Blood test results. Help please.

[Waitingforthesunshine24]

Hello all,

I would appreciate some insight into these blood results. Can anyone tell me what they mean? I have read about iron deficiency but I have been taking ferrous fumerate everyday for about 3 months. I had a miscarriage in May but levels were about the same prior to that.

Much appreciated as googling is giving me too much information

X

Has your Dr who ordered the tests not given any advice?

Nope, just said satisfactory x

Just interested if this means anything x

Not the most useful bits of the full blood count. We dont really pay much attention to mch and rcc... mcv just means the haemaglobin molecules are small ...which is in keeping with iron deficiency.

Haemaglobin,iron studies, b12/folate, haematinics are more useful to have

Iron takes ages to come back to normal as need to replenish all your stores too

These are the other two results. My recent ferritin was 25. I haven’t had B12 done for a while. Thank you so much for replying it’s much appreciated

A ferritin of 25 is way too low (but apparently 'normal'), it should ideally be around 90-100.

Definitely what I have read too. I last had my ferritin checked after my miscarriage so presumed lower level was due to that. Thanks for replying 😃

Ferritin of under 30 means you have iron deficiency anemia. Your dr should be advising you to take iron. Not a vitamin a day but high doses of iron. I have been taking 500mg of ferrous fumerate a day. You can buy it over the counter for about £5 for a month or two’s supply.

I am not a dr but I recently had some private blood tests done. The report they gave me is written in quite easy to understand language. Here’s what they say about the tests you are out of the normal range for:

MCV - Low MCV levels indicate that your red blood cells are a smaller size than they should be. This indicates that you may have microcytic anaemia, which is generally caused by iron deficiency anaemia. Low levels of iron in the blood reduce the amount of haemoglobin which can be made, thereby decreasing red blood cell size.

Iron deficiency anaemia may be caused by a reduced dietary intake of iron, or by malabsorptive conditions such as Crohn's disease, where the digestive tract is too inflamed to uptake enough iron.

RBC - An elevated RBC count can indicate that you have polycythaemia, meaning that you have a greater number of RBCs than normal. This often arises as the body increases red blood cell production in order to compensate for chronically low oxygen levels caused by lung disease, or living at altitude.

Raised RBC counts can also be caused by dehydration, smoking, and kidney tumours which stimulate excess RBC production.

MCH - MCH is looked at in the context of your other red cell blood markers. If your other markers are normal then a slightly low MCH level may not be significant.

Low MCH levels may be caused by anaemia, when the number of blood cells are low. Anaemia can be caused by iron deficiency, which can be caused by not consuming enough iron in the diet, or from conditions such as Crohn's disease where the intestines are unable to absorb sufficient iron. Other causes include gastrointestinal bleeds such as with peptic ulcers, and by a lack of vitamins such as B12 and folate.

So I would start by increasing your ferritin and then the other markers should improve. The optimum level for ferritin is over 100.

Thank you so much your reply means a lot x

Ferritin of under 30 means you have iron deficiency anemia. No it doesn’t. Ferritin is a marker of iron stores, not anaemia.

• @Greybeardy the NICE guidelines state that ‘A serum ferritin level of less than 30 micrograms/L confirms iron deficiency.’ (Last bullet)
• https://cks.nice.org.uk/topics/anaemia-iron-deficiency/background-information/definition/

NHS also says iron deficiency anaemia is a ‘lack of iron’ although most people do associate anaemia with low haemaglobin rather than low ferritin.
https://www.nhs.uk/conditions/iron-deficiency-anaemia/

ferritin confirms iron deficiency as the driver of anaemia (with anaemia itself defined by Hb levels).

there are anaemia states not driven by low iron.

low ferritin, when CRP is normal, signifies low iron stores.

(edited for typos)

@Choux as per pp, low ferritin suggests iron deficiency. You can be iron deficient and not anaemic. You can be anaemic and not iron deficient. The OP hasn’t posted a haemoglobin so you cannot say that they have iron deficiency anaemia. (Doi: iron deficient doctor)

The risk of higher dose iron is it doesn't actually get absorbed and increases the risk of gut side effects which increases the chance of patients stopping taking it

Once a day taken with vitamin c and not near to drinking tea/coffee is adequate for most

Which doesn't contradict what they've said.

Ferritin is iron stores, it's not necessarily an anaemia (but can cause it in some cases). You can be iron deficient, independent of having anaemia (this is what OP is as their haemaglobin is normal)

Just spotted that the OP has actually posted a completely normal haemoglobin so isn’t anaemic.

The definition of anaemia is a low hb, not "most people associate it with", its the very definition of it!

I have beta thalasemia (no real impact on me - I’m just a thalasemia carrier) and my results are similar

Although actually yours is v borderline

Hi all, thanks for replying. Shall I just carry on taking the ferrous fumerate as normal do you think?

Yes. If it gives you side effects there's 3 oral Iron options the gp can swap you to (its really common i struggle to take it without smashing into fragments and eating fragments throughout the day). Take it with vitamin c (orange juice if you like it) as it improves the asorption. Avoid tea/coffee within a couple of hours as that limits absorption

interestingly my daughter was told by her gynacologist that she should take iron suppliments every other day, rather than every day, because it has a better rate of absorbtion. I wasnt party to the whys and wheres of his thinking, but the low dose she takes for endometriosis has been transformational

MCV is a test of the size of your red blood cells. GPs wouldn't normally care much about the other 2 tests done that you've uploaded pictures of. They would be more interested in your Hb (haemoglobin) level.

MCV can be low for lots of reasons. Often if someone has e.g. a beta thalassemia trait, which is a genetic trait more common in certain ethnicities, their MCV can be low.

Low ferritin (iron) can also cause low MCV. Low B12 or folate cause the MCV to raise too high so are unlikely to be the cause of a low MCV.

GP should probably recheck FBC/consider blood film/check ferritin/consider hemoglobinopathy screen depending on your history.

Thanks for this. I’ve been diagnosed with severe anaemia and taking feraccru for about 9 months now following a blood transfusion and iron infusion. My blood tests showed a 52 level and I had to go for a transfusion immediately. I’d get your results checked op. Good luck