MOK

6 Months Lab Results

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Hi, just found this site and it looks really interesting. Looking forward to exploring more. Just 6 months passed since Gastric Sleeve surgery.  Overall high weight 225 and currently 153.  Things are going well I think. 6 month meeting coming up. Recently did 6 month labs and all looks really good, except Serum Ferritin is way above normal at 597 - what could that mean?

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Dear MOK,

 

Ferritin is an iron storage molecule. Interpretation of serum ferritin is fairly complicated. Ferritin is elevated with iron excess, but also goes up under a variety of other conditions. Some of these conditions include acute inflammation, liver disease, and significant malnutrition. I'd discuss your ferritin level with your PCP since so many factors need to be taken into account. 

 

  • The following is quoted from Mariana Koperdanova, British Medical Journal, 2015;351:h3692

  • "Elevated ferritin levels are usually due to causes such as acute or chronic inflammation, chronic alcohol consumption, liver disease, renal failure, metabolic syndrome, or malignancy rather than iron overload

  • Exclude these causes clinically or with initial tests such as full blood count, liver and renal function, and inflammatory markers (C reactive protein or erythrocyte sedimentation rate)

  • A normal serum transferrin saturation (ideally fasting) usually excludes iron overload (where it is raised) and suggests a reactive cause for raised ferritin

  • Unexplained serum ferritin values >1000 μg/L warrant referral for further investigation

  • Consider HFE mutation screen for hereditary haemochromatosis in individuals with elevated ferritin and a raised transferrin saturation >45%"

 
 
Here's the summary of a medical journal article that you might find interesting:
 
 2014 Oct 16;31(2):666-71. doi: 10.3305/nh.2015.31.2.7629.

Ferritin in hypertensive and diabetic women before and after bariatric surgery.

 

In addition to its important role as marker of iron stores, serum ferritin is a marker of systemic inflammation, and obesity has been associated with chronic inflammation.

OBJECTIVE: 

To verify, six months after surgery, the effect of bariatric surgery on the serum ferritin of women who were hypertensive, diabetic, or comorbidity free before surgery.

SAMPLE AND METHODS: 

This retrospective study included 200 women aged 20 to 45 years, with a body mass index (BMI) equal to or greater than 35 kg/m2, submitted to Roux-en-Y gastric bypass (RYGB). Seventy of these women were hypertensive, forty had type 2 diabetes (T2D), and ninety were comorbidity free (CF). They were assessed before and six months after surgery. Anthropometric, laboratory (serum ferritin and hemoglobin), and comorbidity- related data were collected from their medical records.

RESULTS: 

Before surgery, women with comorbidities were older, the hypertensives had higher BMI, and the diabetics had higher serum ferritin levels than the CF women. The study comorbidities had resolved in 68% of the hypertensive women and 86% of the diabetic women six months after RYGB. Also at this time, the serum ferritin of hypertensive women decreased from 110.1±86.3 to 88.7±80.5 ng/dL and of diabetic women, from 164.8±133.4 to 101.2±97.7 ng/dL (p0.05).

CONCLUSION: 

High ferritin in premenopausal obese women was associated with the main obesity-related comorbidities, and these comorbidities determined the reduction of serum ferritin after bariatric surgery.

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