Help understanding labs

I am 6 months out of surgery, and I have my labs drawn every three months. So I just had another set done. My surgeon said everything is fine and she doesn't want me to change anything, but I've read a lot around here abou****ching trends.

For some reason the reports I have access to don't have iron or ferritin for August (2 weeks after surgery) but I know ferritin before surgery was up to 72 (range 10-150). So ferritin in October (3 months out) was 66, this last set (6 months) was 45. Ummm...seems to be dropping. But my iron serum was 67, and now is 105 (range 27-159). So my iron (serum) is going UP? While ferritin is going down...? Am I correct in surmising that my body is robbing from iron stores to keep my available circulating iron up?

Bs are around 1,000. D3 is 73, which is the highest it's ever been. PTH is 23, lower end of normal. So everything looks good.

But what does my iron/ferritin mean? And what should I do about it?

Iron is like money in your pocket -- available to use right now. Ferritin is like money in the bank. Not usable this instant, but for future withdrawals. So your analogy is correct. You are taking stored iron in ferritin for everyday use.

I would start supplementing with iron, or take more if you already are. Keep watching the trend. Trends are every bit as important as current numbers. Good catch.

Low PTH is good. High would mean you were leaching calcium from your bones for your body's other needs.

Thank you for confirming my conclusion. I already take 30mg each night, given that I am obviously not absorbing it all I think I'm safe to double it?

Your assumption is correct. Your ferritin number is still in "normal" range but my hematologist recommends infusions when I get below 50. We can become symptomatic when Ferritin is below 50.

I would not wait until your ferritin drops any lower to add an iron supplement. It's still at a point where you could bring it above 50 with an iron pill.

Remember to find an iron supplement that is 65 mg elemental iron. I like carbonyl iron because it does not cause stomach upset and constipation. Heme iron is good too. Stay away from ferrous iron. They cause the most stomach/bowel issues.

You should take it with 400 mg of Vitamin C to aid in absorption. I take this iron supplement. It already has the vitamin C in it.

Do not take iron and calcium together. They should be spaced at least 2 hours apart.

Do not take iron with tea or coffee. The tannins in tea and coffee slow absorption of iron. Also, do not eat dairy products with iron for maximum absorption.

I take my iron supplement in the middle of the night (literally--it's when I wake up to go to the bathroom, usually around 1am). Nothing else with it, or anywhere near it. My iron has vitamin c with it already, I think. I will check that. I don't consume caffeine, so that's not a worry. :)

My surgeon has me on 30mg, but given that my numbers are dropping I think I'm safe to double that. I'll do that starting tonight.

What "symptoms" should I be watching for? I've noticed I am more tired lately, but it's a hard call whether it's because of that or because of increased physical activity. Any other symptoms I should watch for?

Thank you for your help!

Fatigue, heart palpitations, shortness of breath, leg cramps, restless leg, headache, inflammation or sore tongue, and paleness are some. The first symptom for me was extreme fatigue with restless leg. I was at a ferritin level of 10 when I was having heart palpitations and shortness of breath. That was when I had my first infusion. You really don't want to let it get that bad. It will be fine to double your iron until your next labs. Then you will see if you are absorbing your iron supplements. Some of us simply do not absorb iron well and require infusions.

Two years ago, before surgery, I was stuck in a migraine cluster. I went to my neurologist and he said that low ferritin store can cause headaches, so he tested me for that. It came back at a 6. Yes, 6. All I remember is the bone-crushing fatigue and brain fog. So it's good to know what else to watch out for, thank you.