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very low ferritin
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very low ferritin

Anyone else out there with low ferritin, low iron but not anemic?  My ferritin level was a 9.  I'm super tired and crabby.  I have abdominal pains like little needles poking inside me sometimes & I alternate between constipation and diarrhea.  (Sorry, TMI.)  My doc says he wants me to have an iron infusion but not until we can rule out a GI bleed.  He wants an endoscopy and colonoscopy.  I don't have any blood in my stool and don't vomit up blood so I don't think it's a GI bleed...if so, wouldn't I notice blood?  Anyway, he has put me on iron supplements until Friday when I can get in to see a GI doc.  I have noticed a little more energy since taking the iron but increasing stomach pain.  Anyone else out there with a similar story?
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351246_tn?1379685732
Hi!
First of all let me assure you that most of the GI bleeds go unnoticed. Hence, it is important to do an occult blood test of the stool to look for hidden blood. It is important to find the cause of low iron as ultimately this will lead to severe anemia.
Normally in iron deficiency, iron is low, TIBC is high, percent saturation is low and ferritin is low. The three main causes of low iron are—poor intake, poor absorption, and high loss. Poor intake can be compensated by diet rich in iron and iron therapy. Poor absorption is seen in conditions like Crohn's, IBS, severe acidity etc, and needs to be ruled out. High loss is seen there is a bleeding in your gastrointestinal tract, either due to esophageal varices, polyps, gastric bypass site, hemorrhoids or an ulcer. You should get your stool examined for occult or hidden blood to detect this blood loss. Also you need to get a pheripheral blood smear done to know the RBC count, structure and whether there is cytopenia (general decrease in cell count). The renal function and liver function needs to be checked, and electrophoresis of hemoglobin done to know whether there is thalasemia trait or sickle cell anemia. You need to see if there is vitamin B12 deficiency. Once the cause is found and corrected, then the lost iron is replaced by iron therapy, either in form of pills, capsules or syrups, or as injectable preparations. Consult your PCP regarding this. You should ideally consult a hematologist for this. Hope this helps. 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.
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351246_tn?1379685732
Hi!
First of all let me assure you that most of the GI bleeds go unnoticed. Hence, it is important to do an occult blood test of the stool to look for hidden blood. It is important to find the cause of low iron as ultimately this will lead to severe anemia.
Normally in iron deficiency, iron is low, TIBC is high, percent saturation is low and ferritin is low. The three main causes of low iron are—poor intake, poor absorption, and high loss. Poor intake can be compensated by diet rich in iron and iron therapy. Poor absorption is seen in conditions like Crohn's, IBS, severe acidity etc, and needs to be ruled out. High loss is seen there is a bleeding in your gastrointestinal tract, either due to esophageal varices, polyps, gastric bypass site, hemorrhoids or an ulcer. You should get your stool examined for occult or hidden blood to detect this blood loss. Also you need to get a pheripheral blood smear done to know the RBC count, structure and whether there is cytopenia (general decrease in cell count). The renal function and liver function needs to be checked, and electrophoresis of hemoglobin done to know whether there is thalasemia trait or sickle cell anemia. You need to see if there is vitamin B12 deficiency. Once the cause is found and corrected, then the lost iron is replaced by iron therapy, either in form of pills, capsules or syrups, or as injectable preparations. Consult your PCP regarding this. You should ideally consult a hematologist for this. Hope this helps. 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.
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Avatar_m_tn
Thank you so much for your reply!  I have had my renal function and liver function checked and it all came back normal.  B12 is also normal.  My iron was 27, TIBC was right in the middle of normal, saturation was a 7 and ferritin was 9.  All of my other blood work came back beautiful, including hemoglobin (on the normal blood panel).  I am going to see a GI doc on Friday and have a call into a hemotologist.  Hopefully, I can find some answers soon.
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Avatar_m_tn
Well, my occult blood test came back normal.  No blood.  But my docs still want an endoscopy and colonoscopy.  I was hoping that wouldn't be necessary since there were no traces of blood in my stool.  My newest symptom is leg pain.  It can be really bad at times.  Achy legs and cramping calves.  I guess it's due to the low ferritin?  Also having some heart palpatations.  Not fun.
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351246_tn?1379685732
Yes, palpitations can be due to low ferritin. Also, when the bone marrow is extra active to produce red blood cells, you can have leg pains and chest pains. However, the leg pains can be due to other causes as well. Please report your symptoms to your doctor.
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Avatar_m_tn
Well colonoscopy and Endoscopy are done.  Everything looked ok but I had a biopsy come back saying I have lymphocytosis in my small bowel.  I recently had a blood test for done celiac which came back negative.  My little villi were not atrophied.  So, what types of autoimmune disorders could it be?  If not autoimmune could it possibly be cancer?  No visible tumor was seen to my knowledge.  GI doc put on on a gluten free diet just to see if it would help.  So far (two weeks in) I don't really feel any different.  I have to check back with doc on the 20th.  Thoughts?
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