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?

Anyone with a ferritin of below 30 is iron deficient and should be taking iron supplements. You can buy the exact tablets a dr would prescribe over the counter from any pharmacy as iron deficiency is so common. I have taken these 330mg daily for a year with vitamin c and increased by ferritin by 150 points. (I am post menopause so no periods). Spatone and Floradix contain a tiny fraction of the iron in these tablets. Some people say the tablets upset their stomach but if you can take them they should be your number 1 choice to get your ferritin up to the optimum level which is over 100.

If you are anemic it is worth considering why as, without addressing the underlying cause you will become deficient again if you ever stop taking iron supplements. Heavy periods or poor diet is often the cause but it is possible you have bleeding in the digestive tract. My GP gave me a FIT test (test of a stool sample) to check I didn’t have blood in it.

https://www.chemist-4-u.com/ferrous-fumarate-322mg-28-tablets?_gl=1mz87td_upMQ.._gs*MQ..&gclid=EAIaIQobChMIwIy64czklQMV55VQBh1muySiEAQYASABEgJVLPD_BwE&gbraid=0AAAAADMV1WRw_xsqvoTGjb8BCKJY9L9Fo

The NHS is very weird about this stuff. I am significantly over the top of the range, and have been for years (and seems to be going up gradually), but they still don't do anything. Might as well not have the range.

Btw, I'm also always tired and have hairloss.

Also to everyone with a low ferritin… do you know your haemaglobin? Your body uses the ferritin (iron) to make haemaglobin and if that is low as well - I think the NHS says women are anemic if their haemaglobin is under 120 - that will also make you tired as your body can’t transport enough oxygen to your cells.

Dark green veg doesn’t contain anywhere near as much as iron as people think. Spinach, in particular, was only ever thought to be high in iron because someone recorded the number incorrectly when creating an official chart many decades ago. But none of them even appear on NHS-recommended lists of iron-rich foods.

Liver and red meat are your best options for iron, but if you don’t eat meat, beans and pulses, nuts, soy beans, dried fruit (especially apricots) and fortified commercial breakfast cereals are good.

You also need vitamin C to absorb iron, so if you take a supplement, one that includes vitamin C as well as iron would help.

You really don’t need a doctor for this; you can just buy an iron supplement (or just a multivitamin and mineral supplement, which will include iron) in any supermarket.

Do you know your haemaglobin, folate and B12? Your body makes haemaglobin to provide you oxygen in your cells using iron, folate and B12. If you have high ferritin stores but no folate or B12 you won’t be able to make haemaglobin so the iron stores will build up but you still feel fatigued.

It’s very true about iron and dark green veg. The consultant I saw said you’d have to eat truckloads to get anywhere near the amount you get from red meat. As it happens, I eat liver regularly now

They tested haemoglobin and it was fine. Not high or low.

I don't think they tested the other two. Thyroid was tested and fine.

They just keep telling me I must have inflammation somewhere, then they find something (had fatty liver diagnosis [now resolved], then they found a fibroid [took it out], I have IBS, etc) and say "oh! It's probably that causing the higher reading", but it seems too convenient especially as it's still increasing.

I'm going to get some private tests.

This article explains that iron from vegetarian sources is harder to absorb than iron from meat:
Iron exists in two forms known as haem and non-haem. Haem iron is found in animal tissue (meat) and is the most easily absorbed by the body. Non-haem iron is found in vegetables, beans, pulses and grains and is less easily absorbed by the body.
Good Sources of haem iron are: red meats such as beef, lamb and liver, some fish and shellfish. White meat such as chicken and turkey contain smaller quantities of haem iron.
Good Sources of non-haem iron are: Fortified breakfast cereals or bread, dark green leafy vegetables such as watercress, beans, dried fruit, nuts and soya products e.g. Tofu. (*avoid during pregnancy)
Things to know about the absorption of iron
Consuming haem iron (e.g. red meat) at the same time as non-haem iron (e.g. cabbage) can increase the absorption of non-haem iron. Vitamin C also helps to increase the absorption of iron.

https://www.mkuh.nhs.uk/patient-information-leaflet/good-sources-of-iron

What was your haemaglobin number because what doctors say is fine is often not optimal?

I have had private tests from Medichecks and been really impressed with them. I also did some tests with Monitor my Health where you fill the vial at home yourself. I struggled twice to fill it with non coagulated so they couldn’t give me my ferritin number after two attempts. as they managed to give me some of my results from the blood I provided they just said tough after two attempts. It was cheaper than Medichecks though.

Mine was 24. Not terribly low, but it was too low nonetheless! I was losing my hair by the handful. Every night, I'd have to clear the rotating brush on our robot vacuum with scissors because so much hair was wrapped around it. The robot would just stop working. It was scary! I've never seen anyone lose their hair like that 😬

Not everyone reacts in exactly the same way, but hair loss is more likely when ferritin levels are <40. Once levels are >70, hair often starts to grow back.

A pack of 200 mg ferrous sulfate tablets costs just £2.99 OTC at my pharmacy. It would cost you way more to buy branded supplements such as Solgar, Floradix, or Spatone

Try a suppliment or over the counter iron for three to six months then ask if they will test again. They really only act on it if really low mine was 1. But i agree with you that you want to get to the bottom of the root cause especially with you losing hair. Collagen teamed with the iron and some magnesium helped my hair.

When my iron levels were 17, my doctor told me to buy ferrous sulphate tablets and take 2 a day as it would work out cheaper than getting them on a prescription - they are about £2 - £3 for 84 tablets

My ferritin level was 19 when tested. The app said “normal” but the GP flagged it and prescribed iron supplements. GP said although it is within normal range it was too low. I feel so much better now!

I've not got it to-hand (and I've never managed to make the NHS app work for anything other than repeat prescriptions).

I'll check.

I can't do home tests, I just pass out. No blood comes out of those tiny finger pricks either. Had to have one for cholesterol recently at the medical centre and while some did come out, it took ages and she really had to squeeze my finger (while I tried to breath and not faint).

There's a local place I can use, I must get round to sorting it! I do have some follow up NHS tests to get done on the liver stuff so I'll probably do those first.

You can buy iron tablets at the pharmacy counter in Boots £1.60 for 30. I take them a couple of times a year to give me a boost because I'm a blood donor.

Your Ferritin is very low OP. It should be at least 30 re: NICE guidelines and ideally much higher than that.

Found it:

142g/L, range 120-160, so comfortably in the middle.

Ferritin is 331 and 437 against a range of 13-150.

Apparently the levels are different at different labs because they’re based on a certain percentage of the local population. And they aren’t related particularly to the NICE guidelines. So where I am, the range starts at 10 (probably because it’s a young area), and it’s also likely why the female level is lower. There don’t seem to be plans to change it whatever nice says. The GP also doesn’t prescribe iron tablets here regardless of level, as you can get them from the pharmacist, though they will tell you that you are low and you should get them (mine agreed that lower than 15 was concerning, lower than 20 worth supplementing).

can’t imagine anyone getting infusions without very low HB as my GP tried and they won’t consider it even if you can’t tolerate tablets. But if someone up thread got one at ferritin of 13, (if that was with normal HB), I’m impressed at their local service! a wait of six weeks sounds long but about what I’d have expected if not an emergency I guess. Even urgent scans to check out the bleeding are 6-8 weeks here.

Mine came back as 18 and I was prescribed iron tablets and a check up in 3 months time. Seems the nhs isn’t the same across the board!

I’d ask what my Vit B12 level was…