Rising ferritin but low-ish iron and low transferring saturation

[BloodTestsHelpPlease]

Hello folks. Any ideas about the above?

Have been unwell since covid before Christmas. Fever etc stopped after a couple of weeks but I'm absolutely wiped out. Have been referred to long covid clinic but GP also been doing blood tests for various things.

Ferritin was 191ug/l 3 weeks ago, 213 today (range here is 13-150).

Iron 13umol/l (6.0 - 35.0)

Transferrin 2.95g/l (2.0 - 3.6)

Transferrin saturation 18% (20-40) below ref limit.

Everything else appears to be within normal ranges (LFTs were slightly raised 3 weeks ago but back in range now).

I'm late 40s. Overweight (at least 2 stone). Post-menopause, on HRT (4 pumps/day Oestrogel and Mirena coil). Bowels etc ok as recent colonoscopy clear save for small internal haemorrhoids.

Take 4000iu/day Vit D, Feroglobin and the odd Berocca. At least 2 litres of water a day.

Used to run 3 times a week and work full time. Can do neither. Fed up.

Anyway, those are the only results that look odd to me (will see GP to discuss but appt not for a couple of weeks, can see results on NHS app).

Can anyone shed any light please?

Bah. Can't edit title. Obvs should be transferrin..

Hopeful bump please?

High ferritin often means inflammation somewhere. If you've had Covid recently then that probably explains it.

Thanks @CrunchyCarrot - I actually tested negative on 11 December so should it still be rising?

Honestly I don't know, OP, iron biochemistry is complex and we don't know enough about long Covid as yet, certainly 3 months after having Covid you could still be seeing the effects of that.

Your results show not much circulating iron in your blood (iron quite low in the range) yet a lot is in the storage protein ferritin. Your body is storing the iron at the expense of it being circulated in your blood. Your immune system does this because it wants to keep iron away from any invading pathogens.

Have you had a full blood count done? What about CRP (C-Reactive Protein)? What were your Covid symptoms, how long were you ill with it?

Thanks @CrunchyCarrot that explanation is really helpful. CRP was 5 at end of Feb (last test).
FBC below. White cells slightly raised. Haemoglobin figure is within 1 or 2 of what it has been when tested in the past.
Last bout of covid started with runny nose/dizziness. Got an upset stomach so tested as colleague was positive with that as a symptom. Tested positive 8 December but negative 3 days later. Low grade fever (38-38.5) for a couple of weeks but mainly just fatigue. Didn't have a cough until 1st week in January 🤷🏼‍♀️That went away after a week or so.

Your white blood cells are a bit raised, consistent with infection, and as you said your CRP was quite high too. Covid really is a bugger. All I can suggest is make sure you are eating really well and resting enough. There could still be inflammation in your gut. Maybe. Some of these viruses can really pack a punch even if the actual illness itself would only be classified as 'mild'.

I hope you feel better soon!

Post menopausal women can have higher ferritin, can you get access to any other blood test results with ferritin since periods stopped to compare?

It's definitely trending upwards @Notinthemood12 - in Nov 2023 was 156 and 81 in November 2021 (last period around May 2019).

Thanks, I really appreciate it. I'm trying to eat well (cholesterol also seems to have shot up) and am resting loads. I'm so glad I married a good one! Work have been really understanding too which helps.

I am wondering at the moment if I'll ever get back to normal though

So glad you have a 'good one' - so do I! Makes a huge difference!

Let me know how it goes when you have your appointment. 😊

I’d advise you to go on the Iron Protocol groups on FB. There’s one in the US and UK.
Lots of advice with guides to follow.

@BloodTestsHelpPlease my ferretin is just over 200 and I'm post menopausal for 8 years but not actually had a period for 25 years as had mirena. Doctor says post menopausal women's ferretin levels are often more like men's - often considerably higher than pre menopause

Thanks, will do. GP and long covid clinic appointments both next week.

Thanks for the recommendation @Cozytoesandtoast00

I think I'll leave it until I've spoken to the doctor. I'm not doing great at taking in information at the moment!

That's helpful @Crikeyalmighty and I know other labs also seem to have a higher reference range. I just wish some of the iron would pop out of the stores and into my circulation and then I might feel less dreadful!

Just an update for anyone interested. @CrunchyCarrot GP gave me almost word for word the same explanation as you! He said that ferritin may reduce/active iron come up as I continue to recover. Didn't see any benefit in re-testing right now but maybe in a few months. Keep going with the multivitamins and being kind to myself.

Work have been brilliant so far. Have spoken with occupational health who are also really supportive but both they and GP say basically they're going to leave it up to the long covid team to manage me going forward.

I've managed to work v part time at home and also do things like cook dinner - funny how that suddenly seems like such a major achievement when this time last year I'd be doing over an hour commute, work and 8 hour day, stop at the gym or for a run on the way home and then cook the dinner!

It might be dim and a very long way off but I think I'm starting to see the light at the end of the tunnel.

That's great news OP! So good work is being understanding, too.

My ferritin also came up (not as high as yours) and iron dropped down at the end of last year when I had a lot of bowel inflammation (turned out to be gluten intolerance!). Have yet to do a follow up iron panel but expect a similar result - ferritin to go down as iron comes up again.

You will definitely get there, now things are on the up! ❤

I’m sorry you’re feeling like this and I’m glad you’re starting to feel like there’s light at the end of the tunnel.

Slightly off topic, but I want to add a cautionary note about the Iron Protocol Facebook group mentioned by a pp. It’s full of pseudo science and its recommendations are often borderline dangerous. The site admin has no medical, scientific or research background and makes a huge amount from affiliate links of heme iron supplements.