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Dr. Anil
Dr. Anil, Doctor (MD)
Category: Health
Satisfied Customers: 9520
Experience:  M.B.B.S.M.D with over 30 years of experience in this medical field.
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I have too much iron in my blood and fat in my liver. Blood

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I have too much iron in my blood and fat in my liver. Blood test results show I have High alt, ast and ferritin results, all my other test are in the normal range -Hemochromatosis –what is the hemoglobin and iron levels to warrant phlebotomy? Can I go get blood taken out even if I don’t have hemochromatosis?
I have been working really hard on what I eat. I’ve lost 10 lbs. I check food labels. I watched out for Tran’s fat. Then noticed the iron levels. I’m good about staying away from greasy & fried foods. I thought I was eating healthy, Raison brand, Special k almond flavor, Oat meal. 2 boxes a wk & gallons of milk. Crap, they all are about 25-80% iron. Well I guess work and dealing with my family and parents estate jumps me to the top of the stress factors. My big downfalls are Pepsi and Cajun very spicy blackened food, milk, cheese. I still enjoy a glass of wine every so often. My levels run Alt (alanine ainotransferas) serum Standard range 0-36 U/L between 2007 and 2013 has been running between high of 169 to 88 now at 91. Ast (aspartate aminotransferase,serum standard range 10-40 U/L between 2007 and 2013 has been running between high of 126 and 72 now at 104.
Ferritin Standard range 22-291 ng/mL
between 2007 and 2013 has been running between high of 1157 and low of 691 now at 902
The labs show once again-My levels are still high and continue to escalate. In spite of my trying to exercise and change my diet and habits. I want to do routine phlebotomy to remove any extra blood (and iron) for 6-8 weeks. Then test my blood again. Can I give this blood to some who is low in iron?
The Dr. Response was your hemoglobin (blood) and iron levels are not high enough to warrant phlebotomy. However, I do strongly urge you to follow up with GI department to further discuss possible treatment options, including phlebotomy, considering your previous liver biopsy back in 2007. (The GI department before wanted to prescribe depression medicine-I’m not depressed). They think I have non-ulcer dyspepsia, GERD & NASH or whatever flavor of the month is.
Have you undergone blood work like Serum Iron, TIBC,UIBC,Iron Saturation?
What is your current Hemoglobin levels?
Have you seen a Hematologist so far?
Are you taking any medications?
Have you undergone Liver biopsy?
Customer: replied 4 years ago.

They took a boat load of test. I ddnt see uibc.

Iron and tibc

Iron 214,iron binding cap&unsat 134,total iron binding cap 348 transferrin %sat 61, Hemoglobin,ur,ql negative x,

What is your current Hemoglobin levels? HEMOGLOBIN A1CHEMOGLOBIN A1Chemoglobin a1c 5.7 est average glocose 117

Have you seen a Hematologist so far? No


Have you undergone Liver biopsy? Yes 2007 I have fatty liver. Scaring stage two????

Thanks for providing more information.

The serum ferritin has limitations in being used as a screening test for hemochromatosis, because the ferritin can be elevated due to a wide variety of acute or inflammatory conditions; it is one of several substances referred to as acute phase reactants.

If the ferritin is elevated in the context of a high iron saturation, then there would be concern about hemochromatosis.

In your case, you have associated high Serum Iron and an iron saturation of >45% would be worrisome that further evaluation for Hemochromatosis is warranted.

I suggest you to a hematologist specialist who is more expert at treating patients with hemochromatosis.

As you have fatty infiltration of the liver, this can easily explain the elevation of the AST and ALT, Ferritin.

You need to avoid alcohol as much as possible.

Serum ferritin levels greater than 1000 ng/mL and Hemoglobin greater than 16 gm/dl may require Phelbotomy.

I hope this helps.
If you have any further query then feel free to ask.
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Thank you.

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