Anyone able to comment on these blood tests?

[nebular]

I had some blood tests in Nov this year, for some reason not all the required tests came back but of the results that did, there was this one:
Pathology Investigations

Serum ferritin level 359 ug/L [5.0 - 204.0]; Above high reference limit

The others that came back where things like liver, kidney function, B12, glucose which were all ok.

In Dec 25, had further tests, that came back as follows:
Pathology Investigations

Full blood count
Haemoglobin concentration 107 g/L [115.0 - 160.0]; Below low reference limit
Total white blood count 8.44 109/L [4.0 - 11.0]
Platelet count - observation 331 109/L [150.0 - 450.0]
Mean platelet volume 11.5 fL
Red blood cell count 3.01 1012/L [3.8 - 5.3]; Below low reference limit
Haematocrit 0.331 1/1 [0.37 - 0.48]; Below low reference limit
Mean cell volume 110.0 fL [83.0 - 103.0]; Above high reference limit
Mean cell haemoglobin level 35.5 pg [27.0 - 35.0]; Above high reference limit
Mean cell haemoglobin concentration 323 g/L [300.0 - 350.0]
Red blood cell distribution width 13.7 % [11.0 - 15.0]
Neutrophil count 3.92 109/L [2.0 - 7.5]
Lymphocyte count 4.05 109/L [1.0 - 4.0]; Above high reference limit
Monocyte count - observation 0.34 109/L [0.2 - 1.0]
Eosinophil count - observation 0.08 109/L [0.01 - 0.5]
Basophil count 0.06 109/L [0.01 - 0.1]
Nucleated red blood cell count 0.00 10*9/L; Please note from 30.06.2025 all adult and
paediatric full blood count (FBC) reference ranges
have been updated.

Pathology Investigations

Transferrin saturation index
Serum iron level 12.1 umol/L [9.0 - 31.0]
Serum transferrin level 1.9 g/L [2.0 - 3.6]; Below low reference limit
Transferrin saturation index 28 %

there were others that looked at Coeliac and thyroid, which were both ok.

My GP has marked them as abnormal but expected, but also said to stop iron supplements in Nov. I think I probably need to make an appointment to discuss results, but also feel that nothing looks that bad and also as a side note the full blood count is really similar to one I had in 2012, so don’t feel like they can be anything super wrong.

Does anyone have any thoughts?

I usually run my results through chat gpt. I did the same with yours and it came up with the below.

1. Big picture summary

Your blood tests show:

• Anaemia (low haemoglobin, low red cell count, low haematocrit)
• Macrocytosis (red blood cells are larger than normal → high MCV)
• High ferritin (iron storage protein)
• Low transferrin, with normal iron level and normal transferrin saturation
• Normal liver, kidney, thyroid, coeliac, glucose, and (previously) B12

This combination is not typical iron-deficiency anaemia, which explains why your GP told you to stop iron supplements.

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2. The anaemia itself (FBC)

Key values:

• Haemoglobin 107 g/L → mild–moderate anaemia
• RBC 3.01 and haematocrit 0.331 → confirm anaemia
• MCV 110 fL → macrocytic anaemia (large red blood cells)
• RDW normal → cells are uniformly large, not mixed sizes

This is important because:

Iron deficiency usually causes small cells (low MCV)*
Yours are large*, so iron deficiency is unlikely

The fact that your FBC looks similar to one in 2012 strongly suggests this is:

• Chronic and stable, not an acute or dangerous process
• Less likely to be something aggressive or rapidly progressive

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3. Ferritin being high (359 µg/L)

Ferritin is often misunderstood. It is:

An iron storage protein*
Also an acute-phase reactant* (goes up with inflammation, illness, liver stress)

High ferritin does not automatically mean iron overload.

In your case:

• Iron level is normal
• Transferrin saturation is normal (28%)
• Transferrin is low

This pattern fits better with:

• Anaemia of chronic disease / inflammation Or a long-standing metabolic or inflammatory state*
• Or iron supplementation artificially raising ferritin (very common)

This is why stopping iron made sense.

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4. Low transferrin + normal saturation

• Transferrin carries iron in the blood It goes down* in inflammatory or chronic conditions
• When transferrin is low, ferritin often appears high

Normal saturation means:

• Your body is not lacking usable iron
• And not clearly overloaded with iron either

So again: not iron deficiency

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5. Macrocytic anaemia – what usually causes this?

Common causes include:

1️⃣ B12 or folate deficiency

You said B12 was normal*

• Folate may or may not have been checked (worth confirming)

2️⃣ Alcohol use (even moderate)

One of the most common* causes of isolated macrocytosis

• Can raise MCV and ferritin even with normal liver tests

3️⃣ Liver disease

• Your liver tests were normal → less likely

4️⃣ Hypothyroidism

• Ruled out by normal thyroid tests

5️⃣ Bone marrow variants (e.g. MDS)

• Usually progressive, worsening counts, abnormal platelets or WBCs Your counts are stable over more than a decade, making this unlikely*

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6. Lymphocytes slightly high

• Lymphocyte count 4.05 (just over range)

• This is very mild and commonly seen with:

  • Recent or chronic viral exposure
  • Stress
  • Normal variation

On its own, this is not concerning.

---

7. Why this doesn’t look “super wrong”

You’re correct in your intuition:

The anaemia is mild to moderate*
It appears long-standing*

• Other organ systems look fine
• There’s no iron deficiency
• No red flags like pancytopenia, blasts, or falling platelets

This looks more like a chronic, compensated process than an emergency.

---

8. What’s reasonable to discuss with your GP

When you book the appointment, good questions would be:

Do we have a folate level?
Could this be anaemia of chronic inflammation?

• Is alcohol intake relevant here? Should ferritin be rechecked off iron supplements? Is monitoring enough, or is a haematology opinion useful given the long history?

In many cases like this, the plan is:

• Stop iron (already done)
• Monitor FBC and ferritin periodically
• Treat any underlying contributors if found

---

9. Bottom line

This does not look acutely dangerous*
It does not look like iron deficiency*
It does not look like a rapidly progressive blood disorder*
It does* warrant a calm, structured GP discussion to label the cause and decide monitoring

That’s brilliant thanks. I had used a different AI and it was helpful but it wasn’t as conclusive as this one. In 2012 I was prescribed folic acid, as that was felt to be the reason previously. It was Plasma folate level 11.6 ug/L [3.1 - 20.0] so fine.

Inflammation was mentioned on the 2012 bloods.

I really don’t drink alcohol regularly.

thanks for posting

The MCV is quite high and probably needs explanation, even if chronic. Can relate to medication but is a macroyctic anaemia, which if no clear cause (booze, thyroid, liver,B12, folate), should probably be seen non urgently by a haematologist