Why do I have low iron?

[Yuluml]

I'm stumped as to why I have low iron and the doctors don't seem interested in finding the root cause. My GP did some blood tests recently as I've been having some gut issues - ongoing constipation and a bit of low level pain, pretty sure they only did the tests to placate me. I've done two FIT tests and a calprotectin test and they were normal. I've been tested for coeliac's and I don't have it. Nothing came up except for low ferritin, which is 17, but apparently I'm not anaemic because my haemoglobin is normal (135). My MCH and MCV are both low normal. GP isn't bothered about me having iron tablets, I didn't even realise 17 counted as iron deficient because it is still within normal NHS ranges, but according to NICE guidelines anything under 30 is iron deficient, whether you're anaemic or not. My B12 is quite low too (353) but still in NHS "normal" ranges so nothing doing about that either.

As my FIT stool test is normal and I have no rectal bleeding or other red flag symptoms my GP will not refer me to a gastroenterologist for any further testing. They tell me the most common reason for low iron in premenopausal women is heavy periods. But I do not have heavy periods. They only last four days, I don't have any clots or leaking or heavy bleeding. I did have a miscarriage at ten weeks back in late March, so not sure if that would be a factor. I also have a history of overuse of NSAIDs (neurofen) due to migraines.

Everything I've read says that low ferritin is the first step towards anaemia, so surely I should be having investigations into why it is low? Has anyone else had this and not had either heavy periods or coeliac's? In the states it seems to be the case that everyone with iron deficiency is advised to have a colonoscopy/endoscopy. Doesn't seem to be the case here.

This has only been since I found out I had low iron, prior to that I was eating red meat about once or twice a week. However, I have always eaten lots of spinach, nuts, peas, eggs, beans etc. I have 0 physical symptoms at all (I have had migraines since I was a child and have a v strong family history of chronic migraines so I don't think they are a symptom).

Were you also anemic or just iron deficient?

The GP has said I can take iron tablets if I want to but she will only prescribe them if I am also anemic, which I'm not.

No not anemic just low. Told nt to take 2 to 3 a day

If it's low, just take some supplements. I am vitamin D and folate deficient (this is due to a known condition), but I don't get prescription supplements for that. I buy them from Boots like everyone else. If you aren't supplementing and you aren't having masses of symptoms, then there's no point investigating. Take supplements for 6 months or so and re-test. They'll very likely be much better.

If they aren't improved and you feel unwell, then you can go back and push a bit more for further testing. tbh, I used to live in a country with fully private healthcare (no NHS) and they would have said the same thing, though doctor would have probably tried to sell me expensive supplements to make some extra cash!

This is an nhs cost saving thing not a you don’t need them thing. You don’t need prescription strength iron tablets because your iron is low not full blown anemia so they expect you to go buy them yourself from Tesco. You’d be cutting your nose of to spite your own face if you didn’t.

if you took them for 2 months and your iron stayed the same I’d expect they’d do more tests then.

OP like it not this is how the NHS operates. Why not get a private colonoscopy?

@Yuluml hi OP just wondering if you have any update on this? I’m currently going through something similar and the GPs don’t seem to care!

Can I have an update too pls? I just got tested and my ferritin levels are 8. I feel tired all the time, breathless, depressed and dizzy. She prescribed me iron tablets but my diet exercise etc is good. I also don't have anaemia. I'm worried ill always feel thus bad as had iron tablets before which got me to 11 and then they said I was not low. This cabt be right if your levels are 17?

I have had low iron anemia. Too. Taken iron tablets for last 3 months and it is better but still not within the range. Gp wasn’t bothered told me to take for another 3 months. I had to push - has put me for clotting / coagulation blood test and coeliac . Anyone else had these tests ?

My iron was 22. I found out it was due to too much turmeric in my diet (I was putting it in most of my dishes thinking it was healthy) as it chelates the ferritin.
https://hemochromatosishelp.com/turmeric-benefit-for-hemochromatosis/#:~:text=Turmeric%20is%20one%20of%20the,chelating%20iron%20from%20the%20body.

I had this a few years ago. I needed to be on iron supplements constantly just to maintain a normal level. Healthcare professionals kept on telling me I must have heavy periods, even when I insisted I didn't.

It was only when I became pregnant and was told to stop supplements in the first trimester as I wasn’t having periods anymore, that I finally got taken seriously as my level still went down just as I’d been sure it would.

Two more pregnancies later and whatever it was seems to have sorted itself out now. 🤷‍♀️

@Bubbles254 how did you find out it was the tumeric ? I use too but not too much I would say x

Not conclusive but my ferritin was 60 last year. I then overhauled my diet including lots of tumeric and it went down to 22. The low reading was actually a few days after I had an accident with my tumeric packet and loads of it went into a curry (so much that my toothbrush went yellow!). I then cut tumeric from my diet and retested ferritin a few weeks later and it had gone back up to 55. May of course have been coincidence but it was interesting that tumeric is recommended for people with iron levels that are too high.

11 is still very low. Some health trusts still use under 12 as abnormal, others have updated to under 30. Optimal would be more like 100. Keep taking the tablets!

Go to the pharmacy and buy prescription strength supplements. Ferrograd C has been the best for me.

I have the opposite problem from you. My ferritin is fine, usually 40-50, but I have never had a red blood count in the normal range and my hemoglobin is often low. GP has sporadically prescribed iron tablets. Eventually I realized I felt massively better if I took them regularly (every other day).

Also wish more could be done to discover what the underlying problem is. I also have a tendency to bleeding (two serious PPHs) and often a low platelet count. For the time being I do better taking the iron tablets and a B12 and folate supplement.

Paracetamol does very little for me either. Have you tried paracetamol with whatever pseudoephedrine replacement they use now.? Nowhere near as good as the ibuprofen combination but better than just paracetamol.