Normal hemoglobin but low iron saturation

[Mich1111]

Hi, I am 41 years of age, post surgical menopausal for one year.

The past several months I started to have slightly low hemoglobin of 11.8 and slightly low hematocrit and an iron saturation of 12. I had a cat scan of abdomen and pelvis that was normal in June. I am seeing a GI doctor who will do scopes to check for blood loss.

However, I just got  my recent labs back and now my hemoglobin one month later is 13.3 and my iron saturation is 14.

So now my hemoglobin is normal! Iron saturation is still slightly low. My primary said I am not anemic but just low on iron and suspects maybe just my body doesn't like to absorb iron very well.

My questions are this:

1. Does my hemoglobin now being normal rule out more or less any bleeding since that number wouldn't go up, right?

2. What are the causes of normal hemoglobin but slightly low iron saturation levels?

Thanks.

[Mich1111]

Hi, this is why it is confusing to me. I have not taken any supplements whatsoever. I have ever so slightly upped my iron intake by eating a little more meat but other than that, not really.

Yes, I would think that with blood loss through the GI tract, hemoglobin would not rise which it totally has without even supplementing. In fact, that is the highest hemoglobin number I think I've ever had.

I do have Selective IgA Deficiency so wonder if maybe that is causing me not to absorb perfectly or there's a Celiac that hasn't been diagnosed that I run a higher risk to get due to my zero IgA.

Is it possible to just have low iron saturation and not really ever know why?

[Dr. Kokil Mathur]

Hi!
Transferrin is a substance that transports iron in the plasma. If the saturation is below 20%, the amount of iron carried by transferrin is decreased. In this situation it is also expected that the absolute serum iron will be low. However, if you have taken any iron containing supplements or increased your dietary intake of iron through fortified foods, then your iron may be normal and % transferring saturation will be low.
If you have chronic blood loss from gut, hen before going for endoscopy, you can also do occult test for blood in stool. This test helps identify microscopic blood loss in stool. Normally in this condition serum iron and % saturation both are low. Please discuss with your doctor. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.