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Gastroenterology  (Expert Forum)
 | 
Hemachromatosis phlebotomy regimine
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
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.

Hemachromatosis phlebotomy regimine

by ChrisBry, Feb 24, 2007 12:00AM
Hi there,I was wondering if I controlling my Hemachromatosis controlled correctly I have heard conflicting opinions.I am 33 & have wriiten you once before .I have had this since 1997 now I am currently getting checked every 3 months to see if I need a phlebotomy or not.
Heres a list of the most recent phlebotomies & labs
08/07/06- Ferritin 44
             TIBC  200L
             Iron  104
             % sat 52
Had phlebotomy on Aug 14

11/1/06-  ferritin 14
           Iron    65
           TIBC    252L
           % sat   25
No phlebotomy in November

                          REF
1/02/07 Iron 192H        35-150
        TIBC 259L        260-400
    Iron sat 74%H        11-46%
     Ferritin 26
Had phlebotomy on 1-8-07

I am concerned about the Iron & Iron sat being elevated & the TIBC being below normal.This has been the case alot of the time.Particularly the TIBC. When do you think would be a good time to have my doctor recheck me .We just got stuck on 3 months for some reason & i dont know if this is frequantly enough or not.Do you see any improvements that I could make in the future from this limited schedule I have given you? Not sure if my doctor has any other patients with this.
             Thanks, Chris


  




by Kevin Pho, MD, Feb 26, 2007 12:00AM
The serum ferritin level and transferrin level can be used to monitor therapy.  Normalizing iron body stores would be the goal (defined as a serum ferritin concentration below 50 ng/mL and transferrin saturation below 50 percent).

Checking the levels weekly or biweekly until the iron stores have improved (i.e reached the goals as mentioned above) would be reasonable.  

The TIBC is not a reliable marker of the treatment course.

This option can be discussed with your GI physician.

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.

Kevin, M.D.
kevinmd_
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