How much Ferritin is being chelated

Hi,

I just want ask if anyone knows how much does the Iron being chelated with every Desferal use.



Nur

I think it varies with different doses along the factor that you are taking Vitamin C with your Desferal session or not.

Hi guys

theoretically Desferal is known as hexadentate iron chelator, meaning it can bind six iron molecules. These chelators can bind usually non transferin bind iron. Ferretin it self is not only iron its a protein where iron is stored. By estimating level of ferritin we understand the accumulation of iron  because most of the iron is stored in either ferritin or hemosiderin in the body. Hope you got answer.

Experimentaly we see Desfral should bind 1 to 1 ratio of iron.

Dear Mustho,

Thanks for the explanation.I am told that we received about 200-250 of ferritin per bag with every transfusion. So is there a way to calculate the amout of ferritin that would be taken out with each use of tha Desferal? I am using 4 bottles per night.


Nur

Experimentaly we see Desfral should bind 1 to 1 ratio of iron.

I am told that we received about 200-250 of ferritin per bag with every transfusion.

Hmmm... You forgot to mention the unit. Is it mg or g. If it is mg then each Desferal vial is 500mg. You take 4 at a time; then according to Mushto you should chelate 2000mg or 2g of iron! Cool! That's more than what you are getting at transX! but in reality this doesn't seems to be it. I mean we have to chelate everyday to keep up with all the excess iron and if it were 1:1 ratio, then the docs would have prescribed one vial for every 2 TransX!

I think one of you guys got the figures mixed up! I think that it is g and not mg.

The numbers are correct, Sajid. Approximately 250 mg iron per unit transfused and desferal comes in 500 mg vials or 2 gram vials.

I don't think you've understood Mustho correctly. Experimentally, a desferal molecule should bind one iron atom. This is not a measure of weight and also, as Mustho said, this is experimentally. What happens in the body will not be as efficient. In theory, desferal does the following:

From http://www.emedicine.com/Med/topic1189.htm

Approximately 8 mg of iron is bound by 100 mg of deferoxamine.

So theoretically, 4 vials (2gr) desferal would remove 160 mg iron. If you got two units blood every two weeks, you would be getting one gram of iron each month from transfusions plus whatever your gut absorbed from food. If you took 4 vials of desferal 20 times a month, you would in theory remove 3.2 grams of iron per month. This is assuming complete effieciency of desferal which is unlikely in the human body. Desferal also has a very short half life and this is why a dosage over a long period is necessary. Keep in mind that usually a condition of iron overload may already exist so even if desferal is removing more iron than one is taking in through transfusion and diet, it may be years before iron levels drop to "safe" levels. Each person is different too, and anecdotal evidence will show that desferal does not work equally on everyone.

Exciting information Andy,

My daughter is using one vile every night (five times a week) for last five months (NO ABSENCE). In theory if 4 vials remove 160 mg of iron then she must have extracted approx 160mg every week (contigency of 80% effectiveness). Alternate, total of 3200 mg or 3.2 g in five months should have been removed. She is tranfused one unit every five weeks, which may have given her approx 1.25 gram or 1250 mg of iron over the past five months. Her ferritin level in December was 1500g/dl. This Monday she is testing again for Ferritin and I am expecting a decline (keeping my fingers crossed). Will keep you guys posted.

Regards

The key term is "in theory" but realistically, we cannot expect every molecule of desferal that is infused to also be utilized. It woud be interesting to see a study of how effective desferal really is but we have to remember that there are variables. There are factors like taking vitamin C with desferal that increase the amount of iron available to be chelated. The most important thing is to keep to your schedule and be disciplined taking desferal or any other chelator.

Hi Canadian Family, it’s really interesting the expectations and estimations you have calculated. But let me tell you don’t get worried much even if its not what you have expected. Let me tell you little bit of theory again, from elementary chemistry we know iron as Fe2+ or Fe3+ it can be. In the body also iron can be in either forms and thats how these chelators work also on the basis of those charges and so many other factors also involve, one of them is pH. As Andy said by giving Vit C (Ascorbic Acid) also its helping iron to release so chelators ca bind. My point here is no two human physiology at the same time can be similar. However these values figures are established from so many retrospective studies, there may be slight variation which we cannot explain. Therefore don’t get surprised even if it’s not what you have calculated. Hope to see the results on your next post.

As promised, the results of ferritin are 2759 a lot higher than we expected. Our concerns were shrugged off by the hematologist saying "Ferritin level for the first year after starting Desferal is a roller coaster ride and nothing can be said until it gets steady". She was kind of expecting it and was not worried at all.

I will try to get some detail answer from her why this is the case. Meanwhile anybody on the forum knows please share the knowledge.

Regards

Hi CF,

We have talked about this elsewhere in the forum, but not exactly sure where. So, here it is again: Serum Ferritin (SF) tests are very unreliable. A lot of us trust it as a true indicator of iron in the body because the test yields a number, but nothing could be further from the truth. Unlike other blood tests, a lot of factors can affect this "number": sample quality (iron is not evenly distributed in your blood flow), whether the patient has any infection at that time, and even how long the reagent (that is used to test your sample) has been sitting on the shelves (SF tests are not commonly carried out) ..... So, I would be like your doctor, would not worry too much about it, especially since you have been chelating regularly.

The other important point to note is that SF only measures iron in the bloodstream, but the (more) dangerous iron is the one that sits in your body organs ... heart, liver, pancreas, pituitary, etc. The theory used to be that if you have a lot of iron in the bloodstream, this starts to accumulate in the organs, so SF is a leading indicator .... this is no longer accepted as true since it is now known that iron could go and reside in organs directly and you could have low iron in the bloodstream but high organ iron.

MRIs are better options than SF tests to determine iron toxicity.

Hope that is useful.

Cheers

Poirot