Until recently, I was just beginning to come to terms with my chronic hepatitis B and started monitoring it more carefully.
Then I got hit with something unexpected — a high iron panel, especially transferrin saturation at 84%. This was my first-ever iron test, so I have no previous values to compare.
I haven’t seen a doctor yet (my appointment is in 2 weeks), and I haven’t done a genetic test for hemochromatosis yet.
But these results have pushed me into deep anxiety and even depression. I’m 32, and I keep thinking this adds a massive new risk to my liver and health overall. I’m overwhelmed and afraid that my chances for a long life are now much lower.
It’s been 3 weeks since I’ve started trying to limit iron in my diet. I’ve lost weight due to stress and fear of eating anything “wrong.”
I’m the kind of person who takes every abnormal result very hard, and this has really shaken me.
Please, if anyone has experience with iron overload and hepatitis B — or has faced something similar — I would be incredibly grateful to hear from you.
• How dangerous is this combination?
• Can both conditions be managed safely in the long term?
• Does this drastically reduce life expectancy?
• How serious is this situation really?
Thank you for reading. Any advice, support, or shared experience would mean a lot to me.
Hi @Berserk123,
I empathize with you, as results like this can sound scary. You need not panic or worry yourself too much about this. Worrying and over-stressing yourself can be worse than the test results. I know it is in our nature (as humans) to worry/fret over stuff that is not normal. From the little research I was able to do, if the levels remain high, then it might affect the liver. I am glad you have an appointment to see a doctor about this. Both conditions can be well managed. Decreasing your blood iron levels will be key here. For now, you can avoid red meat or decrease your intake. Reduce your consumption of anything high in iron.
See the doctor in 2 weeks, and let’s see what they say or think. Remain hopeful. Best, Bansah1
Hi @Berserk123,
Yes, you can live a long life. It all depends on your will, attitude, and perception. If you believe you won’t, then you won’t. Both conditions can be managed. Please, see your doctor first before throwing in the towel. I understand where you’re coming from, but sometimes we over-stress ourselves over things that turn out not to be that bad. There are various treatment options available to help patients with this condition. Life is not a straight line, it is up and down. Challenges abound, and we can overcome most of them because we have the will and strength to do so. Don’t lose hope or give up. Stay strong. Bansah1
“Yes, you can live a long life. It all depends on your will, attitude, and perception. If you believe you won’t, then you won’t.”
I don’t think that’s a very helpful thing to say. Worrying about hepatitis B (or any other illness) will not make it worse. Saying such a thing could increase a person’s anxiety.
Hi @Barry,
I think you might have misconstrued my post. The response you mentioned is a response to an earlier message. I was just making the point that we can overcome a lot if we have the will, appropriate attitude, and perception. I am speaking in general terms and not in absolute terms here. Neither was I suggesting that he might not live long. But in general, if we always believe in negative stuff, then that’s what we might see or experience.
I am not saying people should not worry. I was saying you can worry, but don’t worry to the point where it affects you and you want to give up. I was also trying to encourage him to think positively and see things in a different light or perspective.
He mentioned being over-stressed and not able to eat because of worrying. I stated that putting himself through that is not helpful. Stress affects our health which is why we are advised to reduce it. That is in no way saying one should not worry.
It is never my goal or intention to increase someone’s anxiety but rather to encourage them to see that all is not lost because they have an abnormal test results.
Until recently, I was just beginning to come to terms with my chronic hepatitis B and started monitoring it more carefully.
Then I got hit with something unexpected — a high iron panel, especially transferrin saturation at 84%. This was my first-ever iron test, so I have no previous values to compare.
I haven’t seen a doctor yet (my appointment is in 2 weeks), and I haven’t done a genetic test for hemochromatosis yet.
But these results have pushed me into deep anxiety and even depression. I’m 32, and I keep thinking this adds a massive new risk to my liver and health overall. I’m overwhelmed and afraid that my chances for a long life are now much lower.
It’s been 3 weeks since I’ve started trying to limit iron in my diet. I’ve lost weight due to stress and fear of eating anything “wrong.”
I’m the kind of person who takes every abnormal result very hard, and this has really shaken me.
Please, if anyone has experience with iron overload and hepatitis B — or has faced something similar — I would be incredibly grateful to hear from you.
• How dangerous is this combination?
• Can both conditions be managed safely in the long term?
• Does this drastically reduce life expectancy?
• How serious is this situation really?
Thank you for reading. Any advice, support, or shared experience would mean a lot to me.
There are some minor abnormalities in the liver function (bilirubin is elevated) and elevated iron / transferrin is common in people who have HBV infection. However, none of these issues are really dangerous or affect long term outcomes and you should not have anxiety about them. These results are also not really influenced by dietary iron intake so I would stop worrying about this as well.
However, with these results, we are seeing signs that your liver is starting to be affected by your HBV infection (even though your HBV DNA results show relatively low levels of replication). THe most important thing is to stop any progression of liver disease which may be starting to develop. You should discuss starting antiviral therapy for HBV with your doctor with the expectation that once HBV replication is much better suppressed, these results will come back into the normal range.
So, even with my relatively low viral load, is my liver already damaged? And does this mean I need to start antiviral therapy now? I’m really afraid of fibrosis. It feels like everything is going in a bad direction.
Could it be that this was just a temporary failure or spike?
I’ve just been reading a lot of information online, and almost everywhere it says that hepatitis B doesn’t directly affect iron levels in the blood. As one of the possible causes, it might play a role, but in most cases it’s some other problem that worsens the course of hepatitis B.
Re iron, you are correct but elevated ferritin /iron etc are common in patients with HBV and is not associated with altered outcomes (unless liver disease is allowed to progress to cirrhosis).
However the above is a minor point…more important is that you have elevated bilirubin and HBV replication is significant (but not high). Your ultrasound and HBV DNA are also old so this should all be redone again to see about starting therapy.
Hi， @Berserk123
Firstly, from your test results, although your liver function is normal and the liver ultrasound is normal, the hepatitis B virus DNA (HBV-DNA) is slightly high. You are already 30 years old, but you must pay attention that low levels of hepatitis B virus can damage your liver, and these viruses cannot be detected in serum liver function tests. Therefore, you need to start antiviral treatment to prevent the hepatitis B virus from damaging the liver.
Secondly, for the iron test results:
Recheck iron metabolism indicators to exclude experimental errors.
Dynamic monitoring of ferritin to observe whether it gradually increases.
Liver biopsy or MRI if necessary to directly evaluate the degree of iron deposition).
Third, You need to adjust your mindset. Your current situation does not affect your life at all, so don’t be anxious or nervous.
Wow, do I really need to do a biopsy? Isn’t it enough to do an ultrasound and FibroScan? Don’t those also give reliable results that can be trusted?
I’m very afraid that my liver might already be damaged and that this would be a death sentence for me… and that I won’t live long (((
I understand that nothing is affecting my life right now, but I constantly think about how in a few years it might start to affect me. And that doctors might smile at me just so I don’t panic, while deep down they’ll know I don’t have much time left.
These thoughts don’t leave me from time to time.
Right now, I’m very scared to do the FibroScan, because it might show that my fibrosis level is no longer F0 like it was 10 or 12 months ago.
I’m afraid that my condition has already shortened — or will shorten — my life, and that’s terrifying.
And God forbid hemochromatosis is added to all of this — that would make my problem even worse.
Hi @Berserk123 ,
You still don’t have to worry. Even if your fibroscan shows Fo, or F1, F2, fibrosis may still be reversed if you receive antiviral treatment and try not to take drugs that damage the liver. It is recommended that you check Fibroscan to understand the degree of liver fibrosis.
A liver biopsy is done to find out whether iron metabolism is too much deposited in the liver. It can be considered, but it is not necessary at present.
Re iron. I have had anemia for decades. I (55F) used to have iron deficiency. Ferritin has become normal in recent years. Celiac and hemoglobinopathy have been ruled out. Does chronic hepatitis increase ferritin to normal in my case? Do I still have 1) iron deficiency anemia, or 2) alpha thalassemia trait, or 3) both? Thank you.
May 2018
Ferritin 20 (range 12-125 ug/L)
Dec 2023
WBC 5.4 (4.0 - 11.0 x E9/L)
RBC 4.91 (4.00 - 5.10 x E12/L)
Hemoglobin LO 113 (120- 160 g/L)
Hematocrit 0.356 (0.350 - 0.450 L/L)
MCV LO 73 (80 - 100 fL)
MCH LO 23.0 (27.5 - 33.0 pg)
MCHC 317 (305 - 360 g/L)
RDW HI 15.5 (11.5 - 14.5 %)
Platelet Count 174 (150 - 400 x E9/L)
Based on your blood work you do not currently have an iron deficiency. A potential link between chronic HBV and iron / ferritin elevation is liver damage in persons who are not receiving antiviral therapy. Your doctor will have performed these assessments (liver function tests and perhaps an ultrasound) prior to placing you on therapy. Are you taking antiviral medication for your infection? Thalassemia can be confirmed by a genetic test.
Viral load 4log, ALT ~ 40s, ultrasound normal, fibroscan f0-1. Not yet on medication.
My Complete Blood Count has been like this for years: RBC high, Hemoglobin low, MCV low, MCH low, RDW high. FIT test was normal. Is this hbv related, or I need to confirm thalassemia trait? Thank you.