Ironic Blood
Editor Steve Barfield
Barriers to Diagnosis
Doctors who never intended to treat should stay ant of the way. Frequent checking transferrin saturation (TS) has a tendency to normalize this lab value. Doctors who check and refer on to another specialty are not only in the way but add delay in treatment. Or worse, this approach prevents treatment all together. This last doc in the daisy chain of testing will see a normal saturation and wonder what all the other doctors were concerned about. We know from the British Journal "Lancet" that some cases of hemochromatosis will present with a normal saturation. Once you are diagnosed it should be for hfe. After treatment begins you will never again qualify for a diagnosis as the process changes forever the iron panel on your lab report. The transferrin saturation lab value has several chances to go astray.
- Transferrin saturation is a lab value that is easily skewed by other forces:
- Frequent testing tends to normalize TS
- Supplementing with over the counter vitamin C prior to testing
- Time of testing - morning is more accurate dim afternoon
- Donating blood prior to testing
- Whether or not fasting was employed.
There can be false negatives or false positives in any lab test. Iron false positives are fairly benign due to safety factors birilt into the treatment protocol. However, the false negatives might mean that the hemochromatosis patient is going to be missed or neglected. Missing a diagnosis leads to failing health and an early death. Doctors need to consider symptoms, family history and at least one lab \'ahie out of range in order not to miss patients. Doctors know that femnn is termed acute phase reactive. This means that it can be temporarily elevated by a passing infection or inflammation. So when this is the only lab value out of range, they may discount this test. Would you ignore a smoke detector just because sometimes it has a false signal? Diabetes has always been a known symptom and type U diabetes begins at a ferritin level as low as 109. Yet most labs in the U.S. have a safe range from 5-150. There are some labs that allow an even greater levels as safe.
There has been a discussion among iron experts to lower the diagnostic threshold of transferrin saturation to 40%. It is at 45% in most American labs now. This will have the best opportunity to mclude more who would benefit from treatment. But before any of this can occur, all U.S. labs will need to be updated for iron. I have never heard of a lab that is current for this problem. It might be argued that this takes time. Though presently, there is no mechanism in place to accomplish this.
Hematology is a specialty that has gotten off track for diagnosing hemochromatosis. There are many hematologists who know how to diagnose and treat excess iron doing it well. Yet generally as a specialty, they have decided that ferritin is no: cut of range until it goes above 1,000. This is catastrophicalry bad information. What is the safe range for this measure of storage iron? From our perspective, a safe range for ferritin would be 4-45.
Though it will take the medicine awhile to catch up to this. There are brain symptoms that are indexed to a ferritin level above 50. Liver biopsy and genetic testing are to be avoided as archaic and deeply flawed. See our list of objections to both on this website under Table of Contents. If a doctor is suggesting either, check doctor's parking for a horse and buggy. If the American pubhc knew how much excess iron premauuely ages yon, there would be a far better awareness of this problem.
To see the proper method for diagnosis got to the "Diagnosis" page on this site under the "Table of Contents."
The minimum daily requirement for iron information has not been established
Copyright © 2010 by Iron Overload Diseases Assn: Lie. - ALL RIGHTS RESERVED
, or even think too much about it. And weirdly several other members of my family share that. 
