Does OK hemoglobin make a low level of iron in blood OK?

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Discussion Overview

The discussion revolves around the implications of low iron levels in the blood, particularly in the context of normal hemoglobin levels. Participants explore the relationship between iron levels and hemoglobin synthesis, the potential influence of inflammation, and individual physiological variations. The conversation touches on medical interpretations and the relevance of these factors for specific populations, such as senior citizens and endurance athletes.

Discussion Character

  • Exploratory
  • Debate/contested
  • Technical explanation
  • Conceptual clarification

Main Points Raised

  • Some participants suggest that normal hemoglobin levels may indicate that low iron levels are not a cause for concern, as hemoglobin is a major iron sink in mammals.
  • Others discuss the role of hepcidin in regulating iron levels, particularly during inflammation, which could explain low serum iron despite normal hemoglobin.
  • One participant shares a personal experience with autoimmune disease and how it affected their iron levels, suggesting that inflammation could be a factor.
  • Another participant emphasizes that "normal" ranges for blood tests are based on population statistics and may not apply to every individual, indicating that some may have non-pathological variations.
  • A reference is made to literature suggesting that low serum ferritin levels may not impact athletic performance in the absence of anemia.

Areas of Agreement / Disagreement

Participants express differing views on the significance of low iron levels when hemoglobin is normal, with some supporting the idea that it may not indicate a health issue, while others highlight the complexity of individual physiological responses. The discussion remains unresolved regarding the implications of low iron levels in specific contexts.

Contextual Notes

Limitations include the lack of comprehensive medical data for individual cases, the dependence on statistical norms for physiological tests, and the potential for individual variations that do not necessarily indicate pathology.

nomadreid
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TL;DR
What meaning does a level of iron lower than the healthy range combined with the hemoglobin levels in the middle of the accepted range have?
Suppose a blood test shows a value of 41 milligrams per deciliter, with a healthy range between 65-175, yet the hemoglobin levels in the same blood test are perfectly normal, as well as are other indicators in the blood test. A doctor explained that one would not need to be worried about the iron level (so no iron supplements etc.) because of the hemoglobin level. Could someone elaborate on why this could be so (or why not), and under what conditions? [If age and/or sex are factors, the person involved is a senior citizen, male.]

(Caveat: I understand that this is a broad question without the full set of information available to a doctor, and any answer here does not constitute medical advice.)
 
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Consider: the major use of iron is the synthesis of hemoglobin. So, hemoglobin is the really major iron sink in mammals. Humans are mammals. Hemoglobin levels reflect an organism's overall iron levels.

Overiew of homeostasis:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198508/
Hepcidin causes iron sequestering which lowers serum iron levels -- example: during the response to inflammation from infections - a cold, a GI tract infection, etc.

For hepcidin see:
https://en.wikipedia.org/wiki/Hepcidin
 
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Thank you, Jim McNamara. That was very helpful.
 
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Jim is right. The inflammation may be caused by an autoimmune disease. It happened to me. They hunted around, even did a colonoscopy (I was about 50 so the guidelines were you get one anyway). Nothing - except also a high ESR (a measure of inflammation). But one doctor noticed I had a huge blob of psoriasis on my forehead and the diagnoses was immediate - psoriatic arthritis which was confirmed by a Rheumatologist, who examined me and checked the blood work. I would see a Rheumatologist taking along blood tests for inflammation, such as ESR. They will possibly order even more to confirm a diagnoses.

Thanks
Bill
 
Thanks for the suggestion, Bill aka bhobba. However, the blood test which showed the low level of iron included also tests for infection, and those results were well within the norms. A visit to a rheumatologist, with corresponding blood tests, did in fact take place a few months earlier and came up empty. No symptoms since that visit indicating inflammation have been noticed. The GP considers that the low iron level does not warrant further tests, another indication that there may be factors that are not pathological.
 
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back open. Please consider that we do not support commenting on treatments or responses. We can comment on known science, not medical opinion.
 
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nomadreid said:
The GP considers that the low iron level does not warrant further tests, another indication that there may be factors that are not pathological.
Having nothing to do with your specific case but generel conclusions like this makes good sense, because "normal" ranges of ANY physiological or medical test/score are based on population statistics. One can never make certain inferences of individual cases from statistics. But statistics is still a rational tool for motivating when further tests or examinations is required. This is also the case for research where you use random subjects, some subjects simply have a slightly "abnormal" physiology (but this does not imply they are sick or have any problems), it just means they are outlies are does not fit into the statistical or average model of human physiology and medicin.

But if this is made and there are not other symptoms, then it might very well be so that this certainl individual simply has a "deviant" physiology. This does not imply pathology, it just means we are all slightly different. In these case.

/Fredrik
 
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Very good observation, Fredrik aka Fra. Thank you.
 
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This is a topic of interest to endurance athletes, and is discussed in The Lore of Running, Fourth Edition, by Timothy D. Noakes, MD, on pages 913-917. A quote from page 915 summarizes the entire section:

In the absence of established anemia, shown by low blood hemoglobin levels, low serum ferritin levels can probably be ignored, as they do not affect athletic performance (Garza et al. 1997).
 
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  • #11
Interesting and very relevant. Thank you, jrmichler
 
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