Total Iron Binding Capacity?

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AZMOM

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Alright oracle friends on the forum. :) Claire's last labs showed mild anemia - we've been waaaaaay worse. First set of some of these I've seen. GI ordered them when choosing her EN formula.

What can you tell me about the TIBC? Do I care? (of course I care but you know what I mean!)

Iron Blood: 42 mcg/dL (16-128) Total Iron Binding Capacity: 186* mcg/mL (250-450) Percent Iron Saturation: 23 % Ferritin Blood: 168 ng/mL (15-204)

Hugs,

J.
 
Tibc is a concern when it's really high and the ferritin is really low - that means the iron stores are being depleted .
That is what happens to DS.
Low Tibc ??
Not sure what it means
 
mlp - I just think it keeps pointing to her malnutrition due to poor absorption??? Albumin was quite low as well. I swear he's never checked either of these before though! I couldn't figure out why he was checking it now. I guess I don't get to be all knowing on this one (please note my sarcasm).

On a brighter note, I kept checking her temp earlier this week because I am so unused to pink cheeks!!! There was no fever - I'm wondering if it is because she's absorbing the food?????

She is at a 4 day camp right now - it is a "medical camp" - this is her fourth summer to attend. The nurse at check-in said she's seen EN do remarkable things and thought Claire "looked great"! I was a WRECK about taking her and I'm not usually worried about taking her to camp. I think it was because in addition to her regular stuff, I was hauling pump, formula, portable pole, etc, etc, etc. I was on pins & needles thinking that they would call last night, unable to insert the tube (we are blessed to have the facility/camp just 1/2 hour away) and they never called.

:ylol2:

J.
 
Glad it seems to be going well! Hope Claire has a wonderful time!

I second what MLP said -- M's anemia was only concerning when ferritin was very low (like 6 I think) and TIBC was high.
 
Couple of questions:

Which way are the numbers heading?
Is Iron Saturation in range?

It doesn't look like classic iron deficiency anemia.
Could be a combination of IDA and ACD (Anemia of chronic disease).
Ferritin could be acting as a marker of inflammation.
 
Catherine - didn't show a range for iron sat. However there was a value on that one from about a year ago. It was 67% now 23%.

I guess that's why I was leaning to the malabsorption/malnutrition on the TIBC. Her Albumin was low too.
 
With iron deficiency anemia you would expect the iron sat % to be high.

With anemia of chronic disease iron you would expect sat % to be low.

Next question:
Have iron and TIBC both dropped?
And ferritin increased?
 
Catherine - Iron level from 153 to 42, TIBC from 207 to 186, Ferritin 113 to 168. So to your question, yes the first two dropped and the other rising. The sat (I think I mentioned before) dropping to 23% - was 67%.

Thoughts???

I feel guilty about the Ferritin number when everyone is worried about 9!!! :-(

I'm just trying to figure out what he was looking for.

J.
 
With the dropping numbers of Iron and TIBC but increasing ferritin you could be looking at an acute phase response, this would fit with Claire’s current Crohn’s status.

Remember, ferritin is a back door indicator of inflammation. So whilst well within normal range it has been trending upwards.

Dusty. xxx
 
What DustyKat said.

I believe her ferritin is much low than it is reading.

Causes of low TIBC

Lower-than-normal TIBC may mean:

Cirrhosis
Hemolytic anemia
Hypoproteinemia
Inflammation
Liver disease
Malnutrition
Pernicious anemia
Sickle cell anemia

http://www.nlm.nih.gov/medlineplus/ency/article/003489.htm

It could be IDA with concurrent ACD which is treat with iron supplements. This where it tricky iron supplements don't work for ACD, as for some reason the body is storing iron as ferritin. The treatment for ACD is to treat the underlining condition.

Treatment
Anemia is often mild enough that it does not need treatment. It will likely get better when the disease that is causing it is treated.

The condition is rarely severe enough to need a blood transfusion.

Iron supplements may sometimes be used, but only for patients whose iron levels are low. Taking iron pills when your body does not need it can lead to serious medical problems. Always talk with your health care provider first.

For some conditions, such as chronic kidney disease, medicine called erythropoietin may be given. It stimulates your bone marrow to make more red blood cells.

http://www.nlm.nih.gov/medlineplus/ency/article/000565.htm
 
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