Q: Iron panel results

[Guest guest]

Hi all-

I have a question about some recent lab results I received. My patient is a 40 year old female with major physical complaints of insomnia and fatigue. After I got all her old records, I put all her labs in a spreadsheet and noticed that her MCV was running between 80 and 84 pretty consistently for years. Her HgB and HCT have varied, but have been within normal and optimal since 2000. Her RBCs have been high in the past (

5.25 and 5.49), but she isn't great about drinking water. Her RDW was also been > 13 for years.

Based on this info, I did an iron panel with another CBC and got some interesting results. Everything was normal and within optimal on her, CBC except that her WBC were lower than optimal, and her RBC and neutrophil % were slightly higher than optimal. Her ferritin was low normal (

21.2; N=11-120), and iron, TIBC, and % saturation were all low. In iron deficiency anemia, I would expect the TIBC to increase as more transferrin is made to grab any available iron, and the ferritin to actually be low. She tends to be very pale, and has had slightly heavy menses, but nothing significant. She has eaten a lot of dairy (which she is working on reducing).

She had a partial chem with CBC with her MD in October and results were normal except high cholesterol and LDL. Her TSH was higher and free T4 was lower than I'd like to see and hypothyroidism runs in her family (all antibodies neg).

We've been doing drainage, focusing on hormones and liver, and she recently started on HTHY thyroid drops. We're also doing a hair analysis to check for metals. I'm wondering though if these most recent results still indicate iron deficiency anemia given the TIBC and ferritin results.

Thank you-

Hindman, ND, LAc

Portland, OR