Ask a doctor on the topic of General medicine

Iron level Anxiety Heart failure or heart enlargement

May 2, 2019 | 20,00 EUR | answered by Christian Welsch

Dear Sir or Madam,

I have the following problem: my family doctor will not be available for another week, and I already have an appointment scheduled with him. I recently had a iron test done because I have been experiencing frequent heart palpitations and have had relatively heavy periods (the last one was particularly heavy from April 22nd to April 25th). At the time of the blood test, I also had mild sore throat, but it has since subsided. I received the results today: Hemoglobin at 133g/L, iron at 7.4 umol/L, T.I.B.C at 57 umol/L, and transferrin saturation at 13%. The transferrin saturation was very low, with 20 being indicated as the lowest threshold.

I have read that a low iron level can lead to heart failure or an enlarged heart, potentially resulting in sudden cardiac death. I am experiencing a lot of anxiety about this possibility. I am 28 years old. I had a 24-hour ECG in fall 2015 and an ultrasound and 24-hour ECG in fall 2014 due to the heart palpitations, which did not yield any negative results. However, this time period is certainly enough for heart failure or an enlarged heart to develop. My resting heart rate is between 74-87, depending on my stress level, and it can go up to 120-130 during a walk. I am currently not engaging in any physical activity other than yoga. My blood pressure is usually around 112/76 or lower. I do not have any leg swelling or shortness of breath (at least not consciously) and can walk long distances without any issues.

How would you assess the situation? Should I arrange for an ECG and echocardiogram as soon as possible (I would have to pay for it privately as I am currently abroad) to see if there is a problem with my heart? Can an enlarged heart or heart failure be seen on an ECG, or is an echocardiogram always necessary? At what point does the transferrin saturation level become so dangerous that it can lead to life-threatening heart problems? The more I search on Google, the more worried I become. I apologize for that. I understand that it is difficult to make a diagnosis from a distance, but I am very concerned about whether I need to take immediate action.

Thank you and best regards.

Christian Welsch

Hello questioner, first of all, forget Dr. Google, he is the worst doctor there is. You have an iron deficiency because like many women, you lose iron every 28 days. Your body gets used to it. Have your ferritin levels checked to know where your stored iron is and take an iron supplement. I find it impossible for you to develop heart damage with this constellation of findings. Regards, Welsch.