beta thal minor 17w pregnant,high ferritin low TIBC,help me please

Hi Andy and friends,
I'm 31,currently 17w pregnant.I was diagnosed with beta thal minor with normal ferritin and TIBC (last test in 2010). I have just have my blood checked,my Hb is 8.2,low MCV MCH and hematokrit. My ferritin is 175 and TIBC 189. I am always pale but feeling alright,no dizziness no fatique. My baby looks OK too but I am so afraid. Does high ferritin and low TIBC always indicate anemia of chronic disease? Should I have my body checked while I'm pregnant,I don't want to put my baby in danger or any stress. I was miscarriage in 2009 due to BO. This is my 2nd pregnancy after 6y marriage. I'm consuming 4mg folic acid per day,pregnancy vitamin and B complex+vit C.

Hi Andy and friends,
I'm 31,currently 17w pregnant.I was diagnosed with beta thal minor with normal ferritin and TIBC (last test in 2010). I have just have my blood checked,my Hb is 8.2,low MCV MCH and hematokrit. My ferritin is 175 and TIBC 189. I am always pale but feeling alright,no dizziness no fatique. My baby looks OK too but I am so afraid. Does high ferritin and low TIBC always indicate anemia of chronic disease? Should I have my body checked while I'm pregnant,I don't want to put my baby in danger or any stress. I was miscarriage in 2009 due to BO. This is my 2nd pregnancy after 6y marriage. I'm consuming 4mg folic acid per day,pregnancy vitamin and B complex+vit C.

Hi Lily,

You're consuming good and correct supplements. Make sure Vitamin E is natural though.

You might need to get transfused.

-P.

Pratik,Thank you  doctor said I should get blood transfussion if my Hb reached 7 or below (I hope it won't). But the problem is my ferritin is high,blood transfussion will make it worse,won't it?
Anyone knows if high ferritin+low TIBC could be something else besides anemia of chronic disease? I am so worried about my baby if my body should be checked to find what my chronic disease is. I hope it is not ACD.

Hi Lily,

You should be just fine.

175 ferritin (if that's what it is) is just fine. Norms list up to 330. You should be fine. Also try to eat green leafy vegetables, they are the best source of natural way to boost your hemoglobin naturally. A tasty salad which consists of such vegetables could do as well, that way you can enjoy taste as well as the nutritional benefits it has to offer.

Not sure about you, but often non-vegetarians often overlook the benefits vegetarianism has to offer. Either way, non veg offers greater benefits as well.

Best,

-P.

Ferritin is not an accurate measure of iron, and yours does still fall within an acceptable range. It rises due to inflammation or infection and should only be used together with TIBC and most importantly, serum iron. Your TIBC is low, but should be higher than normal during pregnancy. Was your serum iron also tested.? Have you been taking iron supplements during the pregnancy? I assume the preg vitamins contain iron. Has your B-12 level been checked? In addition to ACD, the following could all be possibilities: Hyperthyroidism, hemolytic anemia (thal minors do have ongoing hemolysis), pernicious anemia, Hypoproteinemia and inflammation. If your serum iron falls within the normal range, I doubt there's significance to the TIBC. Are you also taking vitamin E?

Pratik and Andy,
Thank you for your repplies.
According to my lab test,normal ferritin range should be 10-148 ng/mL,mine is 175,they marked it as high. I googled and found out that 306 ng/mL is max normal for women  I am confused now, I hope my lab is wrong and I have normal ferritin.
During my first trisemester I can only eat vege and fruits. After I met doctor and got my Hb checked (8.2), doctor told me to do high protein diet (meat,poultry,fish,egg) so I focus eating meat since then.
I haven't got my serum iron and B12 level checked,I'll ask my doctor to have them checked. Is serum iron and B12 test enough to find the root of my problem?
My preg vit contains iron IPC 30mg,that's the only iron supplement I take. I take 9mcg B12 and 4mg folic acid and vit E 400 iU per day. My doctor told me to raise folic acid dosage to 8mg per day since he found out my "high" ferritin and low TIBC, is it OK for my baby if I raise the dosage up to 8mg?

Pratik and Andy,
Thank you for your repplies.
According to my lab test,normal ferritin range should be 10-148 ng/mL,mine is 175,they marked it as high. I googled and found out that 306 ng/mL is max normal for women  I am confused now, I hope my lab is wrong and I have normal ferritin.
During my first trisemester I can only eat vege and fruits. After I met doctor and got my Hb checked (8.2), doctor told me to do high protein diet (meat,poultry,fish,egg) so I focus eating meat since then.
I haven't got my serum iron and B12 level checked,I'll ask my doctor to have them checked. Is serum iron and B12 test enough to find the root of my problem?
My preg vit contains iron IPC 30mg,that's the only iron supplement I take. I take 9mcg B12 and 4mg folic acid and vit E 400 iU per day. My doctor told me to raise folic acid dosage to 8mg per day since he found out my "high" ferritin and low TIBC, is it OK for my baby if I raise the dosage up to 8mg?

I'll leave up to Andy for other questions to be answered but yes, your Lab technician is wrong. 300+ and around 330 is the higher max limit for ferritin norms, so don't worry!

-P.

Listed range will vary from lab to lab, but no lab should have the upper limit for ferritin listed below 200.
ClinLab Navigator lists the range as

Reference range is 20 ‑ 300 ng/mL in men and 20 ‑ 200 ng/mL in women.

Some will list the same upper threshold the same for men and women.

I totally agree with raising the folic acid even higher and would suggest a B-12 supplement in addition to the B vitamins you already take. Both are water soluble and pose no risk to the baby.

Hi all,
I finally got 3bags of blood transfussion after my Hb dropped 0.5 in a week to 7.7. Now My Hb is 10.8. How much B12 supplement dosage I should take per day?  Is there anything else I can do to maintain my Hb at high level besides taking folic acid,B12,vit E and high protein diet? Andy,what can I do to raise my TIBC?

I would suggest at least 1000 mcg B-12 daily. The sublingual tabs that you melt in your mouth work well. With the higher dose of B-12 and folic acid, your TIBC should climb back to the normal range.

I got my Hb checked 9 days after my blood transfussion. Result came out good,Hb dropped 0.2 point in 9days, iron TIBC %saturation vit B12 folate all in normal range, coombs test both negative, ferrtin increase from 175 (before transfussion) to 423. Is there anything I can do to make my ferritin lower?
Now, 3 weeks after transfussion,my Hb is 8.8,dropped 1.8 point in 2weeks  Doctor suggested me to have LDH/blood film/DCT when my Hb is drop again to find out the reason. Is there any reason or it is just normal for expecting mom with thal minor to have blood transfussion periodically during their pregnancy (monthly in my case)? I am now 22w pregnant,long way to go.
I have consumed 500mcg B12, 6mg folic acid, 400 iU vit E per day. I am in high protein diet since 2months ago. Please anyone help me, is there any other way to increase my Hb and keep it stable without blood transfussion?
Andy, I can't find any sublingual tabs that melt in my mouth. In fact, I have to go overseas to find oral 500mcg vit B12, 100mcg is max dosage in can found in my town

It's normal for the Hb to drop during thal minor pregnancies. Your level is normal for 22 weeks. Usually transfusions will not be done until the Hb drops below 8 in a pregnant thal minor. Take the B12 you can get. There isn't a lot you can do other than do keep your nutrition up. The Hb will drop in most minors and is no cause for alarm.

Andy, I guess I don't need to have LDH/DCT test to find out my Hb drop that fast since it is normal in thal minor preg? I have met new OB,he said that I shouldn't get blood transfusion, even if my Hb reached 7 nor Hb checked. I should just ignore it,Hb will go ups and downs during preg. Baby will not be affected by my Hb since baby got her own Hb which is around 20. Just be happy and enjoy my preg. I wish I could do that instead of feeling constantly fatique. I'm now confused, blood transfusion during pregnancy is helping moms or babies?

Your low Hb will not affect the baby. Your doctor is well informed about pregnancy in thal minors and this is unusual. Transfusion of pregnant minors should be based on their physical health instead of relying on an arbitrary number. If your health is good, you won't need a transfusion. If you get to the point where you are suffering from constant tiredness and fatigue, a transfusion may be necessary. If you are not also taking a B Complex with your vitamins, add it to the mix. If your vitamin D level has not been checked, have it done immediately, as a low level can be a major cause of tiredness. It is also quickly adjusted by high doses. If your tiredness becomes severe and you find normal functioning impossible, talk to your doctor about getting a transfusion.

Hi, I recently had bloodwork labs done.  My hemoglobin is normally 105.  I am now 21 weeks pregnant. (43 years old, IVF baby).  My bloodwork came back Hb 80. Doc gave me iron which upset my stomach GREATLY.  In the meantime, another blood test done showing Hb 78 however my iron stores and saturation are normal.  I was advised to stop iron, but am really worried about hemoglobin.

I don't know what to do at this point!  I am really worried about the baby and I, and can't function through the day.  Feeling zonked and lightheaded.  Any ideas?