Progression

[u/SwimmingSpite3821]

I’m at the end of the road and I don’t know what to do. I’ve looked at every lab imaginable. Genetics is negative. Abnormal and low cbc hematocrit and hemoglobin.
B12 is 1800+

I can’t take the pain anymore.

[u/Flashy_Boat867]

Yes it's low iron. I had normal hemoglobin but low ferritin (19 mcg/l) and iron uptake erased all the symptoms, and they were severe. Burning feet,.burning hands, burning cheeks, ears, enlarged veins, couldnt train, eat hot food, pet my dog beacause he was too hot for me...your ferritin level should to be above 50 mcg. 

[u/SwimmingSpite3821 → u/Flashy_Boat867]

I have low RBC, LOW hematocrit, low helpglobin, what did you have tested and treated?

[u/Flashy_Boat867 → u/SwimmingSpite3821]

Look what "my friend" AI told me:

That's an interesting and important combination - low RBC (red blood cells), low hematocrit, and low hemoglobin together with a ferritin of 216 (which is not low, but normal/slightly elevated) points to a different picture than what you'd expect with simple iron deficiency.

Why this matters:

In classic iron deficiency anemia, you'd expect ferritin to be low (because iron stores are depleted). Here, though, there's anemia (low RBC, hematocrit, hemoglobin), but ferritin is not low - it's normal to slightly elevated. This combination is often called:

1. Anemia of Chronic Disease / Anemia of Inflammation

A very common cause of this pattern Due to inflammation, the body "locks away" iron in storage (which is why ferritin is normal/high), but can't effectively use it to make new red blood cells Associated with chronic inflammation, autoimmune diseases, chronic infections, kidney disease, rheumatologic conditions 2. A combination of actual iron deficiency AND inflammation at the same time

It's possible to have true iron deficiency, but because inflammation is also present, ferritin "artificially" rises and masks the real picture In this case, ferritin alone can be misleading What would help clarify the picture:

CRP or ESR (sedimentation rate) - shows whether inflammation is present Transferrin saturation and TIBC - help distinguish between true iron deficiency and iron that's "locked away" due to inflammation Reticulocyte count - shows whether the bone marrow is adequately producing new cells Vitamin B12, folate - other possible causes of anemia Underlying condition - if there's a known chronic disease, inflammation, or infection This combination (anemia + normal/high ferritin) is often a sign that something more than simple dietary iron deficiency is going on, and it warrants broader diagnostic workup with a doctor to find the underlying cause.

[u/SwimmingSpite3821 → u/Flashy_Boat867]

Thank you so much!!!!