While many of us have made it our business to ensure we are competent IN the business of understanding patients’ iron studies, it sadly seems, many even in teaching and training positions, still have not 🙁 I was sent 2 messages this week that had me lost for words (other than expletives). The first, an email from a final year nat in student clinic with the subject: Please tell me I’m not crazy!!
“Fasted male with high ferritin & high-normal transferrin saturation at two time points, with constantly raised Liver enzymes & neurological Sx. He is currently being treated for blasto in student clinic because they think the high ferritin comes from “blasto infection!!!
He needs to be checked for an HFE mutation, right??”
Ok so high ferritin because of ‘blasto’ is NOT A THING! And on the HFE front…Correct! I ask, “Have you mentioned this to the supervisor? What do they say?” Student’s reply, “They say HFE mutations are uncommon so, in a word, it’s not it. But THANK YOU!!!!!!!!!!!!!!!!!!!!! I feel sane again” So, what do I do? The student is studying at a leading institution, one that has sought advice and input from me in the past regarding their diagnostics curriculum, but it would seem, the clinicians they allow to supervise our precious next gen of nats are not expected to be even as competent as the students themselves. Danger Will Robinson! Danger! [old tv show reference…apologies, young folk!] I’ve [not] recovered from this when I get hit with the old 1-2! A naturopath messages me with a screenshot of a FB group exchange over a set of iron results: Ferritin over 400 but low serum iron and transferrin saturation values…which another health professional, who offers training to naturopaths, says is ‘Iron Deficiency’
Email says, “Please help me, I’ve worked so hard to understand iron studies and this has just CONFUSED THE #@*^ out of me!”
Again someone who would typically defer to the voice of authority here, fortunately knows enough to know to question this (mis)interpretation.
I tell you…you may have thought that when I previously wished for all health professionals to be competent in reading studies…but it’s actually a big ask, it would seem 🤔 Could we just, as a start, get anyone who professes to teach, train or mentor health professionals, to actually get up to speed on this themselves or…keep their mouths 🤐
No wonder our “So You Think You Know How To Read Iron Studies” is in our top 3 downloaded resources!!!
Overt Iron Deficiency Anaemia or Haemochromatosis aside…do you understand the critical insights markers like transferrin and its saturation reveal about your patients iron status? Most practitioners don’t and as a result give iron when they shouldn’t and fail to sometimes when they should. This audio complete with an amazing cheat sheet for interpreting your patients Iron Study results will sharpen your skills around iron assessment, enabling you to recognise the real story of your patients’ relationship with iron.
Or better yet, go the whole hog, with our Iron Package