Questions about my lab results

[jessie_carol]

I have been trying to research what some on my blood test results mean but I know a lot of you have a lot of knowledge about these so I am going to share. My GI did these tests and said on the phone that everything looked good. One inflammation test was high but the other was not. I am not anemic. That's all she said. Now I have them in front of me:

TIBC- high- 454, normal range listed: 250-400 UG/DL. When I looked up what this means it found iron deficiency anemia or late pregnancy (not pregnant). On wikipedia it also said "use of hormonal contraception, but without iron deficiency." Does anyone know about this? I do use hormonal contraception but I don't really trust wikipedia. My doctor said I'm not anemic, but what does this test show then?
Serum Iron- normal- 57, normal range listed: 40-160 UG/DL
Ferritin- normal- 35, normal range listed: 11-340 ng/ml
Transferrin- normal- 324, normal range listed: 250-380 MG/DL
Folate- normal- 23.2, low range listed: <4 ng/mL
I haven't read anything about the four tests above. Is there anything I should know about them? Anything here that would show I am not anemic despite the TIBC test being high?
Vitamin B- normal- 318, normal range listed: 180-914 PG/ML. I'm not sure about this one. I have read other posts on here about these levels needing to be higher than the normal range suggests. Thoughts?
CRP- high- 16.11, normal range listed: 0-3 MG/L. This actually went up from 15.07 two months earlier.
Sed Rate- normal- 18, normal range listed: 0-20 MM. This went down from 27 two months earlier.

Thanks!

 

[David]

Hi Jessie,

Hmmmm. With a high TIBC and iron level of 57 which is borderline I think there's a chance you're slightly anemic though this is an area I definitely need more education in.

However, the vitamin B12 is another story. According to this paper and corroborated with slight variances by these sources:
Swain R J Fam Pract., 1995; 42: 595-61.
Hvas AM et al., Ugeskr Laeger., 2003; 165: 1971-6.
Schneede J Scan J Clin Lab Invest., 2003; 63: 369-376.
Klee G, Clin Chem., 2000; 46; 8(B): 1277-1283.
Hermmann W et al Curr. Drug Metab. 2005; 6 : 47-53
Snow CF Arch Intern Med., 1999 ;159 :1289-98.

With a vitamin B12 level of between 200 and 400 pg/ml, you actually have about a 50% chance of being deficient based upon methylmalonic acid levels which is a much better determinant than serum B12. As such, I would strongly suggest asking your doctor to test your methylmalonic acid levels or see if they just want to supplement you based upon clinical presentation. I'd suggest printing out that paper and taking it with you just in case they need a little convincing

 

[kllyeve]

I'd like to see what the RBC indices are as this might help also to see if there is any anemia. The Hemoglobin level would also help.

You are not consided anemic if the CBC shows everything being normal -HB fine, RBC count fine, Indices fine - even if the storage and backup iron is low. You can be Iron Deficient and not neccesarily have an associated anemia. I know cause that is where I am.

Some reading I did on the Stop the Thyroid Madness website recommended that Ferritin really should be at least 70 or above to ensure proper thyroid function. Mine is currently 45, and I am currently still supplementing to get it up there.

TIBC - as far as a can remember means the total amount of capacity to bind iron - so if it is high there are lots of open spots for iron to latch onto, also meaning there is not as much iron being transported around usually meaning there is not enough iron to transport. Which is supported by the slighty low serum iron.

As David is the hands down site expert on B12, I am not going to address that.

My LAb instructors would be so happy I actually remembered Hematology training!

 

[jessie_carol]

Thanks for your responses. My RBC is 4.91, range= 4.0-5.5 and HGB is 14.7, range= 12.0-16.0. I'm not sure if I should ask for more testing or not. I feel like something isn't quite right because I get a lot of bone pain from my hips all through my legs. It could be from low vitamin D. I am getting retested by my primary care doctor next week to see if my levels are any higher than they were previously. I just don't want my GI to think I am asking for testing that I don't need...

 

[kllyeve]

I would ask for Vit D and Vit K to be tested as well as Calcium. I was deficient in all three when I was first diagnosed.

And the pain in your legs and hips could be referred pain from your intestines. I had pain in my Right knee and hip for years and thought it was arthritis - when the Remicade took effect that pain dispappeared as well. GI thinks the pain in my ileum was radiating into my hip and knee.