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Crohn's Disease Forum » Parents of Kids with IBD » Total Iron Binding Capacity?


06-11-2014, 09:34 PM   #1
AZMOM
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Total Iron Binding Capacity?

Alright oracle friends on the forum. :-) Claire's last labs showed mild anemia - we've been waaaaaay worse. First set of some of these I've seen. GI ordered them when choosing her EN formula.

What can you tell me about the TIBC? Do I care? (of course I care but you know what I mean!)

Iron Blood: 42 mcg/dL (16-128) Total Iron Binding Capacity: 186* mcg/mL (250-450) Percent Iron Saturation: 23 % Ferritin Blood: 168 ng/mL (15-204)

Hugs,

J.
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Julie

Mom to Claire - 11 going on 17

Dx JRA age 3, Crohn's age 6
Acute transverse myelitis at age 5

Started IVIG September 2016
Started Tacrolimus October 2016
Neurontin 100mg twice daily
Folic Acid
Calcium/D supplement
Daily Vitamin
Daily Probiotic

No more Enbrel, Stelara, Methotrexate, Allopurinal or 6MP
06-11-2014, 09:38 PM   #2
my little penguin
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Tibc is a concern when it's really high and the ferritin is really low - that means the iron stores are being depleted .
That is what happens to DS.
Low Tibc ??
Not sure what it means
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06-11-2014, 09:40 PM   #3
my little penguin
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http://labtestsonline.org/understand...tibc/tab/test/

At least some of the answers
Chronic illness or two types of anemia
06-11-2014, 09:49 PM   #4
AZMOM
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mlp - I just think it keeps pointing to her malnutrition due to poor absorption??? Albumin was quite low as well. I swear he's never checked either of these before though! I couldn't figure out why he was checking it now. I guess I don't get to be all knowing on this one (please note my sarcasm).

On a brighter note, I kept checking her temp earlier this week because I am so unused to pink cheeks!!! There was no fever - I'm wondering if it is because she's absorbing the food?????

She is at a 4 day camp right now - it is a "medical camp" - this is her fourth summer to attend. The nurse at check-in said she's seen EN do remarkable things and thought Claire "looked great"! I was a WRECK about taking her and I'm not usually worried about taking her to camp. I think it was because in addition to her regular stuff, I was hauling pump, formula, portable pole, etc, etc, etc. I was on pins & needles thinking that they would call last night, unable to insert the tube (we are blessed to have the facility/camp just 1/2 hour away) and they never called.



J.
06-11-2014, 09:56 PM   #5
Maya142
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Glad it seems to be going well! Hope Claire has a wonderful time!

I second what MLP said -- M's anemia was only concerning when ferritin was very low (like 6 I think) and TIBC was high.
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06-11-2014, 11:30 PM   #6
Catherine
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Couple of questions:

Which way are the numbers heading?
Is Iron Saturation in range?

It doesn't look like classic iron deficiency anemia.
Could be a combination of IDA and ACD (Anemia of chronic disease).
Ferritin could be acting as a marker of inflammation.
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Mother of Sarah dx aged 16, Jan 2012
DX - CD 1/12, asthma
Small bowel to small bowel fistula

Meds: ), azathioprine 200mg, Mesalazine 1.2g x 2, seretide 250 x 2 (asthma), ventolin (as needed)

Currently no supplements.

Has previously taken Multi B, Caltrate, B12 & Iron

Prednisolone (from 30 mg 01/02/2012 to 17/06/2012, 30mg 24/10/12-28/12/12, 50mg 24/1/13-27/4/13)
06-12-2014, 05:51 AM   #7
AZMOM
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Catherine - didn't show a range for iron sat. However there was a value on that one from about a year ago. It was 67% now 23%.

I guess that's why I was leaning to the malabsorption/malnutrition on the TIBC. Her Albumin was low too.
06-12-2014, 06:15 AM   #8
Catherine
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With iron deficiency anemia you would expect the iron sat % to be high.

With anemia of chronic disease iron you would expect sat % to be low.

Next question:
Have iron and TIBC both dropped?
And ferritin increased?
06-12-2014, 08:56 PM   #9
Brian'sMom
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Just found out Brian's iron is really low. Ferritin stores is 9... other iron number was 34 (starts at 50 i think). I had an iron question..... is slow release good? Pharmacist said its easier on stomach... but with a stoma... would slow release make the pill appear in the bag? What's a good supplement?

PS. I just wanted to say again, CROHNS, I HATE YOU!! ...
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symptoms 2005, official dx 6/2010

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Total EEN 12-10-13 to:TPN 1-29-14 - 4-2-14
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Has done round of Flagyl due to abcess 12/10 and 10-21-13 which helped both heal quickly.
06-12-2014, 09:30 PM   #10
my little penguin
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DS uses the chelated form since it is easiest on the stomach .
Slow Fe is easier than regular but not as easy as chelated.
DS ferritin was 9 in end of .
jan
By the end of April I believe it was up to 26.
He takes this kind
http://www.solgar.com/SolgarProducts...e-Capsules.htm
06-12-2014, 11:21 PM   #11
AZMOM
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Catherine - Iron level from 153 to 42, TIBC from 207 to 186, Ferritin 113 to 168. So to your question, yes the first two dropped and the other rising. The sat (I think I mentioned before) dropping to 23% - was 67%.

Thoughts???

I feel guilty about the Ferritin number when everyone is worried about 9!!! :-(

I'm just trying to figure out what he was looking for.

J.
06-13-2014, 03:36 AM   #12
DustyKat
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With the dropping numbers of Iron and TIBC but increasing ferritin you could be looking at an acute phase response, this would fit with Claire’s current Crohn’s status.

Remember, ferritin is a back door indicator of inflammation. So whilst well within normal range it has been trending upwards.

Dusty. xxx
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06-13-2014, 05:36 AM   #13
Catherine
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What DustyKat said.

I believe her ferritin is much low than it is reading.

Causes of low TIBC

Lower-than-normal TIBC may mean:

Cirrhosis
Hemolytic anemia
Hypoproteinemia
Inflammation
Liver disease
Malnutrition
Pernicious anemia
Sickle cell anemia

http://www.nlm.nih.gov/medlineplus/e...cle/003489.htm

It could be IDA with concurrent ACD which is treat with iron supplements. This where it tricky iron supplements don't work for ACD, as for some reason the body is storing iron as ferritin. The treatment for ACD is to treat the underlining condition.

Treatment
Anemia is often mild enough that it does not need treatment. It will likely get better when the disease that is causing it is treated.

The condition is rarely severe enough to need a blood transfusion.

Iron supplements may sometimes be used, but only for patients whose iron levels are low. Taking iron pills when your body does not need it can lead to serious medical problems. Always talk with your health care provider first.

For some conditions, such as chronic kidney disease, medicine called erythropoietin may be given. It stimulates your bone marrow to make more red blood cells.

http://www.nlm.nih.gov/medlineplus/e...cle/000565.htm
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