This Is MS Multiple Sclerosis Knowledge & Support Community

Good morning everyone

I had an appointment with my Dr this morning and my blood results have come back all within "normal" limits. My Dr was very surprised as this is not what he expected. Now, based on the information you have all kindly provided me, I am a little skeptical about the word "normal" when it comes to blood results and those with MS, so your comments and opinions on the results would be appreciated.

Ferritin+Iron+TIBC
Iron 69
Iron Binding Capacity Total 394
Iron/Total Binding Capacity Total 17.5 (L)
Ferritin 30

Thyroid Function Tests
Thyrotropin Sensitive 1.06
Tyroxine Free 1.07

Follicle Stimulating Hormone+Luteinizing Hormone
Follitropin 3.5 <i>
Lutropin 2.8 <i>

Prolactin 6.6 <i>

Vitamin D, 25-Hydroxy (Calciciol) 22 <i>
Vitamin D2 (Ergocalciferol) <4 <i>
Vitamin D3 (Cholecalciferol) 22

I would not be happy with that level of Vitamin D3.

Your desirable level would seem to be 50.

See chart link below.

jackD

http://www.grassrootshealth.net/media/d ... 101608.pdf

Hi Mirry,

you are absolutely correct to be suspicious of 'normal' results. they are arguably one of the biggest farces in 'health care'.

First of all, can you provide the units for each of those results? it's very important. for example i would say you want your vit d3 level at least 100 nmol/L. preferably 150.

you have to divide that nmol number by 2.496 to get ng/mL, which means you wouldn't want to be any lower than 40 ng/mL.

i agree with jack that 50 is a better place to be, but only in ng/mL.

50 nmol/L would only a third of the way to a good level in nmol/L.

without having units for ferritin it still looks low.

it's too bad you don't have b12, zinc, magnesium, uric acid, or any other other b-complex levels. i could tell you a lot more about 'normal' results on those. as in whether your levels were 'ms normal' or 'healthy normal'.

are you still expecting more results to come in? i'll keep an eye out

jimmylegs

hi i had a look for more iron detail, because lots of folks here are dealing with iron overload and there is the iron dysregulation aspect of the CCSVI discussions which some are attributing to excess iron rather than just poor handling.

i searched google using these terms:

total iron binding capacity overload

here's what i found:

http://www.ironoverload.org/diagnosis.html

Test # 1
After a 12 hour fast, measure Total Iron Binding Capacity (TIBC) and the Serum Iron (SI). To achieve the percentage of Saturation you divide the TIBC into SI..

Serum Iron (SI)/Total Iron Binding Capacity (TIBC) = Transferrin Saturation (TS)

Safe range = 12-44%

so yours is 69/17.5 = 3.94% transferrin saturation

to elaborate here is some more detail from my fave lab test info site, labtestsonline.org

Total iron-binding capacity (TIBC) is most frequently used along with a serum iron test to evaluate people suspected of having either iron deficiency or iron overload. These two tests are used to calculate the transferrin saturation, a more useful indicator of iron status than just iron or TIBC alone. In healthy people, about 20-40% of available sites in transferrin are used to transport iron.
In iron deficiency, the iron level is low, but the TIBC is increased, thus transferrin saturation becomes very low. In iron overload states, such as hemochromatosis, the iron level will be high and the TIBC will be low or normal, causing the transferrin saturation to increase.

i'm going to look for a few more calculations to make sure that 3.94 result is done properly. stay tuned ;)

in the meantime here is a link to relevant info on wikipedia.

http://en.wikipedia.org/wiki/Total_iron ... g_capacity

so according to 'wiki authority', and if 3.94 is correct, then your TS is low - apparently this indicates iron deficiency anemia.

that would likewise indicate that you would not have anemia of chronic disease with normal TS.

iron deficiency anemia
Serum iron - low
Transferrin & TIBC - high
TS - low

anemia of chronic disease
Serum iron - low
Transferrin & TIBC - low
TS - normal

hi again mirry i found a backup calculation for TS which sets my mind at rest, especially by adding the 'x100' that is missing from the earlier one in terms of coming up with a 'percent'. (%saturated)

here's the detail

http://www.cdc.gov/ncbddd/hemochromatos ... esting.htm

Recommended laboratory tests for the workup of a patient you suspect may have hemochromatosis are

Fasting transferrin saturation test (TS)
SI and either TIBC or UIBC are usually used to calculate TS.
TS = (SI / TIBC) X 100
TS = (SI / (SI + UIBC)) X 100
Serum ferritin test (SF)

so from where i sit your tests do seem to indicate iron deficiency anemia.

the only reason i can think of that this result came back 'normal' is that lots of other folks who have gone for iron panel testing in the same lab that your doc uses, are also anemic (that would make sense since iron deficiency is sooo common, and not every doc would initiate more in-depth testing with ferritin in the low end of the normal range).

if you only supplement iron, you can drive your zinc down and without seeing any zinc results (or uric acid) i would bet that's not something you want to do.

i don't know what your units for ferritin are, but FYI i try to keep mine up over 100. (can't remember my units either at the moment!)

hope all this makes sense!

jimmylegs

mirry
best to give us the units, as well as the reference range that the lab has given you.

here's the ferritin conversion factor:
ng/mL 2.247 pmol/L

and some reference ranges...
http://www.nlm.nih.gov/medlineplus/ency ... 003490.htm

Normal Results
Male: 12-300 ng/mL
Female: 12-150 ng/mL
...
The lower the ferritin level, even within the "normal" range, the more likely it is that the patient does not have enough iron.*
Normal value ranges may vary slightly among different laboratories...

*at least in this case it is stated right out in plain view that the normal range sucks!

and another site...

http://www.mcc.ca/objectives_online/obj ... loc=values

Clinical Laboratory Tests
Normal Values...
Ferritin 10-250 µg/L

(for anyone who doesn't know, ng/mL and µg/L are the same concentration different decimal place...)

now if you take that conversion factor above, to get the pmol/L reference range, we multiply by 2.247.

which gives us, if we just go with the second one above, an SI ferritin reference range of 22 - 562 pmol/L.

either way it looks like 30 is waaay down there. i have a neat little table from my lab, i'll find it and relay. says what's more or less likely to be a deficiency value.

i have posted this ferritin range info previously; here it is again for your benefit

...(from my local lab.. ug/L by the way)

<18 probably iron deficient
18-40 possibly deficient
41-100 probably not deficient
101-300 not iron deficient
>300 possible iron overload

Good morning everyone

This is all mind boggling, I am trying to make sense of it all. I didnt get any units against the values, but I am going to see my specialist this morning so am going to ask him.

As for the rest of the tests, my Dr screwed up and didnt run them all, he apologised, so now I am going back for more blood tests. aggghhh.

I am going to ask for them to run bloods for B12, Zinc, Magnesium, Uric Acid, B Complex levels. I am going to ask my specialist to request them, that way I dont have to wait for another appointment with my Dr to get bloods requested. It's a really long drawn out process.

This morning I am having nerve and muscle tests done on my upper torso and next week my lower torso. mmmm fun fun fun.

I am going to try and get my head around vitamin levels, wish me luck

Mirry

hey there mirry, glad you are going to be able to get the rest of those tests.

perhaps you can sit down with the doc to help figure out some of the ins and outs of the units conversions on D3 and the calculations for iron.

other than that fire away with any additional questions and i'll try to clarify if and as needed

ugh yea right have fun with those nerve and muscle tests - i don't miss those i can tell ya that much!!

jimmylegs

Hi everyone

Well, went for the first part of the nerve and muscle testing in my arms and hands. OMG is all I have to say. That was wierd to say the least. It hurt like hell in some places.... next week is my legs and feet, oh boy I cannot wait.

I had with me my latest blood work and all the info that I had received from you all. He was surprised how much info and research material I had and was surprised. He was also surprised I had arrange to have any bloods taken at all. Apparently, his clients do not usually arm themselves with information and bring it to him or take matters into their own hands. He was very impressed and I had to tell him, all kudos goes to everyone here, without you, I would be none the wiser on what or which way to go.

He is going to arrange for me to have a range of blood tests done that will cover everything and he also said my levels were not 'normal' as my Dr had advised me, so thanks everyone for taking time to look at them and give me your feedback. I would of just blindly gone along believing what my Dr had told me if it had not been for you guys.

He also mentioned that he believes there is definitely a link between lack of certain vitamins/minerals etc that play a factor in MS patients and he has wanted to start his own study/correlation of results for his own MS patients and look at what he finds. He is determined now to start this after seeing how interested and thorough everyone has been on here and what information I took him yesterday. He tasked his nurse whilst I was there with getting this ball rolling and I am guinea pig number one.

Once again thanks everyone. We might not make a difference on our own, but together we do.

Mirry

how exciting that your specialist is going to start tracking levels in other patients!! that is such a great idea.

mirry i have to say that you deserve some serious kudos too. there are a lot of people who know about the nutrition info out there but not everyone 'takes it to the bank' as it were. good for you for following through.

also you're so lucky to have a specialist to back you up on nutritional work - so important, and not everyone has that advantage, unfortunately.

it remains to be seen what turns up from your investigations but the early stages are very promising. it already looks like you have some action items with ferritin and d3. i look forward to hearing the rest of your results.

good luck with all the rest of the testing. ugh i remember, i had arms hands feet and legs all in one go. fun times. NOT!!

your attitude is great keep your chin up

jimmylegs

Hi everyone

This morning I had the nerve and muscle testing done on my legs. I can say without any shadow of a doubt that was by far the worst thing that has ever happened to me. I thought the pain I felt with my back surgery was bad enough, but this was torture. I will never go back for that test again.... ever, ever, ever.

Anyway, on the brighter side. My specialist talked to me this morning about his progress with starting all his patients with MS on vitamins. If you recall, I talked at length with him last week on the information I had obtained from talking on this site and he said he was going to get the ball rolling after being very impressed with the knowledge and information I was presenting him (based on what you had all contributed). Well, he has already contacted the drug companies and the insurance companies and they have agreed to pay for all vitamins/minerals that his MS patients will be prescribed. I couldn't believe it, I knew he was serious when we were talking last week about further studies etc, but I didn't think he would move so quickly. I am so impressed with him and he has gone above and beyond my expectations. I am going back in a couple of weeks (had neck and thoracic MRI's done tonight) to discuss the latest MRI's so will take back to him further information on the vitamins etc and see what information I can gather from him on this visit.

Hope everyone is well

Mirry

mirry, sorry to hear about the sucky testing. i remember that one - nasty.

very pleased to hear about the vitamins and minerals your doc is implementing! keep us in the loop as this one rolls out!!