Childhood Diseases

Posted by: tlee | 2011/11/03


Re 645 iron supplements

Dear Dr
You answered my previous query re my son (31 months old) and his iron levels. Following your advice we have had him tested and the results are:

Ferritin 26
S-Iron 13.3
S-Transferrin 2.6
*S-Saturation 20
(* not sure if that is an S, the fax is not very clear, it might be a percentage symbol)

Red cell count 4.97
Haemogloblin 10.9*
Haematocrit 0.32*
MCV 64*
MCH 22*
RDW 13.0
(* all of these have an L under the Flag column)

White cell count 11
Neutropholis 42.9% 4.7
Lymphocytes 49.2% 5.4
Monocytes 5.5% L 0.60
Eosinophilis 1.5% 0.20
Basopholis 0.9% 0.10

Platelet Count 362

When reading these results please keep in mind that my son was very ill in June and hospitalised and when tested in hospital we were told his iron store had been wiped out. He was on 7.5ml Ferrimed daily from Mid June to Mid October then had a break of two weeks and immediately became tired and got a sinus infection requiring a 10 day course of antibiotics. At the same time as the antibiotic we put him back on 5ml Ferrimed every 2nd day and he has been on that up until the test yesterday.

The paed told us that the results are not particularly low but my son might be a little anaemic so we need to go back to 7.5ml Ferrimed daily for 6 weeks and then retest.

I have done some research (google!) and it looks like you should not take the iron with dairy or Zinc and calcium. As my son has cereal with milk and Zinplex syrup every morning we have decided to give him the Ferrimed in the evening with strawberries or a glass of Orange directly after supper (so it is with food to ease constipation and with Vit C to help absorption).

Are we on the right track?

We will test again at the end of the year but my concern is that if the levels are up and we stop the Ferrimed how do we know they won''t just drop again meaning that as soon as he is back at school in Jan he will get very ill again?

If levels are low after the lengthy supplementation he has been having surely it is a chronic problem?

Thanks for your time and advice!

Expert's Reply



Your son's serum iron, ferritin and transferrin are all at the lower end of normal.His haemoglobin is slightly below the normal level of 12.5 for his age and all the other red blood cell related tests show a very mild anemia. You are correct, it is better not to give the Ferrimed with milk. There does not appear to be any reason why his haemoglobin level should be below normal with all of this iron supplementation. Your son stools should be tested to make sure that he does not have any blood loss. It is odd that a boy of this age on a good diet and an iron supplement should still have a haemoglobin below normal.Your paediatrician needs to see him from time to time to make sure that he is responding to the iron supplement.

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