High iron serum, low ferritin in 15-month old toddler

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Hello,

My son was diagnosed as anemic at his 1-year check-up. I believe his hemoglobin was 7. I started him on a multivitamin with iron (polyvisol) and we did a complete blood test at 15months. His iron serum was really high (183) and hemoglobin was at 10.2 which was higher. Serum ferritin was at 7 which is low. I saw a hemotologist and they suggested I start him on pure iron drops (3 times the amount of the recommended dose on the box). I asked the doctor why his serum iron was so high and if we should worry about that. He basically didn't address that number at all and just focused on the ferritin levels and how we should get that up as soon as possible. Should I get a second opinion on this? I don't want to overload my child with iron. It seems like his iron (hemoglobin and ferritin) were on the rise so why bombard his body with such a high dose of iron?

Any thoughts?

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10 Replies

  • Posted

    Hi jamie. Not sure about iron levels, but I do know that the hematologist usually knows what he is doing. I know mine certainly does a good job. Maybe you could ask your General practitioner what he thinks, but I'd trust the hematologist.

    Hope you get it worked out.

    Best wishes

     

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  • Posted

    Hi Jamie - by itself, anemia in toddlers is not uncommon, ~10% may have it at some point, and iron deficiency in the diet is by far the most common cause. If your family follows a vegetarian/vegan diet, it takes special attention to get iron and B vitamins at levels needed for children. As your hematologist did, supplements are the first course.

    If the ferritin stays low (7 in a young child is VERY low!), they'll want to look at other possible causes. Low-level bleeding in the intestines from various causes, and less likely but serious would be inherited (genetic) problems related to hemoglobin synthesis or red blood cell enzyme problems, these can all lead to anemia. Lead levels in blood should be checked, too, if not done already.

    Best wishes to you and your youngster; do follow up and let us know how it goes!

    The slightly high serum iron wit such very low ferritin is odd, but if your hematologist isn't worried about "iron overload" neither should you. Agreed that the low ferritin is MUCH the bigger issue here.

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    • Posted

      Thank you for your response. I am sorry, it's not 7, it's actually 9 on the ferritin levels. Still low but a little better. 

      He didn't mention lead levels in the blood. I will look into this. 

       

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    • Posted

      Hi Jamie - that actually doesn't change a lot, 9 is not significantly better than 7 for ferritin, which in a young child should be double digits. After 3 months on iron supplements, you should be seeing a much more noticable improvement. If the iron drops don't help within 30 days, it's time to get serious about checking for hemolysis causes or other things that result in anemia unresponsive to supplementation.

      Do check the lead; easy blood test, especially if you live in an older home or an area with older plumbing. If high, there can be serious long-term effect on your child's mental development, that would be much more concerning than a passing anemia.

      best wishes!

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    • Posted

      I wonder why my hematologist didn't recommend the lead test. We do live in an older home but our walls are made from Florida pine. I'm sure we have old plumbing though. 

      Do you find it odd that his iron serum is really high (183) compared to ferritin and hemoglobin (this is closer to normal at 10.2 but still on the lower end)?

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    • Posted

      Yes, the high iron with very low ferritin and hemoglobin is odd, but not an issue in and of itself. The big issue is, why are the ferritin and Hgb so low?

      Do check the lead levels - if high, there are lots of resources online for possible sources (water, old paint, contaminated soil outside, toys, pottery, antiques...) and how to reduce exposure if present. If not, time to get more focused about pursuing other causes for the anemia.

       

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  • Posted

    Any updates to this? My 23 month old has high serum and high saturation, but low ferritin. His hematologist wanted to up his iron dose but I wanted reassurance that this wouldn't raise his serum or saturation levels.

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  • Posted

    Hi everyone,

    About this high serum iron with not matching ferritin etc in some people; could it be that these tests were done soon after giving the iron supplement that day, before the iron was stored away from the blood?? Or would giving iron supplement to a baby not higher the serum iron levels temporarily?

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  • Posted

    I have high iron and low ferritin and also,my doctor made no comment about it. I've been reading that high iron can be related to inflammatory process in the body. I do have hypothyroidism but mine has not been linked to autoimmune disease. I will see the doc again and ask for antibodies tests.

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  • Posted

    Hi, I have the same issues and was told the Ferritin is the stores in your organs, therefore the doctors look at that as the important reading over hem. Iron overload takes places when the stores (ferritin) is hugh. It is abnormal to have hugh hem and low ferritin, but is usually a sign of low iron due to diet nothing more serious. I would maybe follow up with a specialist if you have hereditary issues, auto immune issues, or symptomatic. Usually you don't have symptoms until it reaches a low no#, my Ferritin was 5 and hem with above normal, like 60. Be your own advocate, sometimes GP and NP won't look at ferritin if iron hem is normal, which was my case. Best of luck!

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