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?

If you look up Dr Amir Khan on instagram he’s done a post all about ferritin levels. He recommends at least 70 for stopping hair loss. My levels started at 16, now at 29. I’ve been taking ferrous fumerate every other day for a few months. I’ve now stopped having palpitations and have much more energy but I still have hair loss. I get it over the counter for £4. Definitely chase this up with your gp, your levels are not high enough despite what the guidelines say.

As other have said, the guidelines are 30, but this has only changed in the last 18 months or so (ive attached 2 of my results, one from 2024 and one from 2025)
You Dr must not be up to date

It's within the normal range they can't do much. You can buy iron tablets yourself though for pretty cheap.
I lost so much blood during childbirth, mine were at 2. I could barkey life him to feed him & I had to stay in hospital for 9 days having iron infusions. That was back in 2023 & i still take iron supplements now.

My endocrinologist said 60 is the minimum she likes to see in women to feel good and keep hair on your head. Buy iron tablets.

Yep. It's bonkers. the specialist I pushed to see said he wasn't sure how I was active at all. I can't exercise. Craziest thing of all...I've learned that women need iron to regulate their periods. I had heavier, clotted periods BECAUSE I was so severely iron deficient...

Hair loss can have other causes. Go back to GP whilst at same time taking supplements.

Why on earth would you rush to comment on a thread about a subject you clearly know nothing about?

I think this advice from @Dunkerquetodover is sound. I’m up to the heady heights of 29 (from 18) taking one ferrous fumerate tablet every other day, and the way I feel is night and day. I’ve gone from feeling weak and awful to pretty much fine (though I will continue as it is still on the low end). FF can be hard on the stomach so every other day helps with that too I find.

My iron and ferritin levels seem to naturally sit in the 'not anaemic, but I can clearly see it from here', place. It took a nice Dr who was holiday cover for my usual GP to say that 'normal' is often very far away from optimal and that I'd be better off taking an iron supplement. After a few weeks I was surprised about how much more energy etc I had and yes, whilst my hair still isn't great the rate of shedding slowed right down.

Take a supplement for a few weeks, see how you feel. Hope you feel more like yourself again soon.

Your Ferritin level of 18 is on the floor OP.

I got mine tested and it was 39. I felt like I was at death's door. Palpitations, breathlessness, zero energy, hair falling out, nails spooning, sugar cravings, the full bhuna of symptoms.

I now take 4 x 28mg of iron bisglycinate (gentle iron) with a vitC supplement every other day and six months later I am feeling much better. My nails are still suffering but my hair has stopped falling out and the palpitations and breathlessness has improved. In fact after about two weeks of taking the supplements I saw a massive improvement in my symptoms.

Unfortunately you need to take your health into your own hands sometimes because what the NHS class as 'normal' can be debilitating for some folks.

People saying this is normal, IT IS CLINICALLY LOW ACCORDING TO CURRENT GUIDELINES and your GP surgery / hospital needs to update itself / check the NICE website

You will feel awful with ferritin of 18. Good luck getting anyone to help you

Ive battled with low iron for 20 odd years. Heavy periods. The ferritin reference range was historically determined using the figures found in what was thought of as a "healthy population". Clearly many women of child bearing age in the "healthy" population were low in iron!!
It really depends on your gp. Most, but not all of the male ones i had were quite ignorant. I had a lovely female one once who confirmed that for my bald patch ( it wasnt quite that bad😁) to improve, the ferritin needed to be at 70 or 80. I was so shocked, in a good way!

PS, when i had a ferritin of 9 I was crying all the time.Iron is essential for good neurological function.

The biggest problem for me personally taking the iron pills and the shock to my digestive system and the impact this has on compliance. In my case it was the side effects were the opposite of constipation.
Iron bisglycinate is much more gentle, as is spatone but doesnt have as much iron as ferrous sulphate or ferrous fumarate.

The latest guidance (I think its becoming more known) is that taking iron supplements on ALTERNATE days actually is better than taking it every day, in terms of both efficacy and compliance ( nasty gi effects). This is because hepcidin levels rise when you take iron, and these block further absorption.

This link is helpful and says what foods and drinks to avoid as quite a lot of things impact iron absorption.

www.uhs.nhs.uk/Media/UHS-website-2019/Patientinformation/Blooddisorders/Iron-supplements-1533-PIL.pdf

This is what I have started taking. Ferritin always below 20 (the last 30 years, and exhausted as hell) at one point it was as low as 9 and there were times I was really suffering and I still couldn't get an infusion for dust. In fact I was even refused an iron prescription when I asked for one once, only because I wasn't working and was seriously broke during covid. Despite having majorly heavy periods and autoimmune disease affecting my absorption of vitamins no one will give me an infusion. Normal pills cause me serious stomach issues.

I think it's really terrible, just another example of the sexist bias and suffering women endure within the NHS frankly.

Why an Earth would you rush to chastise someone, I clearly apologised to the OP for being dismissive.

I am not a phlebotomist, just someone who has been having 3 monthly blood tests for 8 years with consistently questionable results around my iron / ferritin / haemoglobin levels.

And yes my initial comment to the OP was ill conceived (although technically correct as the GP has refused any further help based on the OP's results)

Hmm... I raised my low ferratin of 10 with my GP last week and she said it was on the low side but within normal range, and just recommended getting some multivitamins with added iron. Having read this I think I need to do more!

It seems to depend who you talk to. I was anemic, after my first round of iron tablets my ferritin was still only 24. The GP said
She would prefer it to be over 30, so she gave me another 3 months worth of tablets.

If you have a chat with a pharmacist op they might be able to give you some of the stronger tablets, you don't necessarily need a prescription for them

Just take iron supplements and ask for another blood test in about 6 months (NB - lay off the supplements for a few days before your next test as they can mess with the results).

Advice is to take it on an empty stomach but with vitamin C - either a small glass of orange juice or a vitamin C supplement. Avoid tea, coffee, eggs or dairy products for 2 hours after taking it.

@BelleEpoque27 multi vitamins are a waste of money. Some vitamins react badly to each other so you won’t get any benefit and there’s no point supplementing something you’re not deficient in. Find out what’s low and supplement individually if needed.

Floradix works for us. The tablets, not the sticky brown liquid 😊

Sorry - also, iron supplements are cheap as chips (assuming you can stomach the standard tablets). You don't need a prescription.

Just get some SpaTone

My ferritin is 3, I’ve had to go private to get any form of treatment! Despite struggling to function. Iron tablets just don’t work for me.

Just to say, I took gentle iron for three months (so the strongest you can get as a multivitamin) and my ferritin went from 16 to 19. So my gp told me to move onto ferrous fumerate instead as the multivitamins weren’t strong enough to make a difference. It then went from 19 to over 30. But started to deplete again once I stopped taking it thanks to heavy periods.

Not to put the boot in at all!

But I don't go to my GP just to read a set of numbers off a test result. I can get copies of my results and do that myself.

No.

I go to my GP for them to INTERPRET what the import of the results are and what significance they may have and what they might mean in regards to MY SYMPTOMS. My symptoms as TightlyLacedCorset.

The symptoms that initiated the lab test being requested in the first place.

Part of the problem we have now is the easy availability of laboratory lab tests means they are overly relied on sometimes to exclusion of the patient report of symptoms.

Clearly if the range is between 18 - 200+ and the patient is tracking right on the bottom of the range, yet reporting key symptoms that point to iron deficiency then there's a LOT of room within that range for manipulation and increase. I expect a GP to do that analysis. To look at me as an individual.

NHS guidelines are just that, guidelines not always rules written in stone, GPs are expected to also employ their training to assess and make sense of what the numbers might mean. What is the test actually describing in tandem with symptoms?

The good ones do this.

I do know different GP’s have different thresholds for ranges but certainly under 30 is too low generally.

Diet changes and I’d advise taking ferrous sulphate if you can tolerate/ no adverse side effects, etc. Take it alongside vitamin C, any iron rich food alongside vitamin C, avoid caffeine/ dairy alongside iron rich food as they counteract one another.

I won’t ever let my ferritin get so low again, I was suffering from nightly panic attacks, hair loss, incredibly dizzy, palpitations, very low on energy, weird fizzy lips/ tongue feel, very pale.

Spinach contains most iron when it’s cooked vs raw, up the red meat if you’re a meat eater and dark poultry. I literally upped my intake and it really helped alongside supplements, though the ferrous did most of the heavy lifting- pun intended ha. I also home made daily iron rich smoothies and these helped to up intake also.

Training so hard right now whilst ferritin is so low is literally counter active and pointless, your body needs recovery so it’s likely you won’t see any gains currently because your body needs to prioritise survival instead. Your regime is actually really tough on your body considering you do such intense workouts on back to back days, I’d consider looking into a different routine/ recovery, certainly at least for now but if your ferritin keeps dropping this could be one of the reasons too. A look at your entire lifestyle/ exercise/ diet, if it continues to drop.