Help interpret iron bloods results

[QueenLagertha]

I've just had a call from GP practice that my iron is a bit low. I asked what they were and the secretary said Haemoglobin is 12.5 so normal but iron is 4.8 so a bit on the low side.
What would the iron be that she is referring to?

Have you ever tried a haem iron supplement? I get awful digestive issues - really painful cramps and diarrhoea from the other supplements I tried, including ferrous sulphate, fumerate, gluconate and bisglycinate, even at low doses. I couldn't even tolerate spatone well, just about got away with a sachet a few times a week but it did nothing.

I've found haem iron to be absolutely fine, might be worth considering if you haven't already tried.

My serum iron was at 3. I now have a Lucky Fish (chunk of iron shaped like a fish) which I got from Amazon. You pop it in with the boiling veg, pasta or rice for 10 minutes then pick it out, rinse and dry thoroughly. Honest, it works. They are costly in the West because they distribute them free to people in poor countries where there is high anaemia.

If you boil it for 10 minutes in a litre of water, you can then just drink the iron water. Great little thing.

I've also just bought a cast iron frying pan to use at every opportunity.

I'm hoping to get away with just one course of supplements and then my pan & fish will look after me. They're just ruling out a recurrence of bowel cancer (fingers & toes crossed) as a potential cause and then they can prescribe.

I meant to say that my red blood cell count is at 3. And all the associated readings are low. Sorry for the accidental mislead.

Have you ever heard of lactoferrin? I found this study in children with IBD comparing ferrous sulphate with lactoferrin, looks like it works better and without the side effects of oral iron.

www.nature.com/articles/s41390-022-02136-2

@Utini thanks for your post. What brand do you buy? Would be willing to try this for maintenance after I have my iron infusion! Haven't heard of Lactoferrin either.

@FlipFlops4Me wow. I looked that up. £50. Expensive but if it works would def be worth it. Have your levels improved much do you know. Hoping you don't have cancer again 🙏🏻

@Utini yea these are the symptoms I get also. Awful. The stomach pains make me think I'm having a severe flare so scare the life out of me

Thanks @Destiny123! I appreciate the time and effort so does it mean I am anaemic and should take iron?

My serum iron level was 6.9 and marked as normal, my serum transferrin was marked as normal at 3.34 but the transferrin saturation was 8% and marked as low.

Oh that must be a worry. I remember being doubled over at work in so much pain I was worried something was seriously wrong but apparently iron salts are just a massive irritant to by digestive system, even without IBD!

You can get a haem iron supplement called Optifer on Amazon, there are versions with and without folic acid. The one without is called Optifer alpha and is also a lower dose which might be best as you're concerned about side effects.

I'm currently taking one called Three Arrows Iron Repair, which used to be on Amazon UK but I last had to get shipped in from the US. If you're buying several bottles that works out cheaper but the postage costs mean it's not worth buying just one.

I hope you manage to get approved for an infusion.

@Utini thanks so much for that I will definitely try it. Oh I'll be getting the iron infusion one way or another. Hopefully hear when on Monday when they're sorting out the infusions list for the week.

It'll be your ferritin that's 3, if your red cells were 3 you'd be at absolute best ventilated on icu on multiple blood pressure infusions but much more likely dead.

I've had similar levels from mega heavy periods and 1 iron tablet, regular multivitamins and spatone, living on spinach/broccoli/beans etc got me to normal, it can be done you just have to make super efforts to it. But by all means ask for an iron infusion

Ask your Dr when you see them as it really needs knowledge of your medical history and full blood tests to work out the significance, sorry!

Ah no worries! I did try googling but it's very confusing my gp sent the result and said all fine but it was only when I read them that I saw one of them wasn't etc. hopefully I find out soon

@Destiny123 yes I'm sure it can be done when you have a healthy fully functioning digestive system. My diet is extremely healthy. I am mostly plant based and I put a lot of work in to prepping my meals. Eat chicken or fish once/twice weekly. Could maybe do with upping that for a while. Interestingly I did read that too many legumes and too much fibre can prevent absorption of iron. I always take multivitamins including the Betteryou oral iron spray.

Chicken and fish have v little iron, hence veggies struggle (if you're not veggies red meat will be much better for you).

Theres no reason not to give you an iron transfusion, if they have evidence of tried supplementation, but the service is super stretched so you're far better approaching the consultants secretary in a friendly manner and explaining your symptoms that you're struggling with and suggesting they consider allowing an iron infusion rather than demanding one.

Please don't approach them in the manner of "I'm getting an iron infusion one way or another" as you'll just get the backs up of the people you need to help you out (such demanding statements from patients are really irritating, as with years of medical experience theres lots of things we need to take into consideration, and don't take too kindly to demands (regardless of whether they're correct in their reasoning or not), be friendly it will get you much further.

I regularly go to beg for expedited infusions on my patients behalf (to multiple different teams and managers involved) before surgery, but that's me going above and beyond, which people are less likely to do if not asked nicely, if someone's demanding you're more likely t9 just be put on the routine waiting list than potentially fast tracked

Other things to consider are b12 and folate levels which both contribute to anaemia and are v common in both veggies and IBD (more so with UC than crohns but both can get it)

@Destiny123 I meant I will pay for one privately if they decline. I did ring the secretary and ask to be considered for an iron infusion due to my symptoms etc. I'd be surprised if they say no. I generally have a good relationship with the team.

I'm a health professional myself and deal with difficult patients and their families.

B12 and folate are fine.

I just checked the results again - I have the NHS app. It definitely says

Full blood Count:
Total white cell count - blah
Red Blood cell count 3.00 10*12/l (normal range 4-10)

I am expecting a call from my GP and I have previously ended up in hospital being transfused but while I feel knacked and look like a ghost I'm still standing.

I just had an anaemia test and my RBC was also 3. I didn't think it was that bad? It's only just under the low number (I had other odd results though)

The spatone sachets with apple juice in are good

I am being retested tomorrow

We never use it in hospitals, nor do i ever remember it when working in gp. Haemoglobin is the standard measure of red blood cells/anaemia where normal is >120 females, 130 men

Nhs choices has the lower limit of counts as 3.8 for women

but can't say its a commonly referred to result (never looked at one for significance in 5y at med school and 8yrs as a Dr, haemoglobin (hb) is the go to in England

These are 2 reliable websites if you want to read more though

www.nhs.uk/conditions/red-blood-count/

labtestsonline.org.uk/tests/full-blood-count-fbc

Yes they were looking at it in combination with other results I think (I have a high MCV, low Hb, low RBC). Indicative of Macrocytic anaemia but have normal B12/folate so undergoing some other tests @Destiny123

Good luck in getting your infusion @QueenLagertha

Thanks for the advice everyone. Got the infusion approved for this week 🥳 looking forward to feeling normal again and have ordered some of the supplements @Utini has recommended to try for maintenance thereafter.

Great news, hope you're soon feeling better!

I had my GP appointment but I'm none the wiser tbh. As my Hb and Ferritin were normal but the transferrin saturation was low (8%) they told me I wasn't anaemic and wouldnt need to refer for further investigation of my symptoms (negative fit test) but then went on to say I could take iron supplements to see if that would help some other symptoms (pulsatile tinnitus)

So I was left very confused about why take iron if I'm not anaemic and if anaemic why not refer