Blood Results - March 2026
Patient: Anthony G. | Age: 37 | Male
Context
- Diagnosed ADHD and Autism Spectrum Disorder
- Currently taking Elvanse (lisdexamfetamine) 70mg daily
- Previous ferritin 738 ug/L (Dec 2025) with elevated Transferrin Saturation — reduced via dietary changes; see Blood Results - December 2025
- Presenting symptoms: extreme fatigue, burnout, aching lower back
Iron Studies
| Test | Result | Reference Range | Status | Notes |
|---|---|---|---|---|
| Serum iron | 32 umol/L | 14.0 - 32.0 | At upper limit | See Iron Overload and NTBI |
| UIBC | 53 umol/L | 44.0 - 71.0 | Normal | |
| Transferrin saturation | 60% | 20.0 - 50.0 | HIGH | See Transferrin Saturation - Clinical Significance |
| Serum ferritin | 380 ug/L | 30.0 - 400.0 | High-normal | Down from ~700; see HFE Compound Heterozygosity |
Mineral Panel
| Test | Result | Reference Range | Status | Notes |
|---|---|---|---|---|
| Serum copper | 14.3 umol/L | 12.0 - 26.0 | Low-normal | 16% into range; see Copper-Zinc-Iron Interactions |
| Serum zinc | 12.5 umol/L | 11.0 - 24.0 | Low-normal | 12% into range; see Copper-Zinc-Iron Interactions |
| Caeruloplasmin | 0.206 g/L | 0.15 - 0.3 | Low-normal | 37% into range; see Ceruloplasmin and Ferroxidase Activity |
Liver Function
| Test | Result | Reference Range | Status |
|---|---|---|---|
| Total protein | 76 g/L | 60.0 - 80.0 | Normal |
| Albumin | 48 g/L | 35.0 - 50.0 | Normal |
| ALP | 60 iu/L | 30.0 - 130.0 | Normal |
| Bilirubin | 11 umol/L | < 21.0 | Normal |
| ALT | 27 iu/L | < 50.0 | Normal |
Normal LFTs are reassuring — no current hepatic damage from iron loading. However, ALT can remain normal until significant fibrosis develops.
Copper Reference Ranges
| Population | Range |
|---|---|
| Neonates (<6 months) | 3-11 umol/L |
| Adults and children (>6 months) | 12-26 umol/L |
| Healthy pregnant women | 27-40 umol/L |
Plasma copper increases as an acute phase response. Low-normal copper with normal ceruloplasmin suggests genuine low copper status rather than masked by inflammation.
Genetics - HFE Diplex
Result: Compound heterozygote for p.(Cys282Tyr) and p.(His63Asp)
See full analysis: HFE Compound Heterozygosity
Key points from the report:
- ~90% of Type 1 HFE haemochromatosis cases are C282Y homozygotes
- Compound heterozygotes (C282Y/H63D) "will seldom develop clinically significant iron overload"
- However: your transferrin saturation at 60% and prior ferritin of 700 suggest you are in the minority who DO load iron
- Extended family screening not recommended for C282Y/H63D genotype per current guidelines
Key Patterns Identified
- Iron is at the upper limit everywhere despite dietary changes: iron at ceiling, TSAT 20% above range, ferritin still high-normal
- Both copper and zinc are low-normal: possible competitive displacement by excess iron (see Copper-Zinc-Iron Interactions)
- Liver function is preserved: no current hepatocellular damage
- The genetic-phenotype mismatch: your genotype is "low risk" but your biochemistry shows ongoing iron loading
Cross-References
- HFE Compound Heterozygosity
- Iron Overload and NTBI
- Transferrin Saturation - Clinical Significance
- Copper-Zinc-Iron Interactions
- Ceruloplasmin and Ferroxidase Activity
- Iron-Dopamine-ADHD Axis
- Elvanse and Mineral Metabolism
- Fatigue and Burnout
- Arthropathy and Back Pain
- Dietary Management - Iron Overload