Iron Status

[Guest guest]

I have a 56 yo female patient, six years s/p bypass

who presents with the following data:

ferritin 8 lo

retic count .8 Normal

TIBC 431 hi

Iron % sat 10 lo

She was not given any iron supplements & her

hematologist recommends IV iron. Would you recommend

an oral supplement also? Why is her TIBC close to

normal, (range 228-428 mcg/dl)?

I usually don't see many of these types of patients.

Thanks,

L.S. Kolodin,RD

Warren, NJ

Private Practice

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[Guest guest]

A ferritin of less than 12 is indicative of depleted stores --acute phase reactant or not. The TIBC is high because additional sites have been "opened" for iron uptake. The % sat is opposite the TIBC, lots of open sites so few sites are saturated. The quickest method is the IV iron, we would also give ferrous fumarate in addition to two MVI's with iron.

Jeanne Blankenship, MS RD

Sacramento, CA

-------------- Original message from Lori Kolodin <lorikolodin@...>: --------------

I have a 56 yo female patient, six years s/p bypasswho presents with the following data:ferritin 8 loretic count .8 NormalTIBC 431 hiIron % sat 10 loShe was not given any iron supplements & herhematologist recommends IV iron. Would you recommendan oral supplement also? Why is her TIBC close tonormal, (range 228-428 mcg/dl)? I usually don't see many of these types of patients.Thanks,L.S. Kolodin,RDWarren, NJPrivate Practice__________________________________________________________Never miss a thing. Make your home page. http://www./r/hs

[Guest guest]

Lori,

With the TIBC being high and other parameters low, I wonder about protein malnutition since TIBC is a function of the number of transferrin molecules available to transport heme. If the transferrin is low, check protein levels and protein intake. Perhaps she is not eating enough protein to provide enough transporters and the transporter she has are totally filled with iron, but not enough iron to prevent anemia??? Just a wild thought.

Kathy J. Shattler, M.S.,RD

Director, Nutrition and Dietitians Division

Http://www.ceu4u.com

kshattler@...

"Virtual Continuing Education Institute"

Iron StatusI have a 56 yo female patient, six years s/p bypasswho presents with the following data:ferritin 8 loretic count .8 NormalTIBC 431 hiIron % sat 10 loShe was not given any iron supplements & herhematologist recommends IV iron. Would you recommendan oral supplement also? Why is her TIBC close tonormal, (range 228-428 mcg/dl)? I usually don't see many of these types of patients.Thanks,L.S. Kolodin,RDWarren, NJPrivate Practice

____________________________________________________________________________________Never miss a thing. Make your home page. http://www./r/hs

[Guest guest]

To clarify my previous message, TIBC represents the iron binding ability of transferrin. Serum iron (fasting is best) divided by TIBC x 100 gives % Tsat. Normally Tst% is 25-35%. Higher numbers are suggestive of iron loading. Thus the relationship between %TSat and transferrin. Transferrin < 150 is indicative of malnutrition and I guess that is what i was trying to say.

Regards,

Kathy J. Shattler, M.S.,RD

Director, Nutrition and Dietitians Division

Http://www.ceu4u.com

kshattler@...

"Virtual Continuing Education Institute"

Re: Iron Status

A ferritin of less than 12 is indicative of depleted stores --acute phase reactant or not. The TIBC is high because additional sites have been "opened" for iron uptake. The % sat is opposite the TIBC, lots of open sites so few sites are saturated. The quickest method is the IV iron, we would also give ferrous fumarate in addition to two MVI's with iron.

Jeanne Blankenship, MS RD

Sacramento, CA

-------------- Original message from Lori Kolodin <lorikolodin@...>: --------------

I have a 56 yo female patient, six years s/p bypasswho presents with the following data:ferritin 8 loretic count .8 NormalTIBC 431 hiIron % sat 10 loShe was not given any iron supplements & herhematologist recommends IV iron. Would you recommendan oral supplement also? Why is her TIBC close tonormal, (range 228-428 mcg/dl)? I usually don't see many of these types of patients.Thanks,L.S. Kolodin,RDWarren, NJPrivate Practice____________ _________ _________ _________ _________ _________ _Never miss a thing. Make your home page. http://www.. com/r/hs

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[Guest guest]

What was the MCV?This gives you a good explanation of types of anemia and interpreting the tests you have available to you.http://labtestsonline.org/understanding/conditions/anemia/--- On Thu, 10/13/11, Ewing, RD LD <ewingkri@...> wrote:From: Ewing, RD LD <ewingkri@...>Subject: Iron status Date: Thursday, October 13, 2011, 5:28 PM

I have a 1 year post gastric bypass male with these iron labs:

ferritin = 54 (normal)

IBC=328 (normal)

serum iron=68 (normal)

hemoglobin=11.1 (14-18)

hematocrit=33.4 (42-52)

RBC-3.68 (4.7-6.1)

What interpretation do you make? It appears to me as if iron nutrition is fine and that his hemoglobin is low for another reason. Any other ideas?