Low ferritin, high Transferrin Sat, Haematology not normal

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Hi everyone,

I have been anemic for the past 7 years without doctors ever going in to many detail and investigation why. Now I live in a different country and re done my blood and same result.

Just to mention I am vegetarian for the past 3 years and I had H.pylore discovered 5 months ago, and was tested negative after treatment. I am still taking PPI's for gastritis, which I will stop in 2 weeks and try to build up my HCL levels.

I do believe my bloodwoork wuld be better if my digestive trackt would work normal.

I feel tired a lot, low libido, lethargic.

Could someone have a look and give me some insights, as I will be taking iron supplements when finished with PPI and then do my blood again in 3 months. If you have any suggestions what other things I should ask my doctor to look in to.

thank you

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6 Replies

  • Posted

    The reports open a bit fuzzy, but the iron value looks absolutely ok,

    Iron normal (28µmol/L), (the comment 'low' is for 'if' cases and should not be printed there.)

    You transferrin is almost overloaded obviously with taken in or floating around iron.

    Did you take iron supplements or get iron iv already?

    Were you well fastened during blood sample (morning sample)? (I believe so)

    Your iron itself is good at least at the time of sample taking,

    but something is happening on the way to red blood cells and storage or too many red cells being destroyed freeing iron?

    Could you take a VitB complex transdermal patch already? (24h only once a week)

    You are lower end with VitB12 (lowish end is often already a deficiency, unfortunately methylmalonic acid and homocystein was not measured to clarify) and Folate.


    your blood sample has a lot of burst (damaged, not whole)

    red blood cells (VERY HIGH HAEMOLYSIS PRESENT) and visibly a lot of free haemoglobin (red colour) floating.

    High or severe haemolysis has 2.51-4.5 g/L Haemoglobin freely floating in serum (normally  not more than 0.1g/L).

    Potassium, phosphate, AST and LD are always increased in haemolytic serums since the concentration of those parameters is higher in red blood cells than in serum/plasma, bilirubin is always decreased value since muddling the chemical reaction up.

    We never ever gave out those number values in strong haemolytic serums therefore or marked it right there with 'cave, haemolytic'.

    I don't know if every doc is aware of the impact on certain parameters due to free haemoglobin, when it is much.

    Cholesterol tends to give higher values too in haemolytic serums.

    (ALP, GGT, amylase and iron assays are not effected....)

    Haemolysis happens either when the sample is taken with a too thin needle and too much force applied to get it out, or via transportation of sample (heat, cold, shaking....whoom, red cells burst).

    But there are also causes for haemolysis within your body, meaning the sample was haemolytic prior taking blood.

    = Hemolytic anaemia

    due to extrinsic (autoimmune, medications, infections) , and intrinsic (body produces genetically wrongly formed red cells like sickle cells) hemolytic anemia has a huge range of possibilities.

    Please have a look at previous lab results (if haemolytic) and discuss with your doc asap if that occured before.

    It needs a repeat considering also haemolysis.

    If homocystein and metamalonic acid could be added, would be a benefit.

    (re vitamin levels, but most docs refuse)

    Free Hb level determination in serum would be good too to find out about the degree of haemolysis. This can - even the test costs money - save costs since interpretation was easier and re-run of tests is not indicated.

    If you have constantly haemolytic samples, this needs to be found out as to why since it seems to be like that within your body and mustn't be that way  or explained as to why and tackled.

    If it was a one off, it was most likely due to during or after blood sample taking mistake.

    May just say going off PPI at once causes acid rebound, too much acid, you need to be very slowly coming off, like e.g. half the dose for a month and then again half of it for another month. You cannot split PPI tablets if they have no splitting line, you need lower dosed tablets per se.



    • Posted

      thank you so much for your lenghty analysis and response.

      I do feel I should see a specialyst as I get this kind of results everytime I do blood in the past years. 

      I found 2 more but they are not as detailed as ones I uploaded above. 

      I will be asking the doctor to refer me , I have to redo the blood in March.

      Also I have very painfull periods, this started 2 months ago. All smears and UZV are fine, all sims fine but the pain I feel is like something I have never felt before :S

      Don't know if any of this is connected.

      Thank you again as I feel more confident to ask my doctor for more tests.

      Have a lovly evening smile



    • Posted

      Oh thank you for lab results. I love them.

      The iron level has definitely changed for the better. As to why, I don't know.

      (those older lab results show, how important it is to always mention UNITS of lab results and their reference range since also test methods differ)

      Unfortunately the 2 older results do not state the condition of plasma, if it was hemolytic (or I am blind). Maybe it wasn't?

      You definitely struggle with anaemia though.

      Also platelets like to be on lower count side it seems, now even the white blood cell count is lower (leucopenia).

      This again can be as simply due to missing essential nutrients like copper and zinc, but there are many other possibilities too.

      Has your doc touched the spleen area and looked for enlargement?

      Are you taking meds that (Aspirin, NSAIDs, anti malaria...) muddle with the bone marrow? Any infection that muddles with your system?

      When you see the specialist, please mention your diet, your medications and supplements you take, all your symptoms.

      This needs to be investigated.

      Unfortunately yes, any nutrient intake change will take up to 3 months to show in red blood, but you might want to be in a specialist's (hematologist) hands by then or have hemolysis excluded and re-check white blood count by a sample now.

      (The lower creatinine value is almost irrelevant since it is 'mildly below' 'normal range'. Normal range values are a mathematical term = found in 95% of so called 'healthy' population and creatinine is something, so 5% are already outside of range (usually slightly out of range) and still 'normal';

      you produce creatinine in your muscles, hence if you don't have much muscle mass or are low in protein intake (and liver disease excluded, enzymes look fine), the incoming creatinine for kidneys to flush it out is already low; if kidneys were not good, the creatinine would increase. I am pretty sure the doc did not address creatinine as too low.)

      Hematocrit as expected low....for anemia.

      I think you really should see a hematologist to get down to the root cause and

      if it was food/intake only,

      but I really think other reasons have to be excluded

      and be it absorption problem of provided food and nothing else within your body as organic cause.

      The range of causes is huge and only a specialist can get to the bottom of it.

      You have beautiful liver enzyme parameters btw.

      What he/she might additionally check for is:

      Reticulocyte count 

      (this are 'newborn' red blood cells in the blood stream, with a special stain they can be seen under microscope and counted and given as a % number of all red cells, hence it shows bone marrow making rate - in hemolytic anaemia that count would be high since the bone marrow tries to keep up the rate of destroyed red cells...whyever they were destroyed in the first place)

      If you had hemolytic anaemia (only speculation at this point) and no red cell deformity - seen in blood smear under microscope, too -  (like sickle cells or thalassaemia that explained it),

      Coombs' test should be done (it checks for antibodies that sit on the surface and destroy red cells at a point)

      Usually when too many red cells were destroyed (prior sample taking = hemolytic anaemia), also too much non-conjugated bilirubin would float around, BUT as said: the presence of haemoglobin muddles up the bilirubin test (and shows lower values). If you had already visible skin/eye jaundice, that would be really high bilirubin. So one does not exclude the other (cannot say: ah, you don't have yellowing, it's fine, no hemolytic anaemia because there are different severities and causes.)

      Haptoglobin can be measured: it is low in hemolytic anaemia.

      You had the glucose-6-phosphate dehydrogenase (G6PD) test and was normal

      (I have to say your latest report checked already quite for a number of things like vitamines, thyroid....your GP was doing really well.)

      it checks for one reason for hemolytic anaemia (if they are too fragile and break down too quickly, not lasting 3-4 months as they should). Since this G6PD is a genetic disorder, it is more common around certain ethnical groups. You don't have that it seems, one thing excluded.

      Exclusions bring you closer to a diagnose. It's not for nothing.

      Overall you had a very good start,

      but you do need further investigation if your anemia was a non-hemolytic anemia and just due to diet, or if diet was good, why the digestive system didn't get in abundance offered nutrients in (celiac?).

      If those two root causes of nutrient issues from outside or digestion/uptake were excluded, further investigation and test interpretations need to be done to exclude organic reasons within your body.

      You don't feel well and your report is not normal regarding blood cells itself. (hormones, enzymes tested were beautiful levels, Folate though low.)

      Especially interesting would be, if this high hemolysis was just a one off occurence due to wrong sample handling after blood taking (caused in vitro).

      You must not have hemolysis. In vivo hemolysis is not normal.

      but so far: we don't even know that.

      If you want to wait 3 months (since your results cannot change quickly as red cells live 3-4 months usually)

      or go back to GP for a referral to hematologist rather now due to time span of symptoms and lab results, is up to you.

      Since your iron has improved and only you know, if you changed something (iron supplements, more iron rich veggies plus vitC upon eating), this might help making the decision.

      Some GPs get offended,

      but point out the duration of anemia and the hemoytic result, which might not just be due to sample handling, an investigation that does not need a 3 month wait. And your symptoms, how bad you feel already.

      All all the best!

      Since your white cells are low, please be extra careful washing your hands and staying off sick people, you could be more susceptible for infections.

      Unfortunately I can't tell you what is going on.

      BTW with bit lower platelets and low white blood cell count, the menstruations tend to be heavier and longer.

    • Posted

      you are very good for giving so much of your time and experties to this forum.

      Thank you very much I wil re read this a couple of times. 

      And prob get to my doctor before 3 months are due for retest.  

      I do take Iron when ever it gets low on test, thus improvment smile

      Somethimes I think my diet is poor and I should try and eat better, but I eat the same as my boyfriend (except meat) and he has perfect results, so it's prob not only diet here.

      As i did have H.pylore and was taking to many NSAID for my period over a couple of years, so now my stomac is a bit sensitive and have to be careful what I eat. ( only in the past half year).

      thank you again smile

      thank you again smile 


    • Posted

      Hang in there!

      NSAIDs maybe one of the contributors,

      also instead of meat you need to not just leave it away, but put something else there (protein; beans, eggs, tempeh/tofu if tollerated, some take saitan, must not be celiac for that).

      If you only leave meat away and eat otherwise 'normal', that can lead to malnutrition.

      Also as mentioned a VitB complex transdermal patch might go a long way if taken for weeks or few months.

      Thumbs up for your karma and avoiding dead animal products since the 'mass production' is horrid. Not the meat and eggs are horrid, it's the production way of cheapest, mass profit. I have my own chickens and even they went through sorting...so against it, let roosters live and quick kill for meat for human and animal consumption. The sorting of 1 day chickens is horrid. Books about it.

      Can't even start, but a bit sensitive buying goes a long way if everybody was a bit more critical.

      You can do that and still get hold of your nutrients you need.

      Best of luck!!!


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