38% of Australian with Heart Failure have Iron Deficiency

[pattismith]

It's interesting that in this heart study, they consider
absolute iron deficiency when ferritine is below 100 ng/ml (= 100 µg/l ) and
relative iron deficiency when ferritine is between 100 and 300 if Transferrine Saturation is below 20%

(just to compare, here what french lab gives as reference ranges!!!)

Clinical characteristics of people with heart failure in Australian general practice: results from a retrospective cohort study

Andrew P. Sindone,Deepak Haikerwal,Ralph G. Audehm,Alexander Munro Neville,Kevin Lim,Richard Whaddon Parsons,Peter Piazza,Danny Liew

First published: 28 October 2021

https://doi.org/10.1002/ehf2.13661

...
Of the 1.12 million adults seen regularly, 20 219 were classified as having definite or probable HF
....
The most common comorbidities in people with HF were
-hypertension (41.1%),
-chronic obstructive pulmonary disease/asthma (25.1%) and
-depression/anxiety (18.4%). ...

Just over one-third (37.8%) had iron deficiency
....

While anaemia was infrequent, absolute iron deficiency (defined as serum ferritin level of <100 g/L) was surprisingly common.

Haemoglobin levels were available for 17 382 participants in the definite and probable HF populations.

Of these, 611 (3.52%) had a documented haemoglobin level of <100 g/L.

Ferritin levels were available for 13 604 patients with HF, and 6479 patients (32.0%) recorded a ferritin level of <100 ng/mL.

Relative iron deficiency affected a further 7.6%, with 5205 (25.7%) recording a ferritin level in the range 100–300 ng/mL and just under a third of these (1546) also having a transferrin saturation of <20%.1

Therefore, over a third (39.7%) of the 20 219 patients with HF had documented evidence of absolute or relative iron deficiency.

 

[YippeeKi YOW !!]

Wow!!! Those French ranges are pretty broad .... makes it difficult to determine anything but a sort of sliding scale of where you might be ....

"Ferritin levels were available for 13 604 patients with HF, and
6479 patients (32.0%) recorded a ferritin level of <100 ng/mL."​

Hmmmmm ,,, simple arithmetic would indicate that the percentage of those with ferritin level labs should be 47.6, not 32%, no? Theyre using the entire study's participants to derive a possibly inaccurate reading. Using all participants, including those that didn't have available ferrtin readings would yield a lower and less compelling result, and would also be comparing apples to oranges, since the ferritin levels were what was under discussion and a number of the participants apparently didn't present with ferritin labs.

This is really interesting @pattismith , particularly since I recently lost an old friend to an undiagnosed heart attack. He was being evaluated for anemia and iron deficiency, and died shortly after reachng the ER and just before further tests were due to start ....

Thank you so much for posting this .... your posts are invariably interesting, informative, and/or thought-provoking .....

 

[pattismith]

This is really interesting @pattismith , particularly since I recently lost an old friend to an undiagnosed heart attack. He was being evaluated for anemia and iron deficiency, and died shortly after reachng the ER and just before further tests were due to start ....

Thank you so much for posting this .... your posts are invariably interesting, informative, and/or thought-provoking .....

I'm sorry for your friend, it's so sad.

My ferritin was always between 11 and 22, so I was not considered as deficient all my life.

However, my new young neuropsychiatrist thinks I was deficient from the start .
My symptoms fit with this diagnosis so I am especially interested in the discussion around iron markers and normal ranges.

The debate is very similar to the Vitmain B12 ranges debate.

Normal ranges were initially built by hematologists who discriminated between anemic and non anemic patients.

However, iron deficiency put a stress on mitochondria, muscles, heart, nervous system and brain, with many symptoms but no simple blood test to show the damages on these organs.

It's more difficult to understand, consider and manage iron deficiency than B12 deficiency because you can supplement with B12 as much as you wish, it's not toxic, whereas iron supplementation is more difficult and can even be dangerous if not necessary.

 

[YippeeKi YOW !!]

The debate is very similar to the Vitmain B12 ranges debate.

I agree. Also similar to the incredibly wide ranges given to TSH, made all the more problematic by the fact that TSH is the weakest, least revealing or reliable metric to measure thyroid function.

It's like they created a special algorithm to pinpoint the worst possible method for doing it, then vociferously and furiously defended it as the only way .... for DECADES !!!!

It's more difficult to understand, consider and manage iron deficiency than B12 deficiency because you can supplement with B12 as much as you wish, it's not toxic, whereas iron supplementation is more difficult and can even be dangerous if not necessary.

Totally agree, again. I supplement once or twice a week with 25 mg of bisglycinate form since I haven;t been eating meat during the COVID lockdown and am on an unintentional vegetarian diet .... hoping that's OK, but ust can;t pull it together to drag myself to a lab, since the last blood draw in the ER by an unfamiliar obviously subpar phlebotomist destroyed my last good vein .... which is why I wince everytime someone references a 'medical professional' ....