92-year-old Female with elevated Ferritin Levels

Hi @dave01 Welcome to Mayo Connect. Members in forum aren’t medical professionals so we can interpret test results or offer medical advice. However we can use our experiences to offer assistance or help find answers for each other.

Taking a look at your mom’s blood results, most of her numbers aren’t that far off the normal ranges with the exception of the Ferritin. That is an eye opener.
The two most common culprits of an iron overload are iron supplements or blood transfusions? Is your mom on supplements or had multiple blood transfusions recently?

This is what our Mayo website has to say about High ferritin levels
-https://www.mayoclinic.org/tests-procedures/ferritin-test/about/pac-20384928
Another source I found with some good information is this site from Doctor’s Health Press:
-https://www.doctorshealthpress.com/high-ferritin-levels-causes-tests-treatments/

You’re wondering what comes next. Most likely her doctors will request a few more detailed tests to search for the cause of her iron overload. They may check her liver enzymes for any liver involvement and possibly her spleen.
Were there other numbers in her blood panel for ALP and ALT?

How’s your mom adapting to her new surroundings? Did she recently move from her home to memory care?

So, looking at the various blood panels they show the ALT(SGPT) at 15 Units/L with the Range being (0 - 33) so that seems pretty good. I am not seeing an ALP, but I think this is what they are using Alk Phos at 73 Units/L with the range being (35 - 105) so here again this seems pretty good. Yes, I had to move her from her house where she had live alone for a long time to a Memory Care Facility about 5 weeks ago, she is bewildered, confused, doesn't want to eat or drink, insists she doesn't have an appetite, and has been steadily dropping weight, they just recently put her on an appetite stimulant to try and get her to eat. She adamantly believes she don't need any part of this, but once you're around her for a bit it's pretty obvious we're here because there aren't any other options based on her cognitive ability.

Oh gosh, that’s a difficult position, isn’t it, we need to help our parents transition into that next and perhaps final phase of their lives. I’ve been there too and it’s hard to accept for all parties involved. They were our bastions of strength and guidance all our lives and now the rolls are reversed. Our ‘inner’ child has a difficult time being an adult at that point…but we use what we’ve learned from them about empathy, responsibility and caring to provide the best, compassionate solutions for their longterm care. Still feels like a sucker punch though.

Those are the numbers I was looking for…ALP (alkaline phosphatase) and ALT. If the ALP results were high it can indicate some liver disease, which could be a culprit in her elevated ferritin levels. But her numbers are pretty normal.

So I’m sure there will be some more tests to determine what’s causing the iron imbalance. I hope the appetite stimulant helps her get some much needed nutrition and strength. And I also hope she adjusts to her new environment once she settles in a little more and feels familiar with people, makes some table mates with meals, and maybe gets involved in some of the activities in the Memory Care Facility.
We do have a group in Connect for Caregivers who have family members with dementia. https://connect.mayoclinic.org/group/caregivers-dementia/
There are many conversations in this group with people who are in your same situation as caregiver that might offer you some suggestions to help her accept her new living arrangements.
I’d like to follow along with the ferritin issue. Let me know how she’s doing, ok?

So just an update, still no real definitive answer as to what's causing the extremely high Ferritin numbers, the Doctor put her on 500mg of Cipro 2 times daily, for 10 days, he wants to rule out infection. His belief is that Cipro is a well-tolerated fairly broad-spectrum antibiotic, and once that concludes we'll see where we are. So COVID kinda confounded the issue since it also messes with the Ferritin numbers, so right we're kinda in a wait & see mode until the COVID passes, fortunately her symptoms are mild, little cough, tiredness, and weakness, so just hoping we can get a negative test soon and that will be a relief, since we kinda went into it in a compromised state. The appetite stimulant appears to be working as she is eating and drinking better. We did move her over to the Skilled Nursing Unit since we were thinking she might need an I.V. if her fluids situation didin't change, so we're undergoing another situational transition due to a new setting, so she they gave her a couple low doses of Ativan initially to help smooth the transition. So more to come, she's still very weak and tired,

Thank you for the update, @dave01 Your poor mum didn’t need to add Covid to the mix. It’ll be interesting to see if the Cipro has any effect on her symptoms. If you can get her some yogurt to have once a day between doses that might help her out with any intestinal side effects from the antibiotic.
It’s encouraging to hear she is improving with eating and drinking. I’m sure this is all so alarming for her to be in a strange environment and then having all this medical attention. It can be pretty jarring for someone in Memory Care. How are you holding up?

My husband Will came down with COVID and was so weak, he barely made it to the hospital and could not slide into his bed from the gurney without help. He could barely talk. He was in the hospital for 3 days and they gave him a daily shot of the vaccine intravenously. He recouperated very fast and was ready to come home after the 3rd day. Will had all the shots, including the last Booster and doctor said it was a different variant of the virus.

I am a medical technologist and I am concerned with the CBC. Your mother's MCV and RDW along with her hemoglobin and hematocrit, indicate a macrocytic anemia. I'm guessing it is due to Vitamin B12 deficiency. Her lack of appetite and fatigue goes with it. I would ask to have a Vitamin B panel or at least a Vitamin B12 and Folate done. Tests that are better indicators are also MMA and homocysteine. Unfortunately, once a person gets to their 90s, doctors write everything off to dementia. I went through it with my mom when what she had was delirium due to a UTI which wouldn't show on testing. Once she was on an antibiotic, she was as sound as ever. I fought like crazy with the doctors until the bacteria finally showed up. Hopefully, you can get the doctors to order the B12 test. Good luck. It isn't an easy thing to go through.