What Causes Increased FEP/ZPP Ratio?

Posted on Mon, 28 Jul 2014

Question: On a recent blood test I was rated "high" for my FEP/ZPP ratio. ( I think I have the letters correct). My reading was 46, and the suggested safe range was 5-35. I cannot learn what my trouble here is. I don't know if I am at risk of contracting some serious ailment. I cannot find out why I'm in trouble with this "high" indication. I cannot find out what this measurement is for ( the Dr who requested the test is at a loss to help me). I cannot find out why this measure is bad and what I should be doing to correct it. Can you quickly help? I have asked another online medical health forum the same and received no help
Thanks very much XXXXXXX

Answered by Dr. Indu Kumar (4 hours later)

Brief Answer:
High FEP/ZPP ratio is related to lead toxicity.

Detailed Answer:
Hello XXXXXX
Thanks for writing to HCM

Increased FEP/ZPP ratio is related to lead toxicity.It is usually done to screen and monitor chronic exposure to lead.It is also used to investigate iron deficiency anemia in children.
This test measures the level of zinc protoporphyrin(ZPP) in the blood.ZPP is normally present in red blood cells in small amounts but its value may increase in people with lead poisoning and iron deficiency.

ZPP may be measured by two ways:

1.The free erythrocyte protoporphyrin (FEP) test measures both ZPP which accounts for 90% of protoporphyrin in red blood cells and free protoporphyrin, which is not bound to zinc.

2.The ZPP/heme ratio gives the proportion of ZPP compared to the normal iron-containing heme in red blood cells.

People who work with products containing lead and person who live in older houses may be at an increased risk of developing lead poisoning.

Your symptoms also indicate towards lead toxicity.

You have been prescribed right medicines and you should continue it.
You should contact your doctor.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (13 hours later)

Thank you Dr XXXXXXX
My Rumetologist Dr also advised me to find a Toxicologist, which I am trying to do
- does this possible lead toxicity have any connection to my recently discovered peripheral neuropathy? ... Which I am seeking further tests on
- should I find a way to test the air at my home, office and car?
- are their foods, supplements, or meds I can use to reduce my lead?
- what coming possible harm to my body can I expect from this continuing lead toxicity? I want to get prepared
MUCH APPRECIATED!!'

Answered by Dr. Indu Kumar (19 hours later)

Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXXXX
Thanks for writing back

Yes,most likely peripheral neuropathy is related to lead toxicity.
You should consult toxicologist and try to find out the origin source which is causing toxicity.
Every thing need to be screened to find out the source.
Mainstay of treatment are removal from the source of lead and you may need chelating therapy after evaluation.

There are many systemic effects of long term lead toxicity.You don't worry about this.Timely intervention will reduce its complications.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Prasad