Hemochromatosis and Autoimmune Conditions

[fabric]

I came across this article which indicates a range of 10 ng to 35 ng Fe/ml as normal, which is a lot narrower than the reference (seems to be 18-270 nanograms per milliliter for a lot of these tests):

Serum ferritin iron, a new test, measures human body iron stores unconfounded by inflammation.

Herbert V, Jayatilleke E, Shaw S, Rosman AS, Giardina P, Grady RW, Bowman B, Gunter EW.
Source

Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA.
Abstract

Serum ferritin protein is an acute phase reactant. We hypothesized that serum ferritin protein generated in response to an inflammatory process would have much less iron (Fe) in it than would "normal" ferritin protein, and therefore measuring serum ferritin iron would assess human body iron status unconfounded by inflammation.
BASIC METHODS:

We measured serum ferritin iron in 140 clinical samples obtained from the serum banks of Bronx VA Medical Center Hematology and Nutrition Laboratory (Bronx, NY), the CDC Nutritional Biochemistry serum sample bank (Atlanta, GA), and the sample bank from patients with thalassemia and iron overload treated at New York Hospital (New York, NY). Each was analyzed for three conventional criteria of iron status: serum iron, percentage of transferrin saturation and ferritin protein. In addition, tests for inflammation were also performed: C-reactive protein, WBC and transaminases. Seventy-seven patients' sera from 140 screened met each of three consistent criteria for stages of iron status. Serum ferritin was immobilized by immunoprecipitation with rabbit antihuman polyclonal antibody bound to agarose and separated from other iron-containing proteins, digested with 0.2 ml of 3N nitric acid and analyzed for iron content by atomic absorption spectroscopy.

RESULTS:

Serum ferritin iron ranged in normal controls from 10 ng to 35 ng Fe/ml. The patients with iron deficiency (4/4) and those in negative iron balance (5/6) had values < or = 10 ng. Positive iron balance (8/9) and iron overload (22/22) values were > 35 ng/ml, in contrast to 11/19 with inflammation. Seventeen of twenty-two with overload had values > 100 ng/ml while only 1/19 with inflammation had such a value. Ferritin iron in ferritin protein was > 15% by weight in 14/22 with iron overload but in 0/19 with inflammation.

IMPLICATIONS OF THE WORK:

Serum ferritin iron is a simple, direct measure of iron stores that we propose, in conjunction with measuring serum ferritin protein, as a minimally invasive screening procedure for accurately assessing the whole range of human body iron status, unconfounded by inflammation.

 

[nicklebleu]

So far, I have been tested more than 1100 times for my hemoglobin and since my hemoglobin has varied quite a lot over the years, I have made an hypothesis that there is a correlation between the hemoglobin level and
1. What you have eaten before the test
2. If you had a good night
3. If it is hot or cold outside and how your body is reacting to that
4. If you are stressed or not

Also one need not forget that the spread of measurements for the same sample is in the order of 10 - 15% on either side! So just retesting a low result may bring you over the line ...

:)

 

[Chu]

1) Minimize expenses by:
a) learning every thing you can about the condition.
b) get tested by a low-cost lab directly.
2) Find a friend who is a professional who will help you decant.
3) Learn how to decant yourself.

Can anybody think of anything else?

Find a friendly vampire? Gee, it's just ridiculous that people have to do all this to be healthy.

Some of us are planning on testing our levels again after several cycles of chelation with DMSA and EDTA, to see the effect they have had. But chelators cost money too...

 

[Pierre]

It is exactly the same procedure here. Moreover if your hemoglobin is too high, you can not give blood and they will tell you that it is very dangerous since your blood is too thick.

That's what happened to some of us. To fluidify the blood we use aspirin or vitamin E and we had no problem at all yesterday. Everybody managed to give about half a liter.

Just for clarification, B6 is pyridoxine, B3 is niacin, B12 is (methyl)cobalamin, folic acid/folate is B9

Thanks for clarifying this point. These are B6 and B12 that seem to increase hemoglobin levels.

 

[Scottie]

[quote author=Mr. Scott]
At the same time, alfalfa is apparently rich in inositol, which is an iron chelator.
[/quote]

Added: I've finished reading the "Too Good to Be True" free ebook that Shijing mentioned in a post that's about phytic acid, aka inositol. I stumbled upon it again via a different route, and then I found his post again when the title seemed familiar.

What's really interesting is that this inositol stuff apparently treats all kinds of stuff, exactly like desanguinifcation does. And then they casually mention, "Oh, by the way, inositol is a great iron chelator with no side effects..." The body apparently produces 4g of the stuff per day under normal circumstances.

Well, duh! It seems to me that since the stuff inositol fixes is identical to the the effects of unloading iron, they may not even realize the mechanism by which it works. The book even mentions the Bantu people mentioned in The Iron Elephant, but from a slightly different angle.

Apparently inositol was present in brown rice hulls, corn, sesame seeds, nuts, grains and such, but genetic engineering and cross breeding and all that over the years resulted in many "low phytic acid" variants of certain grains especially because everyone regarded it as an "anti-nutrient". Still, some variants of grains and whatever still contain a fair amount of inositol. It IS a carb, with half the sweetness of sugar. But according to one study, 8g of the stuff per day for 2 weeks was enough to reverse tumor growth in certain cancers. This is all explained in the book - i.e. that it's not a "normal sugar" like glucose, but more of a "weird sugar" like xylitol. Some people consider it a B vitamin, but there is no official RDA. Blah blah blah...

Given that people on Paleo and Keto diets seem to have generally higher iron levels, I'm hypothesizing that in addition to healing leaky gut and thereby increasing iron absorption, the carbs that do have inositol (that will naturally de-iron you) are now missing from these diets.

Anyway, I ordered some and I'm going to try maybe a 1 or 2-week run at 4g per day (halfway between "maintenance dose" and "cancer curing dose"), and then get my blood tested again. Since my ferritin is not uber-high (especially after my half-donation 2 days ago), and my SI is actually on the low end, I figure it might be a good test to see if it can work as a far more accessible and simple "iron maintenance routine" at least. Only one way to find out...

Of course, if you have high ferritin and high SI, I would say to go straight for the donation routine to unload at least one batch as quickly as possible!

 

[Chu]

Here are a few interesting videos:
This lady performs the phlebotomy on herself.
https://www.youtube.com/watch?v=MoFPhuLAixY

Good one to see the movement of the needle.
http://www.youtube.com/watch?v=_8ZsqXFqvQM

This one has some good tips :
http://www.youtube.com/watch?v=kP48pCAzB74

 

[seek10]

Just finished The Iron Elephant, and I attempted to donate a batch today since my SI is 21% and ferritin is 192. Well, maybe that's not so bad since the SI isn't terribly high, but ferritin could definitely be lower.


I will note that I feel fine right now, and I also just ended Round 1 of EDTA + DMSA. Maybe the timing was not ideal for some reason? Who knows.

what is the schedule you guys following for EDTA+ DMSA ?
generally DMSA schedule is once every 2 weeks, 200mg , 3 times a day for 3 days on empty stomach for 5 or 6 periods. Is EDTA is also taken at the same time with same schedule ?

 

[Zadius Sky]

Well, in the Iron Elephant, it is pretty clear that low level of hemoglobin is not due to a lack of iron but more likely to a lack of vitamin B. In particular B6 (niacin) and B12 (folic acid).

Here are bits from the book on that (to add to this thread):

A recent study shows that deficiencies of folic acid, B6 or B12 are associated with heart attacks. Supplying these deficiencies tends to reduce the levels of homocystine levels, which do the dirty work. Very interesting! As it happens, these very same deficiencies result in iron-loading anemia. Don't just supply these deficiencies to help the heart. At the same time make sure to reduce the iron.

Every patient who requires transfusion therapy for an extended time, and certainly every physician ordering the therapy, should completely understand the consequences: that the large numbers of blood transfusions will result in iron overload. Chelators administered by pump will help slow down accumulation and prolong the patient's life. The chelating agents bind with some of the iron and move it out through the kidneys.

Dot, a woman in a small Georgia, suffered a severe anemia that requires frequent blood transfusions to keep her alive. Her hemoglobin dropped periodically to as low as seven. Her particular anemia was pyridoxine-responsive, but before the vitamin B6 deficiency was discovered, Dot had been given iron, lots of it. Giving iron willy nilly for low hemoglobin was virtually a routine medical practice during most of the decades of the Twentieth Century. The wreckage from this practice is still with us.

Dot required transfusion in addition to pyridoxine. Frequent transfusional therapy, however, brought its own problems. While transfusions were reliving the anemia, the burden of iron eventually became the killer. Dot died of hemochromatosis.

Hurdle Number Three: The anemic iron overload patient may be given additional iron.

I grew up in Indiana, where I enjoyed a healthy childhood, with one exception. I was anemic, pale, underweight, easily tired. Anemia is determined by the number, color, size, shape and life span of red blood cells, hemoglobin levels and percentage of hematocrit. Doctors saw the anemic child and prescribed iron. They assumed "iron deficiency anemia."

When I started working in radio and television and I was moving about, I saw physicans in other states. Doctors continued the iron therapy, and when the "run down" condition worsened instead of improving, doctors increased the iron (Trinsicon). Some of the vitamins in the Trinsicon did bring about some temporary improvement. Meanwhile the iron's insidious destruction remained hidden. Clinicians criticize that kind of therapy. They say it clouds the whole picture and makes it almost impossible to assess results. I did and do respond to folic acid and vitamin B12. As it turns out, deficiencies of folic acid and B12 or B6 are specific iron-loading anemias.

It was the excess iron that was causing the pallor, weight loss and fatigue.

It was ironic that I was reading through American Red Cross website yesterday about if one was being "deferred" from donating blood for low hemoglobin, one "have low iron levels" and they'd encourage more iron consumption. One actually needs B6 and B12, not iron.

This book "The Iron Elephant" is hugely interesting especially in view of all the conditions that iron overload can cause or assist in manifesting. No wonder docs and pharma doesn't want to go there. People not knowing about it are sick and need drugs not the simple expedient of giving blood regularly.

Not to direct away from this thread's current discussion, I think this book needs more reviews to get more attention about iron on Amazon (4 currently, mine included) and on GoodReads (just one, mine) websites:

http://www.amazon.com/The-Iron-Elephant-Should-Danger/dp/0963254774/

http://www.goodreads.com/book/show/3501241-the-iron-elephant

 

[Nienna]

- Ketones, Total Cholestrol ( 248 ( ref: 100-199) ) , LDL cholesterol calc ( 165 ( ref :0-99) are HIGH

.
Doctor will give his speech of milk, greens, avoid meat etc. I will gently reject or ignore.

- Nothing else abnormal from Lipid panel, Heavy Metal Panel, Basic Metabolic Panel, CBC panel.

I would suggest not to "gently reject" at all. Just say something like, "Oh, okay". And then carry on with your routine. Telling him that you reject his suggestion is more internal considering rather than external considering. Remember, make it easiest on both the doctor and you. That would entail just agreeing with him. Sincerity with everyone is a weakness. ;)

 

[Jacques]

Can anybody think of anything else?

It's hard to find good research on effects of training on ferritin, but this is what I found:

Anemia, clinical iron deficiency, is not rare among runners, but even more common than iron deficiency is "iron depletion" due to low ferritin stores. Ferritin is an iron-containing protein that is primarily responsible for iron storage in the bone marrow. It is common among distance runners to have acceptable hemoglobin and hematocrit counts even when ferritin levels are severely depleted. For less active people, low ferritin levels are much less significant and don't often draw the attention of medical professionals.

However, the results of low ferritin levels for distance runners are significant. While iron depletion rarely results in the general lethargy associated with true iron-deficiency anemia, distance runners with low ferritin will likely experience abnormal exhaustion, increased blood lactate, slow recovery, declining performances, heavy legs, muscular tightness, loss of motivation, and substantially increased risk of injury. Does any of this sound familiar?

And there's more. Overuse injuries (the type of injuries distance runners get) double with ferritin levels under 20 and triple with levels under 12. I think it's safe to suggest that iron depletion is rarely considered to be the root cause of these injuries. Instead we focus on mileage, running surfaces, shoes and the other usual suspects. If you were nodding your head thinking the previous symptoms sound like a checklist of your most recent season, go get your serum ferritin tested.

People within the medical and running communities have been aware of anemia for decades, but the prevalence and severe impact of iron depletion (low ferritin) is still far too much of a secret. The normal range for serum ferritin levels depends on whom you talk to. I have read everything from 50-150 nanograms per milliliter (ng/ml) to 10-300 ng/ml. However, we know that the lower the ferritin level, even within the "normal" range, the more likely a person is iron depleted. Virtually all female distance runners who have been training for a year or more are well below 50 ng/ml unless they take supplemental iron.

At South Eugene High School, we became aware of the consequences of low iron in the spring of 2001 when three of our female distance runners all came back from blood tests with ferritin levels below 10 ng/ml. All three had all run their best times two years before but had been plagued with injuries and frustration since. During those two years, they had multiple blood tests, but the doctors never checked their serum ferritin levels.

Within four weeks of beginning an aggressive supplementation program, all three felt substantially more energy while running; their enthusiasm and joy for running returned, and they began to run much faster. Within two months, their levels were between 35 and 55 ng/ml. All three went on to compete collegiately and ran times far superior to what they ran in high school.

Since that initial experience, we have suggested that all the girls on the team have complete iron tests. Only five out of the dozens who have been tested, have been within the acceptable range for serum ferritin, and those five were either big meat eaters or had been taking supplemental iron for years. Half of the girls tested have been below 12 ng/ml.

_http://www.trackandfieldnews.com/hs/coachscorner/20051215.html

Besides running, many other types of training have been shown to decrease ferritin level. When young men and women underwent a 7-week (8h/day) military-type basic training pro­gramme, ferritin levels fell an average of 50% and haemoglobin levels fell more than 5% (Maga-zanik et al. 1988). When untrained men cycled 2h/day four to five times a week for 11 weeks, mean serum ferritin fell 73%, from 67 to 18µg *l-1(Shoemaker et al. 1996).

(...)

Even strength training decreases ferritin, as shown by the 35% fall in ferritin in 12 untrained men who underwent a 6-week strength-training programme (Schobersberger et al. 1990).

Page 329: _http://books.google.rs/books?id=QjgKLQWFm6QC&printsec=frontcover&hl=sr&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

A recent study examined the effects of a sixweek high-intensity interval training programme, followed by two weeks’ recovery, on iron status in trained cyclists.(1) Dietary intake was monitored to ensure that iron intake remained consistent throughout the study, but by the end of week three, haemoglobin, haematocrit and red blood cell count (three different markers of iron status) were all depressed. Meanwhile, serum ferritin (a blood protein involved with iron storage) decreased significantly by week five and remained depressed even in the recovery phase. Total iron binding capacity (TIBC – a measure of a blood protein that transports iron from the gut to the cells that use it) was significantly increased after three weeks, suggesting low iron stores. And the researchers suggested that this reduction could be sufficient over time to have an adverse effect on aerobic cycling performance.

Iron loss as a result of endurance exercise has been confirmed in other studies. For example, a large and comprehensive study examined the effects of different types of exercise on the iron status of 747 athletes divided into three groups (power, mixed and endurance sports) compared with untrained controls.(2) The researchers found that the endurance athletes had reduced levels of haemoglobin and haematocrit which was mainly attributable to exercise-induced plasma volume expansion: in other words, the same amount of iron carrying compounds were present, but diluted in a larger volume of plasma. However, they also found that physical activity of increasing volume and duration led to decreased ferritin (an iron storage protein) levels, which were particularly pronounced in runners. This was probably a result of haemolysis – the breakdown and destruction of red blood cells caused by the physical pounding action of running, leading to the release and loss of iron.

This effect of endurance training on iron status has been demonstrated even in very young athletes. An eight-month study examined elite swimmers in the 10-12 age bracket and compared them with non-active controls.(3) Although swimming is regarded as a ‘non-traumatic’ activity, during the competition phase the elite swimmers suffered significant decreases in serum ferritin and iron stores by comparison with the controls.

At the same time, the swimmers showed significantly higher levels of a new and highly sensitive indicator of tissue iron status known as ‘serum transferrin receptor concentration’ (STFR). When cells require more iron, they signal this need by increasing the number of transferrin receptors on their surface; a small proportion of these receptors actually come off the cell surface and are carried into the blood stream, where they can be measured. A high serum transferrin receptor concentration is, therefore, related to iron deficiency at a truly fundamental level – within the cells or tissues.

(...)

However, although many previous human studies have found suggestive relationships between mild iron deficiency without anaemia and reduced aerobic performance, many of these findings have failed to reach statistical significance – ie the results were not sufficiently clear cut to draw reliable conclusions and were probably clouded by the inclusion of subjects with both normal and deficient tissue-iron status.

The problem has been that until recently there has been no definitive test for a real ‘tissue iron deficiency’. While measures like serum ferritin, total iron binding capacity (TIBC) and transferrin saturation do give a much clearer picture of an athlete’s iron status than a simple blood haemoglobin test, they still don’t tell the whole story – only whether an athlete is within certain ‘normal’ ranges.

They say that every cloud has a silver lining, and it seems that a really definitive test has emerged from the battle to detect erythropoietin (EPO) abuse in athletes. The use of EPO to artificially enhance the red blood cell count (and therefore the blood’s oxygen-carrying capacity) in endurance athletes is believed to have become widespread during the mid-to-late 80s; and in the search to come up with a reliable test for possible EPO abuse, a new marker of iron status was identified – serum transferrin receptor concentration (STFR). As we’ve already seen, STFR is an excellent indicator of tissue iron status because it actually shows how ‘hungry’ the cells are for iron.

A marker of iron status

The use of STFR as a marker of iron status is at the centre of some very new US research, which suggests that tissue iron deficiency without anaemia can not only impair aerobic performance but also blunt the adaptations that occur following aerobic training. In the first study, 41 untrained iron-depleted but non-anaemic women were randomly assigned to receive either a twicedaily iron supplement or placebo for six weeks.(11) From week three of the study, all the subjects trained on cycle ergometers five days a week.

As expected, iron supplementation significantly improved several markers of iron status, including serum ferritin, transferrin saturation and serum transferrin receptor (STFR) concentrations, yet this occurred without affecting blood haemoglobin concentrations or haematocrit. And, while the average VO2max and maximal respiratory exchange ratio (a measure of how efficiently oxygen is used in aerobic metabolism) improved in both groups after training, the iron group experienced significantly greater improvements in VO2max.

When the researchers analysed the results for relationships between the iron status markers and the measured improvements, it became apparent that it was the STFR concentrations that held the key. In the women whose STFR levels had been greater than 8mg per litre, taking extra iron produced a significant increase in VO2max above and beyond that produced by training alone; (remember, higher STFR levels indicate that the cells are signalling they need to take up more iron). Conversely, in women with STFR levels below 8mg per litre there were no significant benefits to iron supplementation.

The same researchers followed up with another study designed to investigate the role of tissue iron status in the impairment of endurance adaptation, using STFR as the main marker of tissue iron deficiency.(12) Using a very similar testing protocol, 51 iron-depleted but nonanaemic women were selected and randomly assigned to supplementation with either iron or placebo, undergoing five days a week of training on the cycle ergometer (between 75 and 85% of max heart rate) from week three of the six-week supplementation period. At the end of the study, all of the women completed three consecutive 5k time trials with only a short rest between trials. STFR measurements were taken at the beginning, middle and end of the study.

The researchers were particularly interested to see what differences emerged between women with raised levels of STFR and those without, and also how the former were affected by iron supplementation. The results showed that it was the raised STFR group who benefited from iron supplementation, working at a significantly lower percentage of their maximum work capacity during the first and second 5k bouts (indicating improved aerobic efficiency) and showing the largest overall improvement as a result of the training regime, especially by comparison with raised STFR subjects on placebo.

This placebo group reduced their time trial times by an average of only 36 seconds, compared with 3mins 24secs for the raised STFR/iron supplemented group. Moreover, the raised STFR/placebo group had to work at a higher percentage of their VO2max than the iron group for their relatively negligible improvement! Given that all the women in this study were assessed as iron depleted but non-anaemic, the researchers came to two main conclusions:

[list type=decimal]
[*]Iron depletion as measured by serum ferritin was not a reliable indicator of how the women adapted to training. All the women in the placebo group had depleted serum ferritin, but only those with raised STFR suffered an impaired training response. Moreover, in the iron group extra iron only helped those with raised STFR levels. While iron raised serum ferritin levels, it did not produce any significant performance increase in women whose STFR was already below the 8mg per litre baseline. It appears, therefore, that STFR is a far more reliable measure of a truly ‘functional’ tissue iron deficiency;

[*]iron tissue deficiency not only reduces VO2max but also impairs the body’s ability to adapt to an aerobic training load (probably due to a decrease in the iron-containing proteins involved in aerobic energy production), with serious implications for athletes!
[/list]

Testing for iron status is also far from straightforward. A low blood haemoglobin (Hb) measurement only appears in the very advanced stages of iron deficiency. It’s perfectly possible to have a normal blood Hb level while suffering severe effects from a tissue deficiency.

However, the latest research suggests that, although better then Hb alone, even these tests are insufficient to assess the real need for iron at the cellular level. For example, a reduced serum ferritin concentration generally indicates depletion of the iron stores; but, as the studies mentioned above showed, a reduced serum ferritin does not necessarily mean that performance will suffer because tissue iron stores may not actually be depleted. Serum ferritin is also what’s known as an ‘acute phase protein’, which means that concentrations are raised during inflammatory conditions. Thus, serum ferritin may be normal (or even raised) in an athlete with such a condition even if he or she is genuinely iron deficient. To determine the real need for iron, a serum transferrin receptor test is the best on offer, although it is relatively new and may not be readily available from your GP.

_http://www.pponline.co.uk/encyc/iron-deficiency.html

(The red bold text is mine)

Thanks so much Persej for those articles. I really appreciate them specially since I am a biker, a hiker, someone who skate skiing and gives plasma.

Anyway, just to be sure, I will take the blood test soon.

 

[Laura]

Yes, please write a review! I just did and it was easy using bits of text from the thread here (since I'm really busy, I did it on the fly.)

 

[Gaby]

TSH -6 is still high. He will give a prescription for thyroid, which I will not fill. Not sure what to do with thyroid issue though.

At least it is getting better and probably your thyroid will work better as you get rid of some iron overload. The white blood cell count is puzzling, but since you are going to have more blood-work done, perhaps a wait and see approach will be better, or so it to seems me.

 

[theos]

I had an iron panel done on Monday and got the results yesterday.

Test Description Result Range Units
Iron, Serum001339 37 35-155 ug/dL
Iron Bind.Cap.(TIBC) 232 250-450 ug/dL
UIBC001348 195 150-375 ug/dL
Iron Saturation 16 5-55 %
Ferritin, Serum
Date Collected: 4/15/2013 8:49:00 AM
Test Description Result Range Units
Ferritin, Serum 102 13-150 ng/mL

So my ferritin is out of the ideal range according to this thread but not scary high. There's a blood drive coming up at work and I may donate. I'll also try a course of EDTA and then retest. I'm still waiting for my copies of Iron Elephant and Detoxing with EDTA so I'll read through those and this thread again before proceeding. I'm still trying to wrap my head around what these numbers mean. I'm guessing that because my saturation and serum iron are lower and the ferritin is higher this is not a case of iron overload but indicative of some low level inflammation???

This chart may help: _http://www.labtestsonline.org.au/understanding/analytes/tibc/tab/test

A summary of the changes in iron tests seen in various diseases of iron status is shown in the table below.
Disease Iron TIBC/Transferrin UIBC %Transferrinsaturation Ferritin
Iron deficiency Low High High Low Low
Haemochromatosis High Low Low High High
Chronic illness Low Low Low / normal Low Normal / high
Haemolytic anaemia High Normal / low Low / normal High High
Sideroblastic anaemia Normal / high Normal / low Low / normal High High
Iron poisoning High Normal Low High Normal

 

[seek10]

- Ketones, Total Cholestrol ( 248 ( ref: 100-199) ) , LDL cholesterol calc ( 165 ( ref :0-99) are HIGH

.
Doctor will give his speech of milk, greens, avoid meat etc. I will gently reject or ignore. - Nothing else abnormal from Lipid panel, Heavy Metal Panel, Basic Metabolic Panel, CBC panel.

I would suggest not to "gently reject" at all. Just say something like, "Oh, okay". And then carry on with your routine. Telling him that you reject his suggestion is more internal considering rather than external considering. Remember, make it easiest on both the doctor and you. That would entail just agreeing with him. Sincerity with everyone is a weakness. ;)

I went to the doctor and he wants to rule out effect of thyroid(High TSH) on cholesterol, so he wrote some more tests for folic acid levels, wants ultrasound scanning of thyroid. His take is "you can take medicine or avoid". He told me that he is not going force to take medicine. He himself mentioned that there is a opinion difference of medicine usage if TSH is below 10.

His take on phlebotomy when ferritin is in official normal range (30-400 ) is Unnecessary and it may even be illegal for doctor for prescribe for phlebotomy.

If I want flexibility of suggesting tests or avoid medicine I go to doctors who came from india as they are used to the fact that many indian origin people prefer traditional therapies like ayuerveda, homeopathy, herbs, kitchen medicine than syringes. He is not new to this. They may react differently for American people out of fear of getting sued, that is a different story. When it comes to the point, there is nothing else he can do, I will nod and move on.

TSH -6 is still high. He will give a prescription for thyroid, which I will not fill. Not sure what to do with thyroid issue though.

At least it is getting better and probably your thyroid will work better as you get rid of some iron overload. The white blood cell count is puzzling, but since you are going to have more blood-work done, perhaps a wait and see approach will be better, or so it to seems me.

he wants to wait for other thyroid tests before speculating more. so will wait. Thank you for the feedback.

 

[LQB]

Here is a one-page pdf summarizing the interpretation of the iron blood panel tests:

http://www.perthhaematology.com.au/IronStudies.pdf


Added: eliminated quote