Your Lab Tests Explained: Iron – Is “Normal” Good Enough for You?

So you’ve recently had some blood work done and since you haven’t received a call to discuss any abnormal results you assume everything is normal. After all, no news is good news, right?

 

Or is it?

 

Over the next month, we’re going to discuss 4 tests women will want to know the actual results for because I’ll explain why normal, may not just be good enough.

 

What you really deserve are the optimal results for you.

 

The first test I need to discuss is a test for iron levels. If you’re a woman and you’ve felt tired, you may have heard that iron is important – and it totally is.

 

Common signs of iron deficiency include:

  • Chronic fatigue (feeling tired all the time)
  • Dizziness/feeling lightheaded
  • Weakness
  • Pale complexion
  • Headaches

 

https://youtu.be/4rxmZUywOI4

 

Iron is an important part of our red blood cells, which carry oxygen around in the body. If we don’t have enough iron, we can’t make enough red blood cells. This means we can’t get enough oxygen to our brains, muscles, hearts, lungs and general circulation, over time resulting in many of the above symptoms.

 

Did you know?

The best test for iron deficiency isn’t actually blood (serum) levels of iron!

 

Many women are surprised when I tell them that the most important test for iron is ferritin, a protein that contains iron, and the main storage form of iron in our bodies. This is because ferritin levels decrease before blood iron levels do. When we don’t eat enough foods with iron or aren’t able to absorb them, it’s our stored iron – our ferritin – that gets used to make more red blood cells.

 

In this way, ferritin can serve as an early sign of iron deficiency – because it actually decreases before blood levels of iron do.

 

The problem with the normal range for ferritin is that it is huge!

 

There is some variation between labs, but using my most recent blood work results which was at the start of 2018, the range was 5-272 ug/L.

 

This means that in theory you could be at 10 and be considered normal. Or you could be at 260 and be considered normal.

 

Both being at the low normal or high normal range is a warning sign that iron levels are not optimal, even though they may be “normal”.

 

From my clinical experience, women do better (meaning their energy & other symptoms improves) when ferritin levels are in the 75 – 150 ug/L range.

 

And again, this is individual – because every woman is unique.

 

One woman may feel better at 75 ug/L, and another may feel better at 100 ug/L.

 

When I see sub-optimal ferritin levels – even if they are within normal limits for example 35 ug/L, I have observed women’s symptoms improve with iron supplementation and/or increasing iron-rich foods. I also know that if we don’t do anything to improve these “normal” ferritin levels, it’s just a matter of time before symptoms worsen and the ferritin levels becoming completely deficient. Besides supplementation, it is always important to determine the cause of low or sub-optimal levels. For women, a common cause we need to address includes regulating heavy periods (heavy blood loss depletes iron over time).

 

The bottom line

If you still experience signs of iron deficiency despite having a “normal” ferritin level, ask your doctor what your ferritin levels actually are or better yet get a copy of the results and bring it to a health care professional who can explain if it is optimal for you.  In practice, I recommend my patients always get a copy of their test results and bring them in so we can review if they are optimal for them.

 

Bonus Tip

If you have been supplementing iron, make sure you get your ferritin retested after 3 months to see if your levels improve. If not, the cause of your low iron may be more to do with absorption or blood loss.

 

Next week, I’ll discuss a test that’s often done in conjunction with ferritin levels to help determine causes of fatigue.

 

Until then, take good care!

About Odette Bulaong

A Toronto-based naturopathic doctor helping people optimize their fertility & reproductive health from their first to their last period. Through in-person and virtual one-on-one visits and online programs, I help people understand, trust and love their bodies again so they can take charge of their health & live their best life.

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