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Gastroenterology (Expert Forum)
Increased Ferritin after Venesection
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Increased Ferritin after Venesection
by almara, Jan 22, 2004 12:00AM
I am a 60 year old male. Last year following abnormal liver function tests (AST levels of 62,77,74 & ALT levels of 92,101,84 over 3 tests) I had a liver biopsy which showed micronodular cirrhosis and large iron deposits resulting in a diagnosis of haemochromatosis. Since then I have been undergoing weekly venesection (24 in total to date) and I am concerned that my latest ferritin reading has increased.The readings have been:-
10/06/03 - 1629
04/08/03 - 2321 (start of venesection)
08/09/03 - 2147
10/11/03 - 1520
08/12/03 - 1479
12/01/04 - 1646
The very first reading is a fasting one, the rest were non-fasting.
My haemoglobin count is taken weekly and has been fairly constant in the range 13.5/14.0. I had a AFP blood test in mid November and this was negative.
Following bowel problems throughout December I had a recent colonoscopy which showed no abnormality apart from a small polyp which was removed.
Currently I take Pantoprazole 20mgs daily (for reflux gastritis) and Rofecoxib 25gs daily (for arthritis). Over the last three weeks I have also started taking the herbal medicine Milk Thistle (350mgs daily) in an effort to improve liver function.
My doctor puts the recent increase in ferritin down to a "blip" and continued venesection will eventually right the situation. Do you agree or can you suggest any other reason or further action I should be taking? I am concerned that my reading now is the same as it was back in June last year.
Can stress/anxiety affect the ferritin reading? - I have certainly been pretty uptight about the colonoscopy and what it might reveal.
10/06/03 - 1629
04/08/03 - 2321 (start of venesection)
08/09/03 - 2147
10/11/03 - 1520
08/12/03 - 1479
12/01/04 - 1646
The very first reading is a fasting one, the rest were non-fasting.
My haemoglobin count is taken weekly and has been fairly constant in the range 13.5/14.0. I had a AFP blood test in mid November and this was negative.
Following bowel problems throughout December I had a recent colonoscopy which showed no abnormality apart from a small polyp which was removed.
Currently I take Pantoprazole 20mgs daily (for reflux gastritis) and Rofecoxib 25gs daily (for arthritis). Over the last three weeks I have also started taking the herbal medicine Milk Thistle (350mgs daily) in an effort to improve liver function.
My doctor puts the recent increase in ferritin down to a "blip" and continued venesection will eventually right the situation. Do you agree or can you suggest any other reason or further action I should be taking? I am concerned that my reading now is the same as it was back in June last year.
Can stress/anxiety affect the ferritin reading? - I have certainly been pretty uptight about the colonoscopy and what it might reveal.
Doctor's Answer
by Kevin Pho, MD, Jan 25, 2004 12:00AM
, Jan 25, 2004 12:00AM
It would certainly be possible that the continued phlebotomy would help lower the ferritin level. Depending on when you were diagnosed, it is not uncommon to need 70 to 100 phlebotomies to remove the enormous iron stores in patients who presented with symptoms.
In most cases, the phlebotomy is enough to treat the disease, but in cases where this is not the cause, chelation therapy with deferoxamine can lead to clinical improvement. You may want to consider this.
If you are not having symptoms from the hemochromatosis (i.e. weakness, skin hyperpigmentation, diabetes, arthralgia, EKG abnormalities), then it may be reasonable to continue monitoring the ferritin during the phlebotomy treatment.
It is unlikely that stress/anxiety can affect the ferritin reading.
Followup with your personal physician is essential.
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.
Thanks,
Kevin, M.D.
In most cases, the phlebotomy is enough to treat the disease, but in cases where this is not the cause, chelation therapy with deferoxamine can lead to clinical improvement. You may want to consider this.
If you are not having symptoms from the hemochromatosis (i.e. weakness, skin hyperpigmentation, diabetes, arthralgia, EKG abnormalities), then it may be reasonable to continue monitoring the ferritin during the phlebotomy treatment.
It is unlikely that stress/anxiety can affect the ferritin reading.
Followup with your personal physician is essential.
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.
Thanks,
Kevin, M.D.
Member Comments
by queenesther, Apr 15, 2008 09:05AM
A related discussion, Effects of Green tea was started.
