NORMAL IRON SERUM BUT VERY LOW FERRITIN

Goodevening, this is my first post. I am a Thal Minor and last year I suffered paroxysmal atrial fibrillation with no underlying heart disease and I was given no medication. Had a treadmill test, echo stress test, ecg and thalium test and a heart problem was  ruled out.  I do have hypothyroidsm and I have been taking euthyrox 50 mg for 6 years. I had a low ferritin level and I was told that this was due to my Thal Minor and was not fiven any iron supplements. On a trip to South Africa, I had heart palpitations and went and saw a pathologist who said that I needed to take iron supplements because after doing blood tests he saw that I had low ferritin levels. He prescribed Spatone which I have been taking for the last month and I must say I have noticed that I do not get the palpitations,I  feel very energetic, don't feel fatigue and in general I feel exceptionally well. On my return to Greece I had  some general blood tests done and  checked my ferritin levels . They came back as follows:
Hb11,1, MCV 67,1 fl, MCH 20,4 pg/ερ, MCHC 30,4g/dl, RDW 14,9%. My serum iron is 75 μg% and my ferritin levels 19,0 ng/ml, my B12 419,0 pg/ml and my folic acid 13,7 ng/ml. I also take a multivitamin effervescent tablet (calc vita), folic acid as well as Super Mega B12 supplements.
Now what I would like to ask is firstly, can I continue taking  Spatone with applejuice or should I supplement with ferrous sulphate? How long will it take for my ferritin levels to increase on Spatone? Could the cause of my afib have been caused by very low ferritin levels? What can I do to increase my ferritin levels?
 I would like to thank you in advance for your advice.

I have replied to your PM, but would like to share the post with the group, as the type of iron you are using is the first ever form of iron I would actually recommend to patients with iron deficiency.

Don't worry about ferritin levels. I see low ferritin in thal minor's reports regularly. Testing for iron deficiency is difficult but even more so in thal minors. I feel that if the serum iron is good, then the test to look at is the TIBC, to see if it is on the high side. If it is, your body wants to absorb more iron, indicating iron deficiency. The iron bound in ferritin has no value to your body, so it is much less significant than people realize. It is also affected by many things besides iron and is not a good measure of iron status in minors. I would say keep taking the Spatone as long as you feel better taking it. It looks like a preferred method of getting iron and I would not suggest adding another iron supplement to the mix, as quite often they cause intestinal distress and bloating, making it harder to follow a nutritious diet.

I will also ask if you are taking any magnesium and how much? It can be very useful in preventing heart palps and if you are taking calcium, it should be in a 2:1 ratio with magnesium and vitamin D should be taken along with it to promote absorption. Also, avoid any nasal sprays like Afrin. I had heart palps for several years until I realized it was the over the counter nasal spray causing it. The B-12 is within range, but recent studies suggest that thals should aim for the high end of normal for B-12, as it has been found essential for the bones.

Dear Andy,
Thank you so much for your reply. I used to take magnesium L-Aspartate Hydrochloride granules 121.5 mg  (Trofocard) with milk in the evenings before going to bed, but after my afib I got a bit anxious that maybe this caused it. I had a blood test done and my magnesium result is 2.51 mgr% (normal range 1,6 - 2,6 mgr%), my pottasium 4,01mmol/l (normal range 3,5 - 5,5 mmol/l)and my sodium 142 mmol/l (normal range 135 -155 mmol/l). I am not sure if I should resume taking magnesium supplements seeing that I am in the highest end of the normal range. I have cut down on sodium because my results came up on the high end of the normal range. My cardiologist says that I can take 85 mg of aspirin as a matter of feeling safe myself, it is not necessary,  but I was wondering should I rather take a natural vitamin E supplement.
The only test that I have not had is the Vitamin D test. Should I have this done? Could you recommend something else that I should take as a Thal MInor.
Thanking you in advance for your advice.
Nicci

Nicci,

The first thing a thal minor should get tested is the vitamin D level. Most thals test low and often significantly low. Low D exacerbates every problem thal minors have, so it is important to address first, if low. What is considered a good level has changed drastically in recent years, with 35 being a minimum level and 50-80 considered optimum.  I also favor taking natural vitamin E over aspirin. It addresses the need for antioxidants that aspirin doesn't, while providing the blood thinning property of aspirin. Your magnesium level is good, so you may not need any.

There is one more value in your test, the RDW that is not high at all and would be expected to be high (>18) if you were iron deficient. I think the Spatone has helped, and since the palps have stopped, you can assume you did have deficiency previously. That is really the only definitive test for iron deficiency. If it improves the problem, you were deficient.