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What Do These Thyroid Profile And Vitamin D Levels Indicate?

Posted on Mon, 17 Aug 2015

Question: I'm a 45 yr old female with high iron (109), Low UIBC (107), normal TIBC (297), high% saturation (64), low ferritin (12.8), low RBC (4.1 4) and always low WBC (3.8). Everything else is in the normal range. I am generally healthy, eat very healthy, tired very often. I take 30mg of Armour Thyroid daily and 1000 mg Vitamin D. Levels for that are: free T4 is 0.75, T-uptake is 31,TSH is 0.5, vitamin D is 43. My doctor said he's not concerned with my lab results but I'd like more information as to why my levels are low and high in certain areas. Any concern here?

Answered by Dr. Binu Parameswaran Pillai (4 hours later)

Brief Answer:
to exclude iron excess conditions.

Detailed Answer:
Good day
Noted your concern. Your thyroid profile is good. Vitamin D levels are also normal ( if it is ng/ml).
High iron levels with transferrin saturation needs evaluation. Please repeat this again. If they are in excess you may need further tests to rule out iron excess conditions like Haemochromatosis.
You have not mentioned your Haemoglobin levels.
Have you ever been taking iron supplements or ever had repeat blood transfusions?
Have you noticed excess skin pigmentation lately?
Any family history of liver issues ,,skin pigmentation .
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 days later)

Hello and thank you for your response.
The correct number for my iron is 190 (not 109 as I mistakenly wrote). I have never had a blood transfusion and no iron supplements. No family history of liver issues or skin pigmentation. I didn't have my haemoglobin levels tested this time but 6 months before it was 5.60. My other levels 6 months before the current blood test were as follows:WBC 3.7, RBC3.97, iron 127, UIBC 136, TIBC 263, and %satuaration at 48, Ferritin 20.5.
You mentioned Haemochromatosis but could that be if my ferritin levels are so low (12.8)? Why would my ferritin and UIBC levels be low if the others are high?
Also, any thoughts on why my RBC and WBC could be low?

Answered by Dr. Binu Parameswaran Pillai (29 hours later)

Brief Answer:
Could you attach the actual report?

Detailed Answer:
Good day.

Sorry for the delay. I was travelling and unfortunately didn't not have Internet access all the time.

Could you attach the reports please. That would give more clarity.
Low Haemoglobin (5.6) with high iron is confusing.
Low Hb together with low white cell count and RBC may be indicating a problem at the marrow.
I wonder of you ever had a bone marrow study done?

Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 days later)

Hello,

I hope the attached labs will help.
I haven't had a bone marrow study done.

Thank you for your time.

Answered by Dr. Binu Parameswaran Pillai (33 hours later)

Brief Answer:
Plan

Detailed Answer:
Sorry again for the delay. I am back at work from today .
Saw the reports. Your RBC and White cells have been low even in November 2014. Your hemoglobin levels are reasonably good.

Iron indices are abnormal only once this time which was normal in November. This recent excess iron levels are usually due to either a blood transfusion or with treatment with Iron. If either of them haven't taken place, then the best option is to wait and repeat Iron levels after 2-3 months. If it is still abnormal, then we need to think about Hemochromatosis.
In view of low White cells and RBC, it is advisable to do a Vitamin B12 levels and Reticulocyte count as well.. We need to decide on bone marrow based on these results ( Only if necessary)

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar