Ferritin

[MissDuke]

I am not usually one to ask for health advice on the internet, but thought I would just run this by you knowledgeable lot! I have been feeling ridiculously exhausted of late, muscles ache and I have no motivation to do any exercise so I have put on weight. I am losing hair at an alarming rate and feel out of breath from just walking up the stairs. I am usually very fit and well so this is really getting me down. I should add that I have a very busy and stressful job but I love it, so not convinced that is the cause - but who knows?

Anyway, GP took bloods and said they are fine, which I am happy to accept but also wondering if iron supplementation could help me to feel better - therefore I am keen to hear others experiences.

Hb 130 (range 120-150) - I know this is excellent.
TSH 3.31 (range 0.3-4.2) and FT4 15.6 (range 10.6-23.2) - again, seems very good.
Serum iron 12 (range 10-30)
Ferritin 12 (range 15-150)

Is there any chance that increasing the ferritin could make me feel better despite the iron and Hb being within normal limits?

Thanks for reading

I precede this by saying I have no medical qualifications.

I had similar symptoms to you and a ferritin level of 13. I was told to increase my iron levels by GP as it would help transport(?) the ferritin or something like that.

Basically my iron levels were fine but I needed more iron to boost the ferritin.

Yes, there is a chance.

I have been borderline anaemic for over 20yrs (going between anaemia and just above the threshold continually) and only in the last year or so have they tested my ferritin levels which are very low. I am not currently anaemic but finally I have a GP who is interested in the iron stores (ferritin) and is insisting on retesting my blood every 6 weeks.

My ferritin was 9 originally and she said they like to treat anything under 50. I have an irritable bowel and get really bad stomach problems from traditional iron supplements hence the reluctance to take them long term and the in/out of anaemia. I have now discovered spatone though and have been taking them daily.
After two months my ferritin went up to 12 and I am currently taking two spatone sachets a day in order to speed up the increase. I am being tested again in another 6 weeks.

The spatone for me is a revelation, expensive as it is non prescription but it means I can finally hopefully get rid of the permanent tiredness.

I am tired today but am generally beginning to feel a bit better, I am hopeful that increased ferritin will help longer term. I previously thought low ferritin didn't matter much if the haemaglobin was ok but recent researching has told me that is not the case.

Good luck!

Thanks for your replies! Bleeding heart did you find it made any difference to your energy levels?

Witty, that is very interesting, thank you. I have also dipped in and out of being anaemic over the years but had never had my ferritin tested before. I am a blood donor and at least once a year am turned away for low hb. I think I will give the blood donation a miss for a while? I am so glad to hear that you are starting to feel better and hope that it continues!

Yes I was a blood donor about 20yrs ago then managed one donation about 5 yrs ago when I fainted and then kept ending rejected again so have reluctantly given up.

It is a shame! I am O neg so they text and ring me to remind me to go each time since its in demand, I really don't like missing it.

Op normal ferritin used to be taken as either 15 or 20 however evidence shows that for those that have symptoms raising this to > 50 can resolve a multitude of symptoms. Really you want a prescribed dose at least twice a day, drinking orange juice with meal helps the body absorb the iron.

Yes definitely! Did your GP not prescribe you iron tablets? My ferritin was recentlt 14, I've been on ferrous fumurate for 4 weeks and starting to feel the benefit esp re the terrible exhaustion I was experiencing. So I'd strongly iron supplements!

My ferritin has been low for a few years now. It was 2 and my hb was 8.4, last test result was 9 but hb had gone up to 12 after several months of ferrous fumarate. GP did tell me that doctors are taught that low ferritin with decent hb won't cause symptoms but she's seen evidence otherwise too many times so she wanted me to continue. I know I was still feeling crap at a level of 9. Feel crap now but had to stop the iron as it was making me constipated! Def worth trying iron though

Another thing is that if your ferritin is low and your iron intake is insufficient then sooner or later your haemoglobin will drop too, as there is no iron to used. This keeps happening to me.

I have had unmanageable side effects with all of the available prescription iron tablets and I had to have an iron infusion a couple of months ago when I became severely anaemic, which brought me up to almost normal levels for a while. So my team's plan was just to wait for me to get ill enough for another infusion.

But about a month ago I came across these Feroglobin capsules, which claim to be gentler on the stomach. So I've been taking them for 26 days and counting! They don't seem to have any side effects at all. So if you have issues with normal tablets then these might be an option. I am waiting for my next blood tests to see if they've actually worked... :)

I cannot donate blood after cancer treatment. It's the most upsetting part of the whole experience, it seems like such an easy way to help someone (and get free biscuits!). But once your iron levels are up you should be able to donate again :) until I had a transfusion I had no idea how miraculous it was, I could almost feel the life flowing back into my veins. So it's a fab thing to do

The difference here OP is between being in the reference range and being optimal.

Your Hb is below mid-range
Your serum iron is below mid-range
Your ferritin appears to be below range

Also:

In a healthy person, you would expect the TSH to be around 1. Yours is 3.31. Add this to the fact that your FT4 is again in the bottom half of the reference range, when it should be near the top, and your thyroid appears to be failing.

It looks rather as if you need another conversation with your GP sooner rather than later, about iron supplementation, which must be a priority, but also about your thyroid. It would be helpful if your GP would also test vitamin B12 and folate as they are also likely to be low.

Thanks everyone, I really do appreciate all of the replies. I will definitely make a trip back to the GP and discuss all of the results. Thanks for the specific recommendations of supplements too.

Martha I am sorry to hear about your cancer and hope you are recovered and keeping well.

dotty why not try spatone or there feroglobin someone else mentioned?
Spatone has little if any effect on my stomach but I can't take the standard iron supplements. It is increasing my levels but at a slower rate, still doing the in though

MissDuke thanks, I'm fine now, and sorry I didn't mean to play the cancer card, only empathising with the blood donation

I hope you are able to get some answers from your GP. It might be worth seeing a different doctor if the first one was dismissive.

I hope you feel better soon

Ask for vitamin d to be tested too. I'm another one thinking this could be a thyroid issue causing you to feel rotten. Once your ferritin comes back up and it could take a while, you will feel so much better and no more hair falling out

Thanks again everyone! Martha, not at all, I am always interested to hear of other people's experiences. I am so glad you are feeling better

Poshpenny, Funny I did get vitamin D tested too but got the result later so hadn't posted it. It is 32 nmol/l which is 'insufficient'. The problem is, I had the test done through city assays, which is totally legit, but means I cannot get anything from the GP to sort it? What do people do in this situation?

Had a strange experience the other day which is probably unrelated since my Hb is ok, just ferritin is low. I fainted in work, a proper full on black out, have fainted before but never totally out cold like this. Was such a scary experience. I work in a hospital so the nurses insisted I go to A&E and they did a few tests which were fine.

Really hoping it was just a one off!

1 - Yes, taking lots of "gentle" iron will help. My GP told me I need to take enough to get 100mgs of elemental iron a day. Feeling tons better.

2 - Vit D is very cheap and also v. impt. See other thread on General Health - can't be far away it was on the first page yesterday... the RDA is I think 800ius a day.. my GP has me on 8-10,000 at the moment

3 - In other countries the range for thyroid is different in some as low as 0-2. Ranges are based on all the blood tests they do and using a formula to work out where the majority lie. They're thinking that ALOT of people have thyroid problems and this is skewing the range.

Reference: One of the largest studies of thyroid problems in a population is the Whickham Survey, which studied the thyroid levels of 2,779 randomly selected adults living in the town of Wickham in England from 1972-1973 and subsequently followed for 20 years. Data from the twenty-year follow-up published in 1995 demonstrated an increased risk for the development of hypothyroidism once TSH exceeds 2.0 mIU/L.
Vanderpump, M.P., Tunbridge, W.M., French, J.M., Appleton, D., Bates, D., Clark, F., Grimley Evans, J., Hasan, D.M., Rodgers, H., Tunbridge, F. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf) 1995 Jul;43(1): 55-68

Actually, that last reference doesn't refer to the same issue, but still recognises the need to lower the reference...

I take 3000 Vit D in an oral spray which is often absorbed more easily

Thanks everyone, really appreciate the input Interesting Lucre, thanks. Currently working my way through the thread you mentioned.

Your hair is falling out and you have other thyroid symptoms... Is say your Thyroid level is a bit high (despite being "in range".

You might want to push for a thyroid antibody test (for autoimmune thyroiditis or Hashimoto's thyroiditis).

I take vitamin D drops from Boots. I found the tablets my GP prescribed made me feel sick, but the drops are fine.

Haven't read the rest but when I was having issues thyroid related both endo and GP didn't class ferritin as good /normal till it was over 70-80. I got mine to 130 and it helped a lot.

I'm not sure about thyroid. Technically in range but I'd want that kept an eye on. It would be ok if you were trying to get pregnant and had had mc.

However, if ferritin were higher it might be enough to help things out. Vit d and b12/ folate worth looking at too.

Call me Mrs cynical but if the lab range was reduced to 2 for tsh as described below an awful lot more people would be on thyroxine - but currently you get prescriptions free if On thyroxine. So a lot more free prescriptions. And I think people struggle on with tsh around 3 trying to cope the best they can. So the status quo stays the same.

Climbs off soap box.

I'd forgotten that in the UK you got all free scripts if on thyroxine. Sadly I think the financial/political undoubtedly has an impact.
Having said that, there are allegedly women and let's face it it's hugely a women's issue which again imvho is a reason not to hurry to make changes (feminist rant emoticon) who need to keep to almost 0 to feel ok and those with much higher results who feel fine. But tsk! Prescribing to symptoms rather than blood results? Whoever heard of such a thing!

As others have said, your TSH isn't fine and your ferritin is really low. Mine is 22 and as I also have a TSH of 3.8 (I'm on thyroxine, just increasing my dose due to those results) I have been feeling much the same, but your ferritin is a lot lower than mine. You need iron, you need an anti body blood test, and I think almost certainly you will need thyroxine.