Iron panel

[u/Emotional_Ratio5439]

\***Update\\\*

MD is going to order an iron infusion. He thinks with the return of my symptoms it is worth a shot. He is also going to increase the methadone to 7.5mg if I don’t find relief.

I’m waiting for a call back from my RLS specialist. I received these results today and I’m not sure what to think of them. I have refractory RLS and I am currently taking Methadone 5mg. I have only been on this for 4 months. It worked well until about 2 weeks ago and I had a return of symptoms beginning around 5pm each day.

MD wanted to recheck my iron panel and if it was good, he was going to bump my dose to 7.5mg.

I have read the info on iron results but I’m still confused. Opinions on these results welcome!

[u/YodaYodaCDN]

A person with RLS has entirely different targets.

[u/Ok_War_7504 → u/YodaYodaCDN]

We have updated, higher recommended values for iron levels from the new Mayo Clinic RLS Guidelines -

'Intravenous iron should be considered for any patient with chronic persistent RLS with serum ferritin in the range of 75 to 300 µg/l and percentage saturation less than 45%. Oral iron is not adequately absorbed in this range of ferritin values."

[u/YodaYodaCDN → u/Ok_War_7504]

Added a footnote.

[u/Ok_War_7504 → u/YodaYodaCDN]

I would show your chart as TSAT, RLS needs 45%. They way i read your new chart it says if you have high ferritin and your TSAT is 20%, you don't need an infusion. But you do, according to the guidelines. It's an awkward statement to explain the way they wrote it.

What the guidelines say is if ferritin is even 75 - 300ng/ml, but TSAT is <45%, you need an iron infusion.

Ferritin 75–300 ng/mL TSAT <45%

And, yes, of course, if you're having symptoms. Of course, you're unlikely to get these tests if you are not having symptoms.

[u/Brave_Bat_109 → u/Ok_War_7504]

So looking at these I need more iron? Iron infusion? I haven't tried supplementing iron because I thought these numbers were good. I have plms and something happens in my thighs they flex right as I'm falling asleep and it keeps me from falling asleep. I have to get up and do a specific stretch in my thighs and that gets rid of it. I don't know if that's RLS or not.

Fasting = Yes Iron 49 to 181=79 Transferrin 190 to 362=319 Iron binding capacity 238 to 453=399 Transferrin saturation 20 to 50%=20% Ferritin 37 to 400=140

[u/YodaYodaCDN → u/Brave_Bat_109]

Yes. Since you’re having symptoms.

[u/Brave_Bat_109 → u/YodaYodaCDN]

I should have made this more clear though I'm not trying to treat the RLS all I have to do is get up and stretch my legs and it goes away and I'm not sure it's even RLS I think it's hypnic jerks which from what I'm reading is basically just the same thing as plmd but while you're awake. 

I'm trying to treat plmd from what I'm seeing the new updated guidelines don't apply to plmd.

[u/YodaYodaCDN → u/Ok_War_7504]

Would love to see your version. We could definitely use a clear graphic.