Iron is particularly important to our body, our brain, our energy, and our overall well-being!

BUT! If iron is too low or too high, our body, brain, energy, and overall well-being can and will suffer! So, we need our body iron to be just right! Also, the iron levels tend to s-l-o-w-l-y go up or down, making the effects of too much or too little iron very difficult for us to detect.

Checking our iron status may be accomplished through lab tests – and INTERPRETING THEM PROPERLY! This is not going to be “all you need to know about iron testing”! That would get long, convoluted, and BORING! We are going to focus on Iron Deficiency & Iron Deficiency Anemia.

Our body has two iron compartments – the working iron in our blood serum and the stored iron or ferritin (fair-ih-tin) in our body.

Checking the working iron is simply done by measuring the amount of iron in your blood with a lab test. The normal range is 27 to 139 micrograms per deciliter with the optimal range being between 60 and 110 mcg/dl.

The stored iron is a little tricky! We need the stored iron in case we have blood loss, such as from an injury, or surgery, and need to start making blood immediately! The lab test for stored iron is called serum ferritin. If the working iron is low and the ferritin is low, this condition is known as iron deficiency.

But, ferritin levels can represent two different things.

One, it can represent the level of iron we have stored. The optimal range for stored iron,

for ferritin, is 70 to 100 nanograms per milliliter.

Two, ferritin can be a marker for inflammation that is anywhere in the body, such as painful joints, pneumonia, gastritis, etc.

The normal lab range for ferritin can be 15 to 150 ng/ml, or even 15 to 400 ng/ml. And, if we look at that “range” our question should be: “What kind of “range” is THAT?” So let me attempt an explanation:

First, remember iron changes rather slowly in the body.

Second, inflammation may change rapidly.

Third, when analyzing iron stores, the ferritin level can be falsely elevated, indicating inflammation. But a low ferritin level cannot be falsely lowered.

So, if the ferritin level is low, as in less than 70 ng/ml, the iron stores are probably low. If the ferritin is elevated above 150 ng/ml, it is probably measuring inflammation. (If the serum iron is elevated, then ferritin may be indicating that the iron stores are truly elevated!)

The most common iron problem is anemia due to iron deficiency. Usually, iron deficiency anemia is due to an inadequate intake of iron-rich foods.  The domino effect in iron deficiency anemia usually begins with the ferritin (the iron stores) getting low. Then, the serum iron goes low. At this point, the individual is iron deficient. Next, the hemoglobin and hematocrit (“H&H”) begin to drop because the bone marrow doesn’t have enough iron to make adequate red blood cells to carry oxygen. At this point, the individual has iron-deficiency anemia (low H&H). Months or years can elapse between each of these events!

If a female of childbearing age has heavy periods with clots, there is a high probability she has some degree of iron deficiency. This iron deficiency affects energy as well as academic performance!

BUT BEWARE! Too much iron causes many problems, so before one starts to supplement with iron, checking the complete blood count (CBC), serum iron level, and ferritin level is crucial in building one’s iron back up.

Iron supplements have a reputation for causing constipation. Sometimes constipation can be avoided by taking an iron supplement every other day. The cheapest and most readily available iron supplement is ferrous sulfate, and it is the one most likely to cause constipation. Ferrous fumarate and ferrous gluconate are less likely to cause constipation, but the carbonyl (carbon–eel) form of iron is supposedly the least likely to cause constipation.

Iron deficiency is not just a concern for young women having menstrual cycles. Studies have shown that close to 50% of individuals with heart failure are iron deficient. Even though most of these patients are not anemic, iron deficiency is an independent predictor of mortality.

So, regardless of your age, tuning into your body’s iron status is a good idea!

Personal Integrative Medicine PLLC

Charles C. Adams, MD

4085 Cloud Springs Road        Ringgold, GA 30736

P: 706-861-7377  Fax: 706-861-7922

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