I think my iron levels are low but my GP disagrees - wwyd?

[JohnnyMcGrathSaysFuckOff]

I lead a very active and healthy lifestyle and generally have lots of energy. However recently my hair has started to fall out and I do feel tired and a bit emotional esp in the evenings.

Based on MN advice (thank you!) I booked a GP appt and was pleasantly surprised to be taken seriously. The GP immediately said, might be low ferritin. She ordered full bloods.

Thing is, these have come back now and my ferritin is 18ug/L whereas it describes the normal range as 11-307. These results are flagged as normal, no follow up required.

I can obviously see this technically is in the "normal" range, but it also feels like it's right at the bottom of a very big range.

In this situation, would you pursue? Try to supplement naturally? Or just leave?

Mine was 27 and my NHS GP said that was far too low and put ferrous fumarate on as a repeat prescription, but it is cheaper to buy it OTC in pharmacies. I took 1 a day for 6 months and my levels were back up to about 65 so now I take 1 every three days. Lots of the iron supplements you can buy in supermarkets or amazon are just not strong enough to build your stores back up again from a deficiency. They are probably OK for maintaining already healthy levels. The pharmacy ones I take are 210mg ferrous fumarate

Ferrous sulphate and ferrous fumerate are what would be prescribed and you can buy them cheaply OTC. They aren’t supplements, they are the medication doctors prescribe.

Even the NICE (National Institute for Health and Care Excellence) guidelines classify iron deficiency as serum ferritin levels below 30 μ g/L.

The NHS is notorious for claiming very low levels are within the ‘normal’ range.

Wouldn't you book another appointment if the tests you have had don't identify the issue? The receptionist is only going to give you the results in front of her, if you still need to see a doctor, book an appointment.

In the meantime, I would take a supplement.

I would look at going private @JohnnyMcGrathSaysFuckOff

This thread has prompted me to look at my blood tests. My Ferritin was 10 in 2023 but as my iron level was actually high I was never treated or even investigated any further.

I've been under rheumatology since 2018 and have a FBC every 3 months. General pattern is haemoglobin is low but red blood cells are normal. I'm told by rheumatology and GP this is fine? Last time both my haemoglobin and red cell count were in the normal range was in June 2025.

My condition (an auto immune arthritis) can cause "anemia of inflammation" so I assume my parameters are different to someone without a condition.

Going to flag it again at my next appointment.

Have you tried a basic multi vitamin ?
My iron ( hb) level was often low due to vegetarian diet, didn’t really affect me day to day but I couldn’t donate blood and I like to do so. Few weeks taking a one a day vitamin with iron from boots & I’ve never been low since .

Hair loss needs a ferritin in the 70s or 80s. Get some iron OTC.

NHS 'normal' windows are notoriously low bar.

In many countries what they think is ok would be urgent treatment!

It's worth looking at for eg US sites, web MD and the like.

But I think you'll struggle to argue the case with the GP, might have to go private.

Sorry - I also meant to apologise for being so dismissive in my earlier posts @JohnnyMcGrathSaysFuckOff

I have a named condition, am under a consultant and have had numerous concerning blood test results and still they tell me I am fine (my rheumatology nurse tells me to eat more spinach 😂) so I think you'll really have to make a fuss to get your GP to help. Hence me suggesting going private if you can, like a PP mentioned.

Even NICE guidelines should be higher than 11. I think my test results had the range going down to 30. Mine were 31 and I felt rough AF. I went with Holland and Barrett Iron Biglycinate plus 500mg Vit C and was feeling a lot better within a month. My face and lips totally changed colour once I had been supplementing for a while.

It’s taken me 5.5 years to get an iron infusion. In February I requested a female gp and cried on the phone. She looked at my history and referred me immediately to. My make gp kept adding “ferritin low, which is normal for this patient”! Ffs. It was 6 and I felt awful. I’d be happy with 18 but only because I’ve survived on so much lower so it sounds high to me. Check nice guidelines as it varies. Iron tablets don’t work from me because my starting point was just so low.

I take ferrous fumerate with vitamin c fizzy tablets every other day. Bought online from a chemist. My ferritin is up to 70 but my iron saturation is dire for some reason

It’s normal so the NHS won’t treat it.

You can buy iron from the shops if you feel you need it, do that and go back for a blood test in a few months.

also focus on getting iron through your diet.

What bothers me is them not considering why people who have never had this issue in the past suddenly have it (assuming they're not pregnant/eating a good diet etc), particularly when they have other symptoms. They won't invite you back to investigate in this country, so it seems from those who have been in this situation, as long as you're "just" in the normal range, whereas in other countries, if you suddenly have low iron having never had a problem in the past, and have other symptoms, they investigate links.

Treat it yourself. 18 is low. Not clinically treatable low, current guidelines.
Careful not to overdue it by overlapping vitamins.
BetterYou does an iron-only mouth spray that I would recommend. Floradix is amazing and also include the B vitamins and C. You can also get some sachets that deliver 5mg of iron via iron rich water, mix it with orange juice.
If you had got below 11, like I did, you would be given god-awful horse sized pills that make you constipated and, on occasion, vomit.
Most people can safely take 45mg a day.
I would definitely supplement at 18.
People saying eat iron rich foods but it is not that easy always..some people struggle to absorb iron and menstruating women are often very low.
Avoid caffeine when you take your supplements.
I hope you feel better soon, low ferritin is horrible.

NICE clinical knowledge summary for anaemia says:

Serum ferritin level is the biochemical test that most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

My daughter is on supplements for low iron. She is on iron biglycinate (ferrochel) and liver and spleen capsules. These were recommended by her (US based) doctor. The NHS guidelines are really low and I would definitely listen to your body and give yourself some support.

A ferritin of 18 is low enough to make you feel lousy. As others have said buy Ferrous fumarate OTC. Take one tablet every other day. Less is now more when it comes to oral iron.

If you are premenopausal cause most likely due to blood loss from menstruation (or dietary if veggie). However if you do not have periods, have lost weight, change in bowel habit etc do go back to your GP as may need investigation.

A pp mentions taking vitamin C as well as iron, and as far as I'm aware, taking both together helps your body absorb it better.

If it’s low, and it’s low ish, yes, you need some iron supplements, but you just need to go buy those. Nothing really the GP needs to do other than advise you to do that. How is your vitamin D? Unless over 100, I’d be supplementing with high dose vitamin D as well.

When you say you lead an active and healthy lifestyle what do you mean exactly? Are you doing intense training in an endurance sport? If so have a look at RED-S, symptoms can be similar to what you are describing.

18 is within the normal range but very low for women according to the GP I have seen who specialises in fertility. I also have PCOS/PMOS. so have heavier periods. We naturally have lower stores anyway because of our menstrual cycle. I was prescribed a supplement at 20. You need a dose of 140mg at least. The OTC ones don't really do much as the dose is so low, I was taking spatone and it wasn't doing anything. Tea is big blocker for iron as is dairy, you need to leave it a couple of hours before drinking or eating anything with either of them in after taking it.

Buy ferrous sulphate from the pharmacy (over the counter) it’s better then the “iron” type vitamins.

A little low?! I thought it was bad my old GP’s didn’t comment on mine being 9 and 5 is terrible

You can buy Ferrous Fumarate iver the counter.

My last blood results were similar. I bought some and feel much better.

If it's at the low end of the scale, chances are it will keep declining (unless you up your red meat and spinach!).