If ferritin level is high (double uln) but iron and tibc are low in pt. with remote gastric bypass, is iron replacement still recommended.?

Probable: A high ferritin can be interpreted as an acute phase reactant or chronic inflammation, but if your iron level is low, this can suggest deficiency. Having gastric bypass does cause iron absorption issues including others such as calcium. Routine specific labs are recommended for all bypass patients. Have your primary take a further look at this whether you would need chronic iron supplements.

Not really: What you need is a workup for hemochromatosis. This is a disease of how the body handles iron. You need to know why your ferritin is up before treatment starts.