Iron levels - anyone medical here?

[justanothernamechangemonday]

Hi all

I'm desperate for an iron infusion; can't take iron orally due to IBD.

I'm 30 weeks pregnant and feeling very, very tired, breathless, cracked nails, ulcers on tongue, classic anaemia symptoms.

The consultant midwife at my hospital (my actual Obs consultant is off sick) said my levels aren't bad enough for an infusion.

My Ferritin is 5, my haemoglobin is 100. RBC is 3, haemotocrit 2.7.

These results have been steadily declining; I'm bleeding heavily daily from bad haemorrhoids and am also having an IBD flare.

Ferritin was 10 6 weeks ago. How low can it realistically go before I become very ill??

Any help would be really appreciated.

I’m not a medic but I had an iron infusion when I was 33 weeks pregnant and my ferritin levels had dropped below 5 I know that was the trigger for the referral

hopefully someone won’t more knowledge can help further with your readings but I remember how awful I felt so you have my every sympathy

Are you under a gastro consultant for IBD? If you're flaring, I'd be tempted to contact them to see if they might recommend the iron infusion as it might be IBD dropping your levels.

Yep, the gastro consultant is a whole other conundrum (currently under 2 hospitals which don't speak to one another despite moving 3 years ago) but I've emailed my IBD nurse. Their response is the next step is steroids and they don't want to put me on steroids whilst I'm pregnant so I need to continue taking my current medication.

There's also nothing that can be done for the haemorrhoids blood loss. I feel like a 90 year old who needs oxygen. Even going up the stairs means I have to sit down. It's bleak

Sorry just for info - my Obs consultant signed off on the infusion, has since gone sick and no one seems to know what to do in her absence.

You have my sympathy, it takes ages to get this sorted, I have pretty similar numbers to yours, although ferritin is only 3, and my G.P. is only just requesting an infusion. My ferritin was 4 in October and just got told to wait, I've been exhausted this whole time.

How low can it go before someone seems to care? This is a pregnancy after losses and although I'm
Told baby will be fine, I'm still super anxious that at some point my iron will become baby's problem as well as mine.

Definitely sounds like you need the infusion. Is it documented on your handheld maternity notes that you need the infusion? If so I would call your maternity triage line explaining how ill you are feeling, and your consultant had planned this but is now off sick and you have been given no treatment plan.
You could still try the above without it being documented but it might be harder to arrange.
Failing that, contact the hospital's PALS department and explain that your consultant (give the name of the consultant) planned for you to have the infusion and you are yet to receive this and it is affecting your health drastically. They can investigate this for you and hopefully get in touch with another obstetric consultant who can sort this. I'm surprised your community midwife has not been able to organise this for you but if seems like the service is very variable depending on location.
All the best, hope you feel better soon x

Thank you so much - yes it's documented (no handheld notes in my trust, all digital). Have spoken to PALs 3 times, and been in person. They were very helpful but can't seem to pinpoint an Obs consultant to sign off the volume of iron I need - this seems to be the sticking point. I've spoken to my GP & midwife daily, it seems no one has the power to do anything. I've been told to take myself to A&E if I'm "that ill" but surely there will still be the problem of no one knowing what dose to give me? It's such a bloody bureaucratic palaver!

That's shocking. I was given infusion at a level of 30 for ferritin when heavily pregnant which is what my trust use as the benchmark, they had posters of the pathway to tablets and infusion up in the hospital. Hope you manage to get one and feel better soon.