Questions on lab results

I recently had my 9 month post-VSG Appt, and at my request, I left with some lab orders. I faxed the results to my clinic on Tuesday, and followed up with a phone call today, but I haven't had my questions answered yet. I realize that I should rely on the information and advice of my health care team, but while I await answers, I'm hopeful some of the veterans may be able to share some of their knowledge.

My first question is about my iron levels. My Ferritin is high (213ng/mL in November and 203ng/mL currently). My Iron Saturation is also high (45% in November, within normal levels, but 56% currently). My TIBC is low, 231 mcg/dL in November, and 241 mcg/dL currently. My actual Iron scores are in the normal range (104mcg/dL in November and 134mcg/dL currently). (After my November lab results, my surgeons office had me switch to a multivitamin that contains NO iron and discontinue wearing the iron patches. I don't understand how some of my iron scores can be too high, while others are too low. Any information is appreciated.

I'm also puzzled about my Platelet scores. I am historically between 170-180x10(9)/L (within normal range), but my three most recent scores are dropping and are now low. November 4 had me at 158, November 23 at 140, and March 10 at 114. Could my platelet scores be connected to my iron levels? What kinds of questions should I be asking my surgeon's office? What are they likely to suggest to increase my platelet numbers?

Again, thank you for sharing your knowledge and experience. I am looking to educate myself so I can be my own best advocate on my health journey.

Did you wear patches right up until you had blood drawn? It can keep numbers artificially high.

The wait time is different for different vitamins, but I have seen advice suggesting stopping all supplements, oral or patch, for 3 to 5 days before having blood drawn.

I am trying this again. The site keeps cutting off my response. UGH.

Transferrin is a protein that carries ferritin in blood. When the body needs more hemoglobin and red blood cells, it will signal cells to release ferritin. The primary role of ferritin is to store iron in cells and deliver it safely to areas where it is required. In general, ferritin reflects the body's iron stores.

Therefore, low levels suggests iron deficiency whereas high levels may suggest iron overload in the body. However, elevated levels are often found in the absence of iron overload.

Ferritin can elevated even when both serum iron and transferrin saturation percentages are at low-normal levels or below. High levels either suggest iron excess or an inflammatory reaction in which levels are increased without iron excess. In order to figure out the cause, the other tests are important. TIBC reflects the level of transferrin. Transferrin saturation differentiates between iron overload and other causes of elevated ferritin. Transferrin saturation is the ratio of serum iron and TIBC (serum iron/TIBC). Transferrin saturation is high in patients with hemochromatosis (iron overload), typically > 45% and sometimes >55%. When TIBC is low, high ferritin under these cir****tances might not signal iron overload, but can result from a defense mechanism, sometimes called acute phase reaction. The body will synthesize ferritin in response to an evasion of many pathogens. The resulting conditions are sometimes referred to as inflammatory anemia.

When ferritin is very high, hereditary hemochromatosis needs to be excluded first. The tests for this are serum ferritin and transferrin saturation. A transferrin saturation

A transferring saturation above 45% with elevated ferritin makes hereditary hemochromosis unlikely. Then an investigation should aim to identify a cause. For WLS patients, we may simply be taking too much supplementary iron or over absorbing (not as likely). Additionally, alcohol consumptions, metabolic syndrome, obesity, liver disease, infection or inflammation are also causative factors.

I hope this helps a little bit. You are smart to stay on top of this.