normal iron levels for a 17 year-old

You need to have the Doc check his serum ferritan, a different test than blood levels of iron.

The doc won't test for ferritin. He says it is an insensative test, and that the iron test is better. I am thinking of having the test done myself.

Test for ferritin definitely. It's the standard way to test especially for athletes.

When in doubt and on the low end, it's not a horrible idea to self-medicate with iron, just be reasonable (50-200mg/day maybe?). But get a ferritin test.

yeah its a pretty intense test, they draw blood

Serum ferritin is the test that will give you the results that you need. Google it and learn the specs. Most doctors are reluctant to run this test for the simple reason that it costs them more than a standard blood test.

INSIST upon getting your doctor to perform the test that you want. Keep in mind that "normal" levels of ferritin do not apply to endurance athletes. A low normal reading can still leave a distance runner depleted enough to have impacted performance.

Thanks. I think I am just going to go ahead and have it done myself. I asked for a ferritin test, and the doc did everything but ferritin.

Running Dad,

Unfortunately I know too well the iron levels of a 17 year old high school XC runner. My son has had iron deficient anemia twice in the last four years. His levels each time were 8 and 18. Blood tests over the years when his performance was good (sub 16 min.) showed iron levels above fifty. He has never had iron levels greater than 65. My opinion based on my son's results and his doctor's advice is that your son's iron levels are normal for a high school athlete.

Good luck with getting your child healthy. I know it can be frustrating

I had ferritin levels tested, and they were low. The Doc still denies anything is wrong, and was quite upset that we would dare question his judgment. But at least we know what is wrong.

Doctors can be douche bags when it comes to this. I run d1 athletics at a top 15 running school and have been scolded by individuals for taking iron supplements. I don't remember exactly when i was extremely low on iron in high school but I remember getting Ferritin, Hemoglobin, Iron Saturation,all tested for sure. Iron Saturation was actually a big indicator because I found it was linked to my long term training and I was actually not replacing enough of my stores which is the Iron Saturation. If the Doctor doesn't like you so-called challenging him, ask again. If he refuses, go to a different doctor or at least a lab to get tested, who cares what they analzye it usually is on a personal basis. Someone may be able to run fine with iron saturation level of 10 while another person may feel like they are dying at 20. I looked for the times I felt good and the test results vs the times I was 1 min slower in my 5k and found a direct correlation. Obviously there may be other factors but I found iron issues to be the case. If they give you b.s. about saying he doesn't lose alot of iron because he doesn't have a peroid, throw out the term foot-strike hemolysis. This is iron loss from the popping of vessels in your feet. If you start to consistently check his levels make sure you test in morning because alot of times after workouts and things the results tend to change. There can also be spikes in some of the tests if he is coming under a cold or something. I'm only 19 but i know more about iron and running then 90% of the family dicked doctors out there.

Okay, here is another post that has a bunch of amateur physicians answering. Good for them. Amateur runner giving advice on running=OK (won't hurt anyone). Amateur doctor giving advice on health=NOT OK (may hurt someone). They are only confusing, you though. First off, there is no such thing as ferritin deficiency. A low ferritin level is indicative of iron deficiency, which is a cause of anemia (low red blood cell count).

Anemia is measured by assessing the hemoglobin (the oxygen carrying component of the red blood cell) and/or hematocrit (the percentage of red blood cells in whole blood). When these tests are low, it is appropriate to send tests to assess iron levels. This includes mean corpuscular volume (MCV), total iron levels, transferrin (or total iron binding capacity), and ferritin.

Ferritin is the cellular storage protein for iron. It is one way of measuring iron stores and can be measured in a blood test. Contrary to what the amateurs on this forum say, your doctor is correct in saying that it is not a sensitive test (though it may be the most sensitive of all of the possible tests). However, it is a VERY SPECIFIC test, meaning that when it is low, it correctly diagnoses iron deficiency as an explanation for anemia. There is not another scenario other than iron deficiency that will explain a low ferritin level.

The problem, however, and what makes it not such a SENSITIVE test is that ferritin is also what is called an 'acute phase reactant' which means that it can be elevated in times of physiologic stress (inflammation, illness, injury etc.). So, it can be normal, even in a case of iron deficiency, if the patient has another condition causing physiologic stress. I am not sure what the physiologic stress of a high school training regimen does to ferritin, but hypothetically it could elevate it causing false reassurance. So, it should be used with other ways of assessing iron levels, like the MCV, total iron, and transferrin. If these do not detect iron deficiency, this could be a sign of something called anemia of chronic disease and it may be worth it to look for what might be causing the physiologic stress.

The simplest thing to do, to take things into your own hands, is to put your son on a regimen of iron. Increase the sources of iron in his diet (red meat, green leafy vegetables, cooking with a cast iron skillet) or give iron supplements.

SUMMARY:

1) "Ferritin deficiency" is not a medical condition. Low ferritin is a sign of iron deviciency.

2) In testing for iron deficiency, it is appropriate to measure for ferritin as a first line test, and if normal, use the other tests if there may be the possibility of another coexisting condition causing physiologic stress.

3) Give the kid more iron.

4) Your doctor is your ally, not your enemy. A frank discussion with them about your understanding of things and your concerns will work things out. If you don't trust them, though, get a new doctor. But don't take things into your own hands, missing something that might be contributing to what we call anemia of chronic disease could be a big deal.

Shaggy, MD

Shaggy MD is spot on -- however to add another medical opinion:

--Iron deficiency in runners can be caused either by a) increased iron loss / turnover, or b) poor iron absorption.

In many runners, it is the combination of the two. However, my experience has been that some athletes likely lean one way or another.

With poor iron absorption -- the timing of iron supplements around meals is key to maximizing absorption. You need to take them on an empty stomach to maximize absorption. Always take with Vit-C (aids absorption in the small bowel). Avoid taking ath the same time as anti-inflammatories or with tea (hinders absorption). Liquid iron seems to increase iron absorption more than pill form, simply because you can present the intestine with more elemental iron. The small dosages in slow release pills is a drop in the bucket for what high volume runners need. Most of my colleagues recommend small dosages, where I go for as much as 15 cc Feosol bid for those with ferritin in the single digits. With all the focus on diet, for distance athletes I always recommend at least one hamburger a week -- whether you need it or not.

With greater iron loss -- soft surfaces can make a difference here.

Good luck

Tai Webb, MD

Feasol bid maximizes the ferritan, which in turn transfers single iron absorption digits into increased levels of hemoglobinized red blood cells....

Just kidding, I have no idea what I'm talking about. Carry on.

Thanks for that clarification guys on my statements. Appreciate the input!

Didn't Alan Webb have an iron deficiency? Anyone know what his numbers were?

Wtf. Who recommended 50-200mg per day, you'd f***ing croak in no time. I thought 18mg was the max.

Joe Shmoe wrote:

Wtf. Who recommended 50-200mg per day, you'd f***ing croak in no time. I thought 18mg was the max.

i am sure this is a joke. stay away from medical advice unless you know what you are talking about, even if you are joking. someone could get hurt.

iron is confusing. the mg on the label of the iron supplement doesn't necessarily equal the amount of elemental iron in the supplement.

the recommendation is 50-200mg of elemental iron a day. 325mg of ferrous sulfate three times a day gives you about 200mg of elemental iron. there are other forms, too, but i won't get into it.

beware of constipation with excessive iron use. 325mg of ferrous sulfate three times a day will likely lead to constipation.

shaggy, MD

I have anemia and I take one of those everyday. I don't eat much dark meat. Chicken and fish mostly. Dark greens aren't my bag either. Is that an acceptable supplement?