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Original question: "Can a celiac have abnormal iron tests (ferritin, total iron binding capacity and any others) while having normal hemoglobin and hematocrit levels?  In other words, if you're not anemic, does that automatically mean your other iron tests will be normal?"
Short answer:  Iron tests CAN be abnormal while hemoglobin and hematocrit are in normal range.

Hemoglobin and hematocrit test the number of red blood cells you currently have in your blood stream and indicates if you are iron deficient anemic.   Since the half life of red blood cells is 3 months, hemoglobin and hematocrit are recent measures of iron storage.  Other iron tests such ferritin, total iron binding capacity and iron saturation indicate current iron stores that can be used for production of red blood cells; therefore they predict your future.  If your hemoglobin and hematocrit are normal but the other tests are low you will become anemic since you currently do not have enough iron the make new red blood cells as your current red blood cells wear out.

So anemia occurs toward the end of a process of falling iron stores, which may have been in progress for many year of undiagnosed CD. Although a variety of tests are available to assess iron levels, measurement of an individual's serum ferritin is by far the most useful single measure of iron status, because it accurately reflects body stores and because it is usually the earliest laboratory measure to reflect iron deficiency. Serum ferritin is a sensitive test for indicating both iron deficiency and iron excess. It is not affected by day-to-day fluctuations in iron intake. Also, it correlates well with the clinical effects that can be caused by iron deficiency and iron excess.

Good health to all, 
Cheryl in PA

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