blood test, help?

[hopsalong]

Sorry, not a big deal but would be grateful for a second opinion. Had a routine blood test this week and was slightly surprised when my GP said the numbers were all fine, because a few were out of the normal range. If my transferrin saturation is 10% and my red blood cell count is 3.74 (range given as 3.95 - 5.15) am I anemic? Or does the normal ferritin (70, actually higher than usual) mean not?

FWIW, I feel fairly crappy after various winter bugs including Covid. LDH was also 20 units below the normal range. Google says this is rare but not concerning. I don't think I've had that checked before.

You are iron deficient with transferrin saturations of 10%. Ferritin can be raised by inflammation so ignore the ferritin result, transferrin saturation is much more accurate.

Without knowing your haemoglobin (Hb) I can't comment on whether or not you are anaemic. You can have iron deficiency without (yet) being anaemic.

If your GP isn't taking any action regarding your bloods, maybe speak to your local pharmacist. If they think you could do with some iron, you can buy it over the counter from a pharmacist.

Thank you so much. Very nice of you to reply. My hemoglobin was 122 g/L, marked as being within the normal range, though at low end.

I suppose my question would be -- if I'm not anemic, why is my transferrin saturation so low and could it be a sign of something bad? In the past I have been anemic (lower hemoglobin and ferritin) but that number has been higher (around 20%).

So you have iron deficiency but you're not anaemic.

There are loads of reasons you could be iron deficient. It could be something silly like you're not consuming enough iron (are you vegan/vegetarian, especially if you're new to that way of eating and haven't yet learnt how to eat it properly? Have you been on a restrictive diet eg to lose weight?), or you're consuming it with other foods/drinks which limit your body's ability to absorb iron (tea/coffee/dairy/some medications limit your body's ability to absorb it, vitamin C is good at helping your body to absorb iron). What are your periods like or have you recently been pregnant? Have you had any surgery recently that has caused some bleeding?

The fact that you've been anaemic in the past suggests it is a long-term problem and less likely to be something nasty. Nasty things to look out for would be bleeding from somewhere you shouldn't be bleeding from, which could be obvious or could be something like darker coloured stools. Any unintentional weight loss or changes to your bowel habit?

Your GP has already reviewed your blood results and they have access to your medical history and your historic blood results, but if you want to have a chat to your GP or the pharmacist, they can assess you and advise whether any action is needed. They may suggest altering your diet or they may suggest iron supplements (current research suggests taking one iron tablet alternate days as consuming too much iron means you have a lot of iron in your stool, your bowel thinks you have too much iron so releases a hormone to tell your body to stop absorbing it).

About half way down this page is a list of iron-rich foods and foods/drinks which can limit the absorption of iron (the page is entitled iron deficiency anaemia but the same advice applies) www.nhs.uk/conditions/iron-deficiency-anaemia/

Thank you, Magnolia. Very generous of you to reply like this. The only change I've made recently was to do dry January, so I thought I'd be in blooming health! Was actually trying to gain a bit of weight (slightly underweight) so have been eating well, I think, and quite a lot of meat. But I haven't had a blood test for a couple of years so perhaps was worse before Jan. I'll take the iron pills and perhaps the occasional Guinness...