Okay so a patient's ferritin is 1380 ng/ml and their TSAT is 11, HGb has been dropping and the Crit is now 30.6 EPO use is rising - DOQI tells me to hold IV iron - What to do?

EPO stimulates GI absorption of Iron - try heme iron - patients can take it with meals and binders and they don't get constipated, actually gets absorbed - Check it out

Our facility uses an IV Vit.C protocol.

Evaluate the patient for:
1. Infection
2. Inflammation
3. Aluminum toxicity
All of these can cause the body to put up a protective "barricade". This process keeps the iron stored (ferritin) but not available for use (tsat). There is nothing you can do to make the ferritin shift. All of the above issues will cause the problem.

This is interesting. Can you tell me where I can get info on labs? I've seen the chart that explains labs, but I would like more in depth info that explains the values and how they interact.