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?

I take it in liquid form every other day, prescribed by the GP. It's easier on my stomach. Also with Vit C and I drink spearmint tea for any bloating/constipation.

Black pudding is even better. Bury black pudding is the lowest fat version if this is a consideration. I love liver but you need to be a little bit careful of excessive vitamin A intake if you're having it more than once or twice a week, especially if there's any history of osteoporosis in your family.

Your ferritin needs to be above 70 ideally to prevent hair loss and they’re probably not taking that into consideration. Biotin supplements are also very helpful.

@rainbowsnack thank you!

They are not aware of the levels of ferritin associated with hair loss - and that is really anything under 70. So their interpretation of this blood test is pretty pointless. They can't, generally, offer any dietary advice to improve OP's symptoms, or suggest what supplements she ought to take - she's just been told her ferritin level is in the "normal" range, bye bye.

You need to supplement with iron, and take it away from calcium, or dairy, and preferably with a glass of orange juice or a vitamin C supplement as well. Also, not around the time you are drinking tea. Did OP get any of those suggestions? No.

The NHS “normal” ferritin range has been on a downward incline for some time. Early 2025 the baseline was 30. I had more bloods done a year later and it had changed to 11. They’ve done the same thing with thyroid testing too.

I haven’t rtft

However that is very low and in your case why not just get an iron infusion if possible to see if you feel any better

And don’t take the supplements with a cup of tea. It stops absorption. See guidelines.

NHS iron tablets are awful anyway . Get some floradix liquid and you will feel better soon . That iron is not that low , I constantly get mine at 4 and I’m a mum of 4 and work full time and still here

Hi thanks!

This is really helpful.

I am going to talk to my GP but have also seen a pharmacist today who agreed 18 was way too low, sold me ferrous fumarate and advised to get B12 checked too.

I'll keep this post in mind in case the tablets do not make me feel better soon.

Hi @JohnnyMcGrathSaysFuckOff if you are going back to the GP for more tests perhaps ask to get your Vitamin D checked too. A high proportion of Brits are deficient in Vit D due to our poor weather and a deficiency can cause fatigue and low mood. It can also have long term issues for your bone density.

https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency

If you can afford it, I’d have an iron transfusion. They were about £300 a time when I checked 4 years ago.

I had very very heavy periods leading up to my hysterectomy - I ended up in A&E three times in a year as the bleeding was uncontrollable. I was told over and over that my iron levels were normal.

Then, when I went for my pre-op blood tests, they said my iron levels were so low, it would be dangerous to operate.

So I was given three transfusions on the NHS. The reason I’m recommending this AS WELL AS follow up supplements is that I felt 300x better within minutes.

(As it turned out, I did haemorrhage during surgery, and had to have another blood transfusion while I was unconscious. I then fainted the first time I got out of bed after the operation and had to have yet another one. So much for my iron levels being fine!!)

https://www.which.co.uk/reviews/nutrition-and-supplements/article/best-iron-supplements-agqAm8y8ow15

This is also good advice for how to make sure the iron you do take gets absorbed https://www.which.co.uk/news/article/im-an-iron-expert-here-are-five-things-id-never-do-ar1xC5P6aJXT

This is behind a paywall. Can you mention the top three please?

I would just buy over the counter iron tablets. 18 is too much on the low side for the symptoms you are describing. Get yourself some folic acid as well. Private clinics have much higher thresholds so it could be worth investing and seeing a private doctor.

Interesting to see that some people's GP consider their levels low and others don't - it really is a postcode lottery!!

In March my serum ferritin was 21 - apparently thats a NORMAL result, despite me feeling like dogshit!

It seems to be the laboratories can set their own cut off points - so in one lab what would be flagged wouldn't in another, so the GP just sees No Action and files it away. As I said upthread, my lab needs you to be under 5 for ferritin to get a flag! It is a postcode lottery but I don't think it is all on the GP here.

Normal doesn't mean optimal.

Sadly this is a common issue with the NHS and blood tests for lots of things.

They wouldn't help DP with issues around his muscle weakness and loss of libido because his hormone tests were within normal range, right at the bottom so he had to go private for that and it made a massive difference to him.

Just buy some iron supplements and drink orange juice with them when taking them for better absorption.

I believe just this week new information was shared that they even believe women's iron should be significantly higher.

Check your NHS app - when I went for a blood test last year because of how exhausted I was (ferritin at 14), they tested for loads of things including B12, so that might be in there already.

I find it sad that the gp says fine, move on, or here are some tablets without looking at the reasons why its so low. Heavy periods, malabsorption there may be an underlying reason for these things, which may be causing other symptoms, we should find out why and fix the underlying cause not just top up on tablets.

My ferritin was 11 I took tablets until they were causing horrendous stomach pain. Told the doctor, she said I was mistaken and the tablets were not causing the pain. I disagreed. She told me to stop taking them then and close the door on the way out.

I had managed to get my level up to 17 after 18 months of ferrous sulphate.

My ferritin was 6 a few months back and it was immediately flagged (understandably!). I was also anaemic (haemoglobin 99 when it should be 115). After a few months of supplements I was no longer anaemic and my ferritin was up to 11, so not huge progress but not nothing. That result was also flagged - I was told that anything under 30 is considered a problem and requires supplements, so I'm still taking them.

I'd suggest alternating ferrous fumerate and spatone (natural iron) every second day. It's more likely to be absorbed and it'll cause fewer stomach problems. You have to build your stores up over a long period of time.

By rights your GP should follow up to find out why your ferritin is low, but I suspect the only reason I got any action was because I was actually anaemic. They gave me a FIT tests for potential bleeding in my colon. That was clear but later testing revealed adenomyosis, an endometrial polyp and an ovarian cyst so basically a shitshow of stuff going on.

I don't think GPs take low iron/anaemia seriously enough, largely because it's not a symptom men tend to get. I find it very telling that ferritin is not checked in standard over 40 health checks for example.

You want to be closer to 70. 30 is the minimum not the optimal.

I would pay for a private iron IV. They’re £140 per treatment near me and full effects take 6 weeks rather than 6-13 months like tablets

Update!

I had a GP appt on the phone today and it was a different dr, and she was so helpful actually.

She said, of course 18 is too low! I'll prescribe you iron tablets.

I said she didn't need to as I'd bought some. She agreed the pharmacist had given me the right ones and said my ferritin levels should be much closer to 100. She booked me a blood test for 3 mos' time to see if the tablets were working.

I have only taken 2 but I think I might feel a bit better already! Placebo effect??? Who knows.

But there is so much useful info on this thread, I'm so glad I started it and hope it helps others.