Blood work- ferritin

Hi Everyone

I'm looking for input on my test results I have an appointment with my surgeon in two weeks and just received my blood work results from the lab.

My Ferritin level in January was 25 NG/ML and now its down to 19 NG/ML. My surgeons office doesn't even test for that but I've asked my Dr to because I know how important it is. I actually don't how to approach this topic with the PA but I'm worried it's tanking fast. Should I be concerned? My iron level is 105 and I know they are going to look at that and say it's fine. Any offers of help would be appreciated.

Probably not low enough for them to worry about, mine was 12 before surgery, started taking 2 pre-natal vitamins a day at 1 month out but at my 3 month blood work it was down to 8, so now I'm also supplementing with daily iron. They'll reevaluate for my 6 month bloodwork. I have a history of anemia but am post menopausal.

I'd say you may want to make sure our PCP monitors post surgery.

That is not true according to my surgeon. He orders a referral to hematology when the number drops below 20.

I'm was wondering if we were dealing with american vs canadian measurements as 20 is still well within normal for our standards(5-272), personally I've never been over 20. I just looked it up and ours are measured at Ug/L the US measurements are ng/ML with 20 to 500 being the normal range.

So it look's like we're right on both sides, but with different numbers, wondered when you said referral below 20 but it makes sense now as that is base line normal.

I think everyone has to consider the source when asking questions on these forums as we're not all living in the same country with the same measurements.

You are 4 months out of surgery, and your ferritin is 8 and dropping -- with a history of anemia. It doesnt matter which units you use, an 8 is an extremely troubling number. I would get myself to a hematologist today if I came up with an 8.

This will ONLY get more dire the farther out you get from surgery. Don't discount how serious this is.

Unfortunately can't see anyone till they've seen a testing trend, hence getting tested again next month, I have a very good relationship with my PCP and she was going to order follow up bloodwork but I already had an order. She did say that if it hadn't come up they might try oral iron? but I would wonder how that would work if I don't absorb the pill form, but I assume it might also be a different type. At least the infusions would be covered the only one of my regular medications I'm no longer taking is insulin and I always run out of coverage before I run out of year. But I knew I'd need supplements going into this.

MichelleS61,

I had a WLS many years ago, that is not done now, kinda like a RNY+ other proceduress for weight loss...I have a mal absorbtion of many nutrients including Iron. I could not take any over the counter forms of ferrous sulfate or other irons, they just cramped me...

There is one Rx'd Iron that I can take and it absorb, it is a complete formula (with all needs to absorb).including the intrinsic factor that enables absorbtion . I was initailly started on it for 2 x a day for several months to build quickly. The name of that pill is FOLTRIN, it does come in a generic now. So even if you need to pay out of pocket is affordable. This capsule is of a size easy to swallow.. about .what is a "0" size..or the size of a tylenol caplet, but in a capsule.. There is also a MVI by walgreens that has intrinsic factor in it, but it also has calcium..and was too big for me to swallow.

I am off of it now and am using a extract of dessicated liver. it is available from Carlson labs, and beef calf or buffalo calf , grass fed both work equally well for me. last bottle i bought was 55$ or so and was 180 caplets. They recommend 6 a day, but i take 2-3 and it enables one to absorb iron from other foods such as greens and raisins.

Your information is completely wrong and at 5 months post op you are not in the position to be advising others on Ferritin.

So I will ask you this Michelle, you were at a 12, you are at an 8 now, you don't have far to go before you get to zero, what then? I don't think you truly understand how important Ferritin levels are in a post gastric bypass patient. An 8 is in fact dangerously low. You will start to feel the side effects eventually of having such a low Ferritin.

And do you realize that being post menopausal has NOTHING to do with your ferritin levels right? I see you mention this all the time and its totally a mute point. Your ferritin might not drop as rapidly as a menstruating woman but it is dropping. Everyone, men and women post gastric bypass need a strong ferrtin level. Iron Ferritin levels are your "bank account" of iron stores. Look at it this way, if you got into a car accident and you were bleeding profusely your body is going to lose a lot of blood and then its going to look for its "iron stores i.e. Ferritin" to build the blood back up. If you only have a ferritin level of 8 your body does not have a lot to build its stores back up. If I lose all the cash in my wallet (blood) and I only have $8 in my bank account (ferritin) then I am screwed and have pretty much no money (iron stores).

I keep my ferritin at 100-150, closer to the 150. I do menstruate heavy each month hence why I keep it so high as it drops rapidly due to the heavy menstruation. I do know many OHers here that do not menstruate land they keep their ferritin at a minimum of 50 - 80. I do use the Iron patch from PatchMD as I do not absorb oral iron and I have tried multiple brands. My Ferritin got down to a 4 two years ago and I thought I was going to die. Literally the side affects of low ferritin anemia are so horrible I could not function. I have had multiple iron infusions to get my ferritin to the numbers they are at now and I will continue to get infusions until I do stop menstruating. I never ever want to feel that way again with a ferritn of 4, it feels like death. I am in Canada and getting Iron Infusions is way easier than our American friends but if people's ferritin is dropping that rapidly they need to advocate for themselves and get a referral to a hematologist and get infusions. And then keep on top of the blood work to ensure its at an acceptable level. I get blood word done every 3 months at Life Labs to ensure all my labs are at good levels.

For the record, at my Centre, Toronto Western they were not concerned at all that I had a ferritin of 4. I took matters into my own hands, saw my family doctor who said that a 4 was totally unacceptable and started me on the iron infusions. There are a small handful of OHers here who have excellent Centres/Surgeons who will order iron infusions once they see the drop in ferritin but generally I see over and over again most Centres don't think a low ferritin is anything to worry about and they are wrong.

I hope you can increase your ferritin with the daily iron and you won't be like me and need infusions.

Interesting I'm through the same center and had the same surgeon, I would hope that at a level of 4 they were treating you especially if you felt bad, and I'm sure if we discover in a month when I retest that I'm not absorbing that they'll do the same for me, the unfortunate thing about ferritin levels is the range of "normal" from 5 - 272 is really broad, I've always tested in the lower range and I know what Iron deficient anemia is like as I've had it too, and wouldn't want that to happen to anyone. The person I replied to was pre surgery so her concern was whether they'd do surgery, but her ranges were still within normal.

It's important that we advocate for ourselves after surgery as not all clinics or doctors are fully educated, but it's not necessary to scare people when they haven't even had surgery yet, not everyone has issues absorbing iron, but if it's been a problem before your surgery and you're aware of it it's definitely something that you personally need to keep an eye on. I was concerned which is why I'm now taking iron as I was really tired, and for me that can be a sign.

I'm not pre surgery. I two years out.