Seeking Insight on Blood Work Results: Low RBC/WBC, Ferritin, but Elevated Iron Saturation
Profile: 33-year-old female, 5'9", weighing 130 pounds. I do not drink alcohol and I do not smoke. I've been grappling with persistent fatigue, experiencing dizziness and light-headedness, and noticing that I bruise easily. Mornings are particularly tough—I often wake up feeling as if I've been run over by a bus. It’s worth mentioning that I suffered a hip fracture at 18 from a minor fall, which adds to my health history. Recent laboratory results (February 2025) revealed: - RBC: 3.9 million cells/µL (below normal) - WBC: 3.4 thousand cells/µL (below normal) - Hemoglobin: 11.9 g/dL (low-normal) - Hematocrit: 35% (below normal) - Ferritin: 18 ng/mL (low) - Iron: 178 µg/dL (high-normal) - Iron saturation: 58% (elevated) - TIBC: 306 µg/dL (within normal range) - Platelet count: normal I've consistently had low ferritin along with mildly low RBC and WBC counts, but the recent finding of high iron saturation is new to me. My current medication regimen includes: - Liothyronine, 15 mg daily (divided between morning and evening) - Methylphenidate extended-release, 36 mg - Sertraline, 75 mg daily - Bupropion XL, 300 mg daily - Dextromethorphan, 90 mg daily - Omega-3 and vitamin D supplements - Melatonin, 6 mg at night In terms of family medical background, my grandparent had leukemia. I recently consulted with my healthcare provider, who indicated that my lab results were “normal.” However, I continue to feel unwell on a daily basis. I'm curious if there could be any relationship between the persistent low RBC and WBC levels, low ferritin, and the recently noted high iron saturation. Should I advocate for a referral to a hematologist, or am I overreacting? 😩
Answers (1)
8/13/2025, 12:31:01 AM
OpenHealth AI
It seems you are understandably concerned about your recent blood work results and the ongoing fatigue and other symptoms you are experiencing. Let’s break this down.
Key Points
- Low RBC and WBC Counts with Low Ferritin: These may indicate anemia or bone marrow issues.
- Elevated Iron Saturation: This unusual finding, paired with your low ferritin, suggests that while your body stores iron poorly, you may have an adequate amount circulating.
- Persistent Symptoms: Your feelings of fatigue, dizziness, and bruising warrant further attention.
Explanation
- Anemia can occur for various reasons, including nutritional deficiencies, bone marrow issues, or chronic disease processes. Your low ferritin indicates low iron stores which typically contributes to anemia, while your high iron saturation is puzzling because it usually aligns with iron overload conditions or a mismatch in metabolic processing.
- Your symptoms, particularly the fatigue and dizziness, could be linked to these blood findings and need further investigation.
- Your past hip fracture could suggest a concern with bone density or metabolic bone disorders, which can also relate to blood abnormalities.
Next Steps
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Monitor Symptoms and Keep a Journal: Document your daily symptoms, including when they occur and their intensity. This information can help identify patterns and be useful for healthcare consultations.
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Hydration and Nutrition: Focus on staying well-hydrated and consuming a balanced diet rich in iron (such as leafy greens, lean meats) and vitamin C (to help with iron absorption). Avoid high-calcium foods and supplements around iron-rich meals, as calcium can hinder absorption.
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Request a Referral to a Hematologist: Since you have persistent symptoms and complex blood results, it’s reasonable to discuss with your healthcare provider the possibility of referring you to a hematologist. Be clear about how your symptoms impact your daily life. A specialist can provide targeted evaluation for underlying conditions related to your blood counts.
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Follow Up on Medication Effects: Some medications can impact blood cell counts or cause symptoms you describe. Discuss with your healthcare provider the possibility of reassessing your medication regimen for potential side effects or interactions.
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Re-evaluate Your Overall Health: Consider getting a full panel of tests to assess for other potential causes of your symptoms, including thyroid function (given your liothyronine use) and other vitamin deficiencies (like B12), as these can also produce similar symptoms.
Support and Reassurance
It's perfectly okay to advocate for your health, especially when you feel unwell. Your symptoms are valid, and getting the right support can lead to better management of your condition. Trust your instincts and seek further clarification from healthcare professionals who can help you navigate this, including a hematologist if necessary. You are taking important steps by seeking answers, and I encourage you to keep pursuing the care you deserve.
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