I did not realize how much complexity here is with iron metabolism and all the functions apart from transporting oxygen to cells. So, I have been exploring the many functions of iron. I have also become fascinated with the possible incorrect or overly simplistic interpretations of ferritin. It appears from my early look at the significance and correlates of - particularly-low ferritin - that having low ferritin levels may be a favorable phenomenon; however, its not entirely clear what all is involved in these correlations with particular diseases or disease markers. I enjoyed this explanation of blood work and am glad to see a physician take the time and have the skill to explain these bodily processes in a way that is understandable.
Thanks for your kind words! Glad you enjoyed the video. You're right, iron studies are far more complicated and go much much deeper, but I hope this overview is a nice primer. When it comes to ferritin you probably want the right amount. For women this adjusts up as women get older, but high levels are certainly an issue and/or indication of potential issues at play. Low levels aren't great, once you're in the deficient range (a range which was brought up recently in the UK to align with men), there's potential for all kinds of problems. It's great you're own research, keep the focus on peer reviewed articles and even meta-analyses if you can. You'll find the strongest evidence there.
Very well explained!! However, I have a friend with low iron levels and low TIBC level which doesn't make any sense to me! Any idea what might cause it?
i hope you've gotten your answer by now. but if anyone else is wondering, that can happen in chronic inflammation. inflammation makes your tissues essentially trap iron inside them and so TIBC is low (because the body does have iron). but because the iron cannot reach the blood, serum iron is also low. i'm not sure i explained that well but i stumbled upon this during my studies and thought i'd share.
@@plsbekind thank you for your explanation. I've heard this before, but how can you find out where exactly is the inflammation? I wish some one could explain this
I love this video, but what does it mean if you have low iron saturation, low tibc, and high ferritin. Can hemochromatosis cause low iron saturation and high ferritin, because i was diagnosed with that, but i dont want my iron saturation getting too low if i have phlebotomys done.
I have both a low iron level and a low TIBC level (with a normal ferritin level). How can this happen? In the video you are saying that iron and the TIBC number should have a negative correlation, right?
I'm having chest pains and nerve pain since 2 months. I was absolutely fine and when one day started having chest pain... It scares me a lot... I have done my ECG echocardiogram endoscopy and what not... Doctor said my heart was fine.... All the doctors are saying that I have in society and anxiety is causing me e these weird pains all over my body and specially my chest pain.. somewhat I was not ready to believe them... I I'm having extremely dry lips... It's sometimes even bleed when the skin comes off, kind of dry skin. And people tell me that I looked very unwell... I got my vitamin test done.... And my vitamin d level is 12.... Dr never asked me for a bit test but can my chest pain and other pain all around my body and specially my wrist and my feet can be a sign of vitamin d deficiency... Can vitamin d deficiency at a level of 12 be so severe Also I have had breathing issues now a days... Strange tightness in the body. ... Lump in the throat feeling... And upset stomach... And I'm also having lump in the throat feeling.. can dis be due to vit d or calcium deficiency or iron deficiency?
Thanks for the video, you made it easy to comprehend for a lay person. I have a strange combo. Borderline high iron, borderline low ferritin, normal iron binding capacity and slightly high saturation percentage. MCH is also slightly high. Any idea what this suggests? Should I increase or decrease dietary iron? My primary care MD seems clueless. Thanks
How does iron saturation test play into these other markers? Is that the same as transferrin saturation? That is the only marker low on my recent panel.
So… my results came back TIBC high at 452, but Ferritin normal at 263, iron 133, iron sat 29%, RBC 5.3, Hemoglobin 16. So what’s up with that?? All normal but TBIC high. 🤷🏼♂️ my doctor had no answer for me.
What about a 5 year old child that has high iron saturation, but notmal ferritin that is on the low side of normal (22). Her binding capacity is mid normal at 318, but she also has high hemocrit, high hemoglobin, high platelets and slightly elevated potassium, slightly elevated calcium. (She isnt dehydrated as I have recorded what she has drank every day and she has drank plenty). Her symptoms are extreme constipation, fatigue, leg weakness, joint pain, memory loss (she often forgets what she did 30 mins ago) etc. Her albumin levels have aldo been steadily climbing. They are still normal, but barely
Have your doc check for hereditary hemochromatosis checking gene snippets for C282Y and/or H63D. Blood letting/phlebotomy may be warranted because iron overload is very dangerous, especially in children. Also, don't go by just ferritin. If iron saturation is high, then that is cause for concern and something should be done immediately.
Non transferrin bound iron. NTBI .... I think this explains the subsect of people dealing with iron overload, yet have normal ferritin levels. I'm one of those people. NTBI is considered one of the most toxic forms of iron in the body because of the potential to cause rediculous amounts of free radical damage. There are videos about it that explain it in very simple terms. Hope this helps 👍
I feel im dying i have symptoms like fatigu, Extreme Brain fog, irritable, anxiety, depressed, ligh headed feeling like im going to faint, tired for days after every workout, heart palp all day, bruising easily and small red blood-colored dots under the skin. My serum level are low, transferrin did start to increase last test and transferrin saturation are low but i have normal ferritin, I have heard that ferritin can be normal with inflammation in the body? i think my b12 injections have depleted my iron levels? do u think i have iron defiency? my doctor dont say anything do u think i should get some iron supps and etst if it get better? Thx for the video good info.
Not all conditions of iron overload present with high ferritin. My iron is 233 (High), UIBC 62 (low), saturation is 79% (extremely high) ...but ferritin is 86 (low normal). For all intents and purposes this would be considered classic iron overload, except for the ferritin number. Which is misleading! So much so that my naturopath dismissed the abnormal numbers because he was taught to think that ferritin was a marker that showed overall iron levels, and told me I shouldn't worry. I regret having not went to someone who knew better. There's something called NTBI "non transferrin bound iron" that is exactly what it states.... iron that is not bound to ferritin. This could explain why someone (like myself) could present with a laundry list of iron overload symptoms and still have low ferritin. It's because not all of the iron in my system is bound to ferritin. This is not good, under any circumstance, regardless of ferritin numbers. I am in the process of getting the genetic testing to rule (in or out) hereditary hemochromatosis. There are videos on this platform that explain it in simple terms. Ferritin is a good marker, but it excludes a large number of people who still suffer from iron overload symptoms without high ferritin.
3:05 so am wondering why my TIBC isn’t high according to your video.? Pls help me. My results. TIBC 265 ug/dL. (250 to 450) Iron. 68 ug/dL ( 38 to 169) % iron Sat 26 ug/dL. ( 15 to 55) Ferritin 48 gn/mL (23.9 to 336.2) So if iron level
Hi i have heamochromotosis iron blood level was 1382 family history all males died early 50 I was diagnosed 2half years ago had extra benefit of extra o2 in blood advantage of strength and endurance when training all my life however things caught up with me by time I was 50 I’m 57 now had repeated venesection iron now at 200 had mri of brain kidneys liver all ok except liver is saturated still had fibroscan showed liver flexible so no damage (I’ve never drunk alcohol ) my question is how is my liver still saturated yet my iron in my blood low (relatively ) my iron drop approx 40-100 after each treatment my diet is strict ( drink milk do reduce absorbtion rate no vit c) what is the mechanism that the liver uses to dump the iron I know the liver grows dies same rate each day my cholesterol is v low under 2 bp 117/70 weight 12 stone 5 ft 9 been power lifter for 30 years free diver etc so was extremely fit half marathon 1hr 19 approx 6 min per mile max breath hold freedive 4mins 40 plus meter depth bench press 145 kg all in my 40s now I sit in a chair unable to exercise much or even do light diy I was a builder so fatigued feels like anemia ( relatively)day xplination would help thank you
Serum iron is reduced in ACD, reflecting the decreased availability of iron. Serum transferrin is typically normal or low, and its fall in acute inflammation is thought to be due to increased degradation. Depending on transferrin concentration, TIBC can be low or normal. Transferrin saturation is typically low and is a reflection of the decreased serum iron. Serum ferritin is either normal or elevated, in part due to ferritin's role as an acute phase protein but also the net effect of diversion of the body's iron into this storage protein within the reticuloendothelial system in ACD.
@@TheStealthDoctor Can you please explain that once again with a bit easier language pls? So i am interested in what to look for if i have low TIBC and low Iron? Cheers
I've found it quite difficult to get good information for my situation: normal iron in blood, but elevated ferritin. It's not super-high, but finding info online of how to normalize ferritin when other markers seem okay was nearly impossible. I've since donated blood more frequently (once every 2-3 months) and it seems to have fixed it.
Are u doing the donation on your own or recommend by provider? Hopefully you are using other labs since you’re iron level is normal to begin with.. ferritin has different influences…
@@mandykal Yes, got better help. Provider said I was fine to donate blood, but ordered more tests. Looks like it may have been a temporary situation. My first doctor said ferritin was fine, nothing to worry about (because he had seen worse LOL) - I tried to communicate that I want the best for my long-term health, not a comparison to an unhealthy population.
@@OnlineCoachPaulStrobl Right, I've read the most likely reason donating blood is often heart healthy is because it lowers iron levels. Just like women have lower rates of heart disease than men - but only until they reach menopause.
Here’s proof that the iron test (ferritin) is bs: Two recent papers measured the influence of iron on early puberty. One paper measured it via ferritin tests, the other paper via actual iron intake. And, arrived at exactly opposite conclusions. ferritin correlated positively with late onset of puberty, while iron intake correlated with early onset of puberty. Of course only the latter finding is relevant, as iron intake is factual, while ferritin is a pisspoor marker apparently, or rather, excess iron intake seems to result in lower ferritin. Nutrient Intake through Childhood and Early Menarche Onset in Girls: Systematic Review and Meta-Analysis, 2020 Micronutrient status in middle childhood and age at menarche: results from the Bogotá School Children Cohort, 2017 From this I would conclude btw that ferritin is only a late stage indicator of iron overload. Ie, when a ton of liver cells burst spilling all their ferritin content. It has always been debated where does the ferritin in the blood come from anyway, as it isn’t released into the blood by design. In healthy humans, eg children, ferritin is soaked up even more quickly from the blood when there’s too much iron, so again, it is an absolutely useless marker.
Wrong info provided in this video about vegans and iron intake. Here is the correct information: In a large 2003 study published in the journal Public Health Nutrition, researchers compared nutrient intake among more than 65,000 men and women between the ages of 20 to 97 years. Except for saturated fat (which was highest among omnivores), vegans had the highest intake of all other studied nutrients, across the board - including iron.
I did not realize how much complexity here is with iron metabolism and all the functions apart from transporting oxygen to cells. So, I have been exploring the many functions of iron. I have also become fascinated with the possible incorrect or overly simplistic interpretations of ferritin. It appears from my early look at the significance and correlates of - particularly-low ferritin - that having low ferritin levels may be a favorable phenomenon; however, its not entirely clear what all is involved in these correlations with particular diseases or disease markers. I enjoyed this explanation of blood work and am glad to see a physician take the time and have the skill to explain these bodily processes in a way that is understandable.
Thanks for your kind words! Glad you enjoyed the video. You're right, iron studies are far more complicated and go much much deeper, but I hope this overview is a nice primer. When it comes to ferritin you probably want the right amount. For women this adjusts up as women get older, but high levels are certainly an issue and/or indication of potential issues at play. Low levels aren't great, once you're in the deficient range (a range which was brought up recently in the UK to align with men), there's potential for all kinds of problems. It's great you're own research, keep the focus on peer reviewed articles and even meta-analyses if you can. You'll find the strongest evidence there.
Hi, I know this video is old but what would cause low TIBC but everything else within normal range?
Thanks a lot ❤️ you explained it too well
Do you need to fast before a ferritin blood test?
Very well explained!! However, I have a friend with low iron levels and low TIBC level which doesn't make any sense to me! Any idea what might cause it?
i hope you've gotten your answer by now. but if anyone else is wondering, that can happen in chronic inflammation. inflammation makes your tissues essentially trap iron inside them and so TIBC is low (because the body does have iron). but because the iron cannot reach the blood, serum iron is also low.
i'm not sure i explained that well but i stumbled upon this during my studies and thought i'd share.
@@plsbekind thank you for your explanation. I've heard this before, but how can you find out where exactly is the inflammation? I wish some one could explain this
What if %Saturation is low , But tibc , ferritin is normal
@@dependablez7001i also have this you found out what it is?
I love this video, but what does it mean if you have low iron saturation, low tibc, and high ferritin. Can hemochromatosis cause low iron saturation and high ferritin, because i was diagnosed with that, but i dont want my iron saturation getting too low if i have phlebotomys done.
I have both a low iron level and a low TIBC level (with a normal ferritin level). How can this happen? In the video you are saying that iron and the TIBC number should have a negative correlation, right?
I'm having chest pains and nerve pain since 2 months. I was absolutely fine and when one day started having chest pain... It scares me a lot... I have done my ECG echocardiogram endoscopy and what not... Doctor said my heart was fine.... All the doctors are saying that I have in society and anxiety is causing me e these weird pains all over my body and specially my chest pain.. somewhat I was not ready to believe them... I I'm having extremely dry lips... It's sometimes even bleed when the skin comes off, kind of dry skin. And people tell me that I looked very unwell... I got my vitamin test done.... And my vitamin d level is 12.... Dr never asked me for a bit test but can my chest pain and other pain all around my body and specially my wrist and my feet can be a sign of vitamin d deficiency... Can vitamin d deficiency at a level of 12 be so severe
Also I have had breathing issues now a days... Strange tightness in the body. ... Lump in the throat feeling... And upset stomach... And I'm also having lump in the throat feeling.. can dis be due to vit d or calcium deficiency or iron deficiency?
I’m not a doctor but your iron levels could be low. Did your doctor check your iron?
I have all these symptoms you mentioned. did you get better? what did you do?
Definitely, I had the worst chest pain when I had iron deficiency
Thanks for the video, you made it easy to comprehend for a lay person. I have a strange combo. Borderline high iron, borderline low ferritin, normal iron binding capacity and slightly high saturation percentage. MCH is also slightly high. Any idea what this suggests? Should I increase or decrease dietary iron? My primary care MD seems clueless. Thanks
Same here!
What if like me, your ferretin is low and CRP raised?
How can iron overload cause problems if it's always bound to either transferrin or ferritin ?
Excellent explanation! First video and I’m hooked! Liked and subscribed!
Welcome aboard!
Why would ferritin be low but transferrin saturation be higher mine is 52 and can’t get ferritin above 50.
Did you have any white coating on your tongue bro even my ferritin is low but transferrin saturation is high 53
@@Masspeace no I didn’t. Try to be patient with ferritin coming up.
@@nicoc7024 my ferritin is 80 I’m really concerned about my saturation which is 53
@@Masspeace how many times have you checked it?
How does iron saturation test play into these other markers? Is that the same as transferrin saturation? That is the only marker low on my recent panel.
My bloods 888 what should I do ?
Doctor says...6 weeks retest.
So… my results came back TIBC high at 452, but Ferritin normal at 263, iron 133, iron sat 29%, RBC 5.3, Hemoglobin 16. So what’s up with that?? All normal but TBIC high. 🤷🏼♂️ my doctor had no answer for me.
What about a 5 year old child that has high iron saturation, but notmal ferritin that is on the low side of normal (22). Her binding capacity is mid normal at 318, but she also has high hemocrit, high hemoglobin, high platelets and slightly elevated potassium, slightly elevated calcium. (She isnt dehydrated as I have recorded what she has drank every day and she has drank plenty). Her symptoms are extreme constipation, fatigue, leg weakness, joint pain, memory loss (she often forgets what she did 30 mins ago) etc. Her albumin levels have aldo been steadily climbing. They are still normal, but barely
Have your doc check for hereditary hemochromatosis checking gene snippets for C282Y and/or H63D. Blood letting/phlebotomy may be warranted because iron overload is very dangerous, especially in children. Also, don't go by just ferritin. If iron saturation is high, then that is cause for concern and something should be done immediately.
My Ferritin is low but my Total Iron and Iron Saturation levels are High. My iron saturation level is 63! What could be the possible cause of this?
I have the same issue as well as low hemoglobin. Did you ever find out the problem?
Non transferrin bound iron. NTBI .... I think this explains the subsect of people dealing with iron overload, yet have normal ferritin levels. I'm one of those people. NTBI is considered one of the most toxic forms of iron in the body because of the potential to cause rediculous amounts of free radical damage. There are videos about it that explain it in very simple terms. Hope this helps 👍
@@jonkurzawa5352 Thanks for the reply!
My ferritin level is 6.0 but iron is within the desired range. What does that mean
I feel im dying i have symptoms like fatigu, Extreme Brain fog, irritable, anxiety, depressed, ligh headed feeling like im going to faint, tired for days after every workout, heart palp all day, bruising easily and small red blood-colored dots under the skin.
My serum level are low, transferrin did start to increase last test and transferrin saturation are low but i have normal ferritin, I have heard that ferritin can be normal with inflammation in the body? i think my b12 injections have depleted my iron levels? do u think i have iron defiency? my doctor dont say anything do u think i should get some iron supps and etst if it get better? Thx for the video good info.
Hi are you any better
Not all conditions of iron overload present with high ferritin. My iron is 233 (High), UIBC 62 (low), saturation is 79% (extremely high) ...but ferritin is 86 (low normal). For all intents and purposes this would be considered classic iron overload, except for the ferritin number. Which is misleading! So much so that my naturopath dismissed the abnormal numbers because he was taught to think that ferritin was a marker that showed overall iron levels, and told me I shouldn't worry. I regret having not went to someone who knew better. There's something called NTBI "non transferrin bound iron" that is exactly what it states.... iron that is not bound to ferritin. This could explain why someone (like myself) could present with a laundry list of iron overload symptoms and still have low ferritin. It's because not all of the iron in my system is bound to ferritin. This is not good, under any circumstance, regardless of ferritin numbers. I am in the process of getting the genetic testing to rule (in or out) hereditary hemochromatosis. There are videos on this platform that explain it in simple terms. Ferritin is a good marker, but it excludes a large number of people who still suffer from iron overload symptoms without high ferritin.
3:05 so am wondering why my TIBC isn’t high according to your video.? Pls help me.
My results. TIBC 265 ug/dL. (250 to 450)
Iron. 68 ug/dL ( 38 to 169)
% iron Sat 26 ug/dL. ( 15 to 55)
Ferritin 48 gn/mL (23.9 to 336.2)
So if iron level
What is wrong with those results? They look normal.
Hi i have heamochromotosis iron blood level was 1382 family history all males died early 50 I was diagnosed 2half years ago had extra benefit of extra o2 in blood advantage of strength and endurance when training all my life however things caught up with me by time I was 50 I’m 57 now had repeated venesection iron now at 200 had mri of brain kidneys liver all ok except liver is saturated still had fibroscan showed liver flexible so no damage (I’ve never drunk alcohol ) my question is how is my liver still saturated yet my iron in my blood low (relatively ) my iron drop approx 40-100 after each treatment my diet is strict ( drink milk do reduce absorbtion rate no vit c) what is the mechanism that the liver uses to dump the iron I know the liver grows dies same rate each day my cholesterol is v low under 2 bp 117/70 weight 12 stone 5 ft 9 been power lifter for 30 years free diver etc so was extremely fit half marathon 1hr 19 approx 6 min per mile max breath hold freedive 4mins 40 plus meter depth bench press 145 kg all in my 40s now I sit in a chair unable to exercise much or even do light diy I was a builder so fatigued feels like anemia ( relatively)day xplination would help thank you
Hi Steve, are you any further on in finding any answers ? How are you feeling now ? I’m 44 and have genetic hemochromatosis.
dam how do u lower it
in anemia of chronic disease ,iron is low and tibc also low. How will you explain that?
Serum iron is reduced in ACD, reflecting the decreased availability of iron. Serum transferrin is typically normal or low, and its fall in acute inflammation is thought to be due to increased degradation. Depending on transferrin concentration, TIBC can be low or normal. Transferrin saturation is typically low and is a reflection of the decreased serum iron. Serum ferritin is either normal or elevated, in part due to ferritin's role as an acute phase protein but also the net effect of diversion of the body's iron into this storage protein within the reticuloendothelial system in ACD.
@@TheStealthDoctor Can you please explain that once again with a bit easier language pls? So i am interested in what to look for if i have low TIBC and low Iron? Cheers
My ferritin in normal but tibc, saturation, and total iron is low. What does that mean?
Also my hemoglobin is normal.
How does fever affect iron absorption?
I've found it quite difficult to get good information for my situation: normal iron in blood, but elevated ferritin. It's not super-high, but finding info online of how to normalize ferritin when other markers seem okay was nearly impossible. I've since donated blood more frequently (once every 2-3 months) and it seems to have fixed it.
Are u doing the donation on your own or recommend by provider? Hopefully you are using other labs since you’re iron level is normal to begin with.. ferritin has different influences…
If you're not in iron overload there's no reason to donate blood. Your ferritin is ( was ) high for other reasons.
@@shinola228 Isn't donating blood good anyway? And yes, I've switched doctors and gotten better advice.
@@mandykal Yes, got better help. Provider said I was fine to donate blood, but ordered more tests. Looks like it may have been a temporary situation. My first doctor said ferritin was fine, nothing to worry about (because he had seen worse LOL) - I tried to communicate that I want the best for my long-term health, not a comparison to an unhealthy population.
@@OnlineCoachPaulStrobl Right, I've read the most likely reason donating blood is often heart healthy is because it lowers iron levels. Just like women have lower rates of heart disease than men - but only until they reach menopause.
Not the shark 😮
And I will be happy
Here’s proof that the iron test (ferritin) is bs:
Two recent papers measured the influence of iron on early puberty.
One paper measured it via ferritin tests, the other paper via actual iron intake. And, arrived at exactly opposite conclusions.
ferritin correlated positively with late onset of puberty, while iron intake correlated with early onset of puberty. Of course only the latter finding is relevant, as iron intake is factual, while ferritin is a pisspoor marker apparently, or rather, excess iron intake seems to result in lower ferritin.
Nutrient Intake through Childhood and Early Menarche Onset in Girls: Systematic Review and Meta-Analysis, 2020
Micronutrient status in middle childhood and age at menarche: results from the Bogotá School Children Cohort, 2017
From this I would conclude btw that ferritin is only a late stage indicator of iron overload. Ie, when a ton of liver cells burst spilling all their ferritin content. It has always been debated where does the ferritin in the blood come from anyway, as it isn’t released into the blood by design. In healthy humans, eg children, ferritin is soaked up even more quickly from the blood when there’s too much iron, so again, it is an absolutely useless marker.
Nice!
are you a doctor?
Wrong info provided in this video about vegans and iron intake. Here is the correct information: In a large 2003 study published in the journal Public Health Nutrition, researchers compared nutrient intake among more than 65,000 men and women between the ages of 20 to 97 years.
Except for saturated fat (which was highest among omnivores), vegans had the highest intake of all other studied nutrients, across the board - including iron.
False
Nice !
Thank you! Cheers!
@@TheStealthDoctor Hi any ideas what it means to have high ferritin, high b12 and normal iron?