Your Medical Tests: When Normal Isn’t Quite Normal

Any time you go to a physician’s office and have a lab test done, x-rays taken or any other diagnostic test performed, get a copy for your records and, if you go to another healthcare provider for the same issue, bring a copy of your test results. Never settle for “they said it was a little low but I don’t need to take anything.” On many occasions I’ve asked people to bring in their lab tests only to find that a “little low” isn’t acceptable. And, the most common tests that doctors aren’t aggressive enough with – vitamin D and iron.

While the “normal range” of vitamin D is 30 – 74 ng/mL, experts recommend doses of 50-70 ng/mL for optimal health. And, even if you are just a little below normal, supplemental doses of vitamin d may take a long time to get your blood levels up above the lower cutoff. Keep in mind that people respond very differently to both supplements and prescription doses of a vitamin or mineral. Some of us need less while others need a lot more to maintain adequate levels of the nutrient in our body.

Testing for iron isn’t so clear cut, mainly because you should, optimally, get a full iron panel to see where you stand. Just getting your hemoglobin and hematocrit tested may mean very little. And, even if your ferritin (your storage form of iron) levels are within normal limits they may still be indicative of iron deficiency anemia. For more information, see Figure 1 on this page titled Diagnosing Iron Deficiency Anemia.

Be your own health advocate by doing your homework so you are informed and know what questions to ask. After all, you know your body and how you feel better than anyone.

Restless Leg Syndrome: Tips for Prevention

A few years ago I first heard about restless leg syndrome and just couldn’t imagine it was a real phenomena. An urge to move your legs at night because it feels like something is crawling up them, they ache or feel pulled? That would constantly make a person wake up! Indeed, it does... and restless leg syndrome is one of those things that scientists just don’t know much about, which makes it really tough to treat. However, there are a few key things you can do (this list is compiled from a mix of the research and what my dietitians colleagues, with decades of combined experience, have uncovered from working with their clients):

1. Avoid emotionally upsetting events. Or rather, learn coping skills since life can throw you a curveball sometimes.

2. Get a good bed. After all, your sleep will improve no matter what if you have a good mattress, sleep in a room cool in
temperature with no lights (cover up those bright red displays on TVs, clocks etc. and turn your phone off or put something
over it so it doesn’t light up incessantly).

3. Get your storage form of iron, your ferritin, checked (this is a must, don’t settle for only having your hemoglobin and
hematocrit checked). Iron deficiency anemia can cause restless leg syndrome. Your ferritin levels will likely need to be
above the lower limit (12 ng/mL) to alleviate your RLS symptoms. A ferritin level above 50 ng/mL is necessary.

4. Consider a nighttime calcium/magnesium supplement to help you sleep.

5. Relax before bedtime, avoid any stimulants (caffeine, nicotine) and of course, avoid alcohol.

For more information restless leg syndrome, check out this blog.

Blood Tests for Iron Deficiency Anemia

Iron deficiency anemia is a little confusing. Hemoglobin and hematocrit are the two most common tests for this kind of anemia but they really don't tell the full picture. Instead, a full iron panel can tell your physician more about what is going on in your body. Here's a look at what a full iron panel tests for:
Hemoglobin (Hgb) – is a protein in red blood cells that carries oxygen to your body’s tissues and carbon dioxide from your tissues to your lungs. Low levels of hemoglobin indicate that the body has a reduced capacity to carry oxygen throughout the body.

Hematocrit (HCT; or PCV, packed cell volume) – this measures the percentage of red blood cells in the blood. So for instance, if your HCT is 40%, this means that 40% of your blood volume is composed of red blood cells.

Red Blood Cell Count (RBC) – bed blood cells are your oxygen carrying cells. A low RBC signals anemia.

Transferrin – a transport protein that carries iron. If a person is iron deficient, transferrin levels will be high.

Serum Iron – measures the quantity of iron in the blood that is bound to transferring. Serum iron levels are low if you are deficient in iron.

TIBC (Total Iron Binding Capacity) – measures your body’s ability to transport iron. If a person is iron deficient, their TIBC will be high.

Ferritin – measures your iron stores in the body. When your blood levels of iron drop, your body can pull iron from your ferritin. Lower levels of ferritin signal iron deficiency.