been treated with capecitabine within the two previous months, or who will be treated with capecitabine at any time following treatment with SIR-Spheres@,
(viii) portal vein thrombosis.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thx
So much . I read the SIRT criteria and my father only has extra hepatic malignant disease so
It would not be possible right ?
The only way it would be is if chemo changes things right ?
So much . I read the SIRT criteria and my father only has extra hepatic malignant disease so
It would not be possible right ?
The only way it would be is if chemo changes things right ?
Brief Answer:
Avastin has risk of lung embolism, Raltitrexed and oxaliplatin should work
Detailed Answer:
Hi XXXX,
Welcome and thanks for writing back with an update.
1. I guess that is the reason the doctor will not recommend SIRT for your father.
2. The probability of avastin causing pulmonary embolism might have to be considered and given only when the benefits are thought to be greater than the risk.
3. Chemotherapy with Raltitrexed plus oxaliplatin can still be considered as a promising treatment and hoping it is able to control the cancer in your father.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Avastin has risk of lung embolism, Raltitrexed and oxaliplatin should work
Detailed Answer:
Hi XXXX,
Welcome and thanks for writing back with an update.
1. I guess that is the reason the doctor will not recommend SIRT for your father.
2. The probability of avastin causing pulmonary embolism might have to be considered and given only when the benefits are thought to be greater than the risk.
3. Chemotherapy with Raltitrexed plus oxaliplatin can still be considered as a promising treatment and hoping it is able to control the cancer in your father.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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