Would this be making me feel so unwell as my gp disagrees?

[Littleladybugs]

I have extremely heavy periods- during them I cannot leave the house as the bleeding is so severe and I get so dizzy.

I take ferrous fumarate (x2 a day ) have done for 3 years now, gp said add spatone if I really thought I needed to which I did and now also feroglobin liquid.

Im exhausted and can’t function , a 10 min walk makes me so exhausted I have to sleep afterwards, I get breathless. The gp told me ‘this ISNT biological’ asked me to do a depression questionnaire but so many questions were focused on fatigue issues that she scored me as being depressed (I’m not)

My ferritin is 9 and my haemoglobin 113 of relevant - they said ferrous fumarate is all they can/ will prescribe but it’s not the cause of my issues so I don’t know what to do

Should have added ttc so can’t take anything hormonal for heavy periods

Have you had your B vitamins/folates tested? I wad breathless, exhausted and low and it turned out I needed massive amounts of folic acid in order to absorb the iron. You can either push for blood tests or just buy a high quality, high dose b vitamin supplement and wait a couple.of months to seen if it helps...?

I’m really sorry you’re having this horrible time. Could you have an iron infusion? It’s an instant hit of iron which makes you feel better quickly. I had this with v heavy periods. I couldn’t take the iron supplements. I got breathless, couldn’t speak or think straight. It was in the middle of covid so I thought I wasn’t coping with lockdown. Why does your GP think it’s not biological? I’d be speaking to someone else.

I’m so sorry you’re going through this. My ferritin is 11, HB 109 and Im in pain, unable to function. Just sleeping.

Can you see a different GP? The fact that they advised you to add Spatone is really concerning. NICE guidelines state if that treatment via Ferrous Fumerate doesn’t get your HB levels within normal range, you should be referred to specialists.

Dont be afraid to push and keep pushing. It’s hard, you just end up too exhausted to get the help you need and you end up normalising the extreme fatigue. But it’s not normal, it really isn’t.

Incidentally, I charged GP surgery recently and the difference in care between the two surgeries has been insane. In my old one, I was just always told I was depressed. Refused HRT despite not having period for 2 years and repeated blood work showing post-meno levels of FSH and Estrogen aged 36 😕 By the time I got proper dx for early menopause aged 40, I already had osteopenia.

My new surgery couldn’t be better. Can always book to see specific doctor/s. Really active referring me, following up, blood tests, looking at my whole health. Welfare calls from social prescribing when at my lowest.

If you are extremely anaemic, TTC really isn't a good idea right now. Not only does it reduce your chances of conception, it increases the risk of miscarriage, becoming extremely unwell if you do miscarry and puts both mum and baby at risk if the pregnancy goes to term. And if you are unfortunate enough to also have HG or 'just' bad morning sickness, you have absolutely no reserves to cope with that.

I sympathise, I really do - but I think right now, you'd be putting yourself at greater risk with pregnancy and you need to think about taking that off the table whilst you get up to a healthy level.

I work in pre-op rather than GP but we always consider a ferritin < 30 as iron depleted and try to replace it even if Hb is normal. (And incidentally Hb 113 is anaemic and women shouldn’t have a lower Hb than men despite historical references ranges but I won’t get on that soap box today.)
an iron transfusion might really help and some proper treatment for those heavy periods so you stop loosing so much iron every month. Have you referred to a gynaecologist?

I would put off TTC for 6/12 to get this sorted and feel better. Your Hb will plummet during pregnancy (dilution anaemia) and you’ll feel worse.

I felt awful with ferritin that low.
I eventually went on the pill

I got anemic in pregnancy.
Look into transfusion, maybe ask a different gp

I asked the gp and she said I didn’t meet the criteria for anything more than ferrous fumarate? (ferrous sulphate made me vomit) and just said add spatone if I was that sure the problem was my iron levels. I have an appt on 22/2 to see a different gp as totally fed up now of this

Yes I’ve been seen but they couldn’t find any reason (I’ve always had very heavy periods and struggled with this sort of thing but it’s so much worse the last 3 years my periods got closer together and I think that’s why. I used to be 35+ day irregular cycles and now very regular 28 days so I’m bleeding more often )

I’m on cycle 28 (took 5.5 years for dc1 and 15 months for dc2 so I’m not sure it’ll even happen plus I’m 40 now). I do wonder if I have endometriosis

Have you been scanned for fibroids? It could tie in with the heavy periods, impact your ttc and be adding to your fatigue.

My scans are always fine the only comment I get is that my lining is thick/very thick but not abnormally so , once they said they thought they saw signs of adenomyosis but the next scan was ‘normal’ so that wasn’t diagnosed

Shocked your GP is not sending you for an iron infusion. WTF!

If the second one doesn't, do you have the funds to get one done privately? You shouldn't have to, but the NHS seems to be dead at the moment

You can be prescribed something called tranexamic acid to take during your periods to make them less heavy.

I asked for Tranexamic Acid for my heavy periods and it’s been fantastic at reducing the bleeding. It won’t help increase your iron but it might help prevent it worsening. You just take it for the first 3/4 days of your period.

I’m really glad that you’ve got an appointment with a different doctor booked. Hopefully it will go better. Two years of supplementation, and still that anaemic must be really awful.

Don’t let them fob you off.

Tranexamic acid is, for me, the difference between needing iron infusions & blood transfusions for the damage (not sure how else to put it!) my heavy periods do on top of the rest of general bleeding-disordery shenanigans. Absolutely ridiculous they’ve not prescribed this (&/or mefenamic acid).

Please go back & keep pushing. Possibly with flashcards to explain wombs do not in fact roam wild & free about the body causing women to be irrational & possibly mad; but they can & do make women really very physically unwell & checking into the spectacular bleeding propensity of yours (& then balancing it) is the thing to be doing. Not suggesting you must be depressed because you’ve not yet had baby no 3 - I assume that was the implication?

I would ignore the comments telling you not to try to conceive, it's v common for menstruating women to be anaemic and since normal lower limit is 120, 113 isn't extremely anaemic as one poster wrote.

Also, did you know that iron isn't absorbed well if you take it with food? It reduces the bioavailability. In the past the advice was to take it once a day with orange juice! Newest guidelines say take it on an empty stomach though...

My friend has been very breathless. Her GP told her it was all in her head and sent her a link to a mental health charity; it was an online appointment We, her friends, told her to phone 111 who promptly sent her to a local hospitall. Correctly diagnosed and taking antibiotics within 2 hours!

I take mine with a fizzy vitamin c tablet in water which seems to be a decent compromise

OP you must feel shit, my ferritin is 66 and I'm actively trying to increase it for hair growth

My hair has been falling out for 6 months the gp said that was stress related !!

Fair enough. But I wasn't personally that much of a fan of being in hospital for weeks 17-19 and 22-28 due to repeated bleeds and an Hb of 4.2. Or the degree of blood loss and poor healing following a planned section and the following recovery period. I wasn't even that anaemic beforehand, as I'd only been having light withdrawal bleeds on the Pill, but HG put paid to any reserves very quickly.

It’s literally half the thickness it was and my plugs and hoover are full of hair all the time now where it’s fallen out everywhere