High Ferritin Low Albumim

Dear Doctor,

I am a WM 225 lb 5'10.  I saw my primary for some vaccinations ( Hep A, Hep B, Varicella, DTap) about a week ago.  She noticed on my labs from last year that my hemoglobin was 17.4 and slightly out of range.  She wanted to do some yearly labs and ordered a serum ferritin as well. I gave the blood about 30 min after she gave me the injections. She ordered a serum ferritin that came back 550. Albumum came back 2.6 alk phos was 17 everything else ok. She ordered the gene test for hemochromotosis ( came back negative ) and sent me to a hematologist.  He re-ordered  the iron studies and everything came back ok and ferritin was down to 500.  Hematologist said to recheck in 3 months.  I have not been eating well the last couple of months and probably don't get even 40 gm of protein a day.  Other wise I am in ok health with no swelling, or other signs of liver disease.  I am a pharmacist so please feel free to get as detailed as you feel comfortable. My questions are.

How likely is hemochromotosis(?) with the negative gene test, ok iron study and elevated ferritin

How likely is liver cirrhosis the cause/result of the low albumum and high ferritin.

Do I need to press for more testing (liver biospy?)

Thanks for your time.

[Kevin Pho, MD]

The definitive test would be a liver biopsy.  If the gene test is inconclusive, or if there is continued suspicion of disease, that biopsy would be the recommended next step.  

Hemochromatosis is one of the more common causes of a markedly elevated ferritin level.

Otherwise, other diseases that lead to inflammation and some cancers can also raise the ferritin level.

These options should be discussed with your GI physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com