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Thursday, June 22, 2017
I`m a 24 year old male who recently had testing done to check for iron abnormalities. The testing was prompted by my feeling extremely fatigued, experiencing heart palpitations, developing premature gray hair, having a pale complexion, etc. According to my doctor, the results of my tests were all `normal` but I certainly don`t feel normal. The results are as follows:
Iron: 184 ug/dl (range given as 41-196 ug/dl)
Total Iron Binding Capacity: 301ug/dl (range given as 236-404 ug/dl)
Total Iron Binding Capacity Unsaturated: 117 ug/dl (range given as 100-315 ug/dl)
Ferritin: 32 ng/ml (range given as 22-322 ng/ml)
Transferrin: 61% (range given as 15-60%)
My concern is that my Ferritin level is low-normal and my Transferrin % is high, which as I understand it is not normal. I should mention that I do have diagnosed Ulcerative Colitis, which has been in remission for 4 years and has never reappeared following the initial flare up. I`m sure colitis plays a role in absorption of iron, but I`m not sure if my test levels are more a result of my colitis or something else like iron deficiency or hemochromatosis. I`ve been tested for Celiac disease in the past as well and have tested negative. Another factor worth considering is that my Mother is anemic and my Grandmother died from non-alcoholic cirrhosis of the liver (primary biliary cirrhosis), which her doctors never could entirely trace to a definitive cause and I`ve heard can be associated with hemochromatosis.
My doctor is providing little help and doesn`t seem worried, however I simply don`t feel right. Any advice you can provide on how to proceed, what further testing I should request, etc. would be greatly appreciated. Thank you.
Most likely your fatigue is coming from your Ulcerative Colitis, which can cause non-specific symptoms even when supposedly in remission. Your ferritin is reassuring in that at a level of 32 ng/ml, that really tells us that you are not iron overloaded at the moment. Your transferrin is slightly high, but that is not specific.
From my perspective, at least we know there is no significant iron overload at this point that is causing problems. Beyond this, you will need to check with your primary care provider for all the other symptoms you have.
Mark Wurster, MD
Former Clinical Assistant Professor of Internal Medicine
College of Medicine
The Ohio State University