to be annoyed by the doctor about my iron levels!

[Gennz]

Ths is a very boring AIBU. I just want to have a rant.

I hav a 5 month old DS. Lately he has been sleeping a lot better but still not sleeping through - he goes to bed at 7, I dreamfeed him at 10 and he wakes between 3 - 5 for a feed and gets up at 6.30 - 7am. So only waking once. I'm still BFing.

However I have been feeling more exhausted than I did when he was newborn and waking round the clock! I feel dizzy and faint, can barely walk to the end of the road, my arms feel weak, I generally feel like I've been run over by a truck.

I had very low ferritin levels - 10 (e.g. iron deficient) in pregnancy and took iron supplements. The normal reference range is 12 - 150. I feel now like I did then - i.e. it's not just the normal shatteredness that comes with sleep deprivation or broken sleep. I'm sure that's the culprit now, so I started taking the iron supplements I had left over from pregnancy & upping my red meat intake. I went back to the doctor for blood tests and my ferritin came back at 26. (Thyroid function etc all came back fine so that's not it).

I called the doc & said I knew the ferritin was within the normal range but it was still quite low & I was taking my leftover iron already but that they were going to run out soon & given my symptoms I'd like an iron prescription to get it up further (from what I can tell from doing a bit of reading online - yes yes I know, don't trust Dr Google ... but still...) while 10 - 150 is "normal" optimal ferritin levels for females are 70 -90.

She said no, it was well within normal, they wouldn't prescribe and if I wanted iron supplements I would have to buy them over the counter myself. And that I was probably just "tired from the baby" (at which point I really wanted to hit her - I mean no shit that hadn't occurred to me! The baby might be affecting my sleep, oh really?! )

AIBU to think this is a bit blinkered? I don't really mind about buying the iron supplements myself, but if someone presents with symptoms is it not bit bloody lazy & narrow minded to say "no that's not it, no I won't help you" and stick to a massively broad reference range for a possible issue? I already feel much better afer a week of taking my leftover iron supplements and upping my red meat intake.

Is the GP allowed to prescribe medication that 'the guidelines' tell her that you don't need? I have no idea.

But as iron tablets are so easily available to buy yourself, then that's what you should do. Maybe the doctor made the judgement that you would continue to take iron tablets whether she prescribed them or not, so decided to save the NHS a little bit of money. I think it's right that doctors let people buy their own supplements where possible.

I think its a bit rubbish to say no thats not it, but not investigate any other possible causes.

It's not NHS, I'm outside the UK. I would pay to get a prescription. (I actually didn't realise these iron supplements were available without a prescription, if I had I probably wouldn't have called her).

Yes she is allowed to prescribe, I have been prescribed supplements before when blood tests indicated that levels were low end of normal but not optimal.

I am prepared to accept that I am being a little bit U, but I think she is too... If th refernce range was narrower I might be less annoyed but it's massive, I'm at the low end and I'm symptomatic.

Ferrous sulphate tablets are available over the counter and would be significantly cheaper buying them like this than paying for a prescription.

What's more annoying is that I only got the blood results back because I asked the lab to send them to me, if I hadn't I would never have heard from the doctor as everything came back in the normal ranges. If hadn't started supplementing myself I'd still feel like shit.

Ye I only just realised Margrat ... so ths whol rant is pretty pointless. I'm still annoyed though.

This was a very boring AIBU and you just wanted to have a rant.
Job done.

Normal range is normal range and it's very difficult to argue your case. However, really, it is not expensive to go into the chemist and buy ferrous sulphate OTC. I go through periods where I take one tablet a day when I feel 'anaemic'. I have never asked for a script. I just buy it. But do talk to the chemist. Like all tablets, you want to be absolutely sure of the dosage.

The problem is, you have symptoms but the diagnostic results of the bloods say 'good news, you're normal', even though you don't feel normal. I hear what you're saying with regards to your frustration. And I have totally felt all fuzzy, faint and anaemic, had bloods done only to have them come back as normal. The GP is not at all being lazy or narrow-minded. He/she is simply following protocol. I know. It's not the answer you want to hear. ;-)
Have you considered a B-12 supplement? Also, take your ferrous sulphate with vitamin C for better absorption.

I think you're being a bit unreasonable - understandable if you're tired and iron deficient. But really if you can get them yourself then do it - the doc obviously feels that you're in the normal range for iron levels and so upping your green intake and a bit more red meat along with supplements will sort you out.
I hope you start to feel more yourself soon though!

Yes Clobbered

Just buy them.

GPs in the UK only prescribe if a patient is below the reference ranges, not if they are just a bit low, so yours may be the same.

If you are not NHS why would you even want a prescription?

Also... here's the deal and I'm just being totally straight: You have a 5 month old baby. Babies are awesome. I've had three. But having babies takes "I feel like sh*t" to a whole new level. You. Just. Don't. Sleep.
Let's not pretend here... everyone talks about dreamfeeding, co-sleeping, breastfeeding, bottlefeeding, etc, etc, etc NO ONE has found the holy grail... the gold dust that will allow you to have 8-10 solid hours of sleep throughout the first year of your baby's life. It's just hard! Mothers need to say that more often. It is bloody hard, that first year. You feel ill with fatigue. It's more than being shattered. And to be honest, this is most likely what's going on with you. B vitamins... can't recommend them enough.

I think that if I were utterly exhausted, had actually managed to drag myself to the GP and had a response like that from the doctor I would feel exactly like you do about it. I have actually been to the GP due to horrendous relentless exhaustion and had a similar response and it's rage inducing. That might not be a reasonable response but hey, extreme tiredness doesn't predispose you to being reasonable.

The thing is, the sleep is actually not too bad now. He's only waking once, it takes 5 minutes to feed him, I pop him back in the cot and he goes back to sleep. I'm getting 7+ hours of sleep, with usually only one waking so it doesn't make sense for me to feel so terrible - and now I have been taking iron supplements I feel much better.

It would be a shame if I'd just accepted that feeling so awful was par for the course for having a 5 month old baby when something so simple has made me feel a lot better.

I am prepared to accept that I was being unreasonable to the doctor! However I do think that the ref ranges for ferritin are too broad. But that's not her fault.

senren we're not NHS but we do have a public health system - it would be much cheaper to get a script. But it's not the end of the world.

I think you have nailed it Sweet!!

ferrous sulphate was great for my ferritin levels. And cheap

OP have you had your thyroid function checked? The tiredness and exhaustion I felt with under active thyroid was off the scale really. Easily controlled with medication. Takes a while to kick in but makes a huge difference. (I also thought low iron was at fault.)

I do agree that the reference range for ferritin levels is too broad. Mine are at 6 atm, and although I know that's a bit low, I have no clue what I should be aiming for them to be when they can be anywhere from 12-150.

I agree with pp, I'd buy some tablets if I was you and carry on taking them. Hope you feel better soon.

Cripes Penguin do you feel like shit warmed up? I felt like the walking dead when mine were at 10!

Awake I wondered if it was thyroid as have tested positive for antibodies in the past but everything came back well within normal.

Yeah, I feel bloody awful! Dr's kept saying it was the pregnancy, but I kept arguing I shouldn't be feeling worse in the second trimester than I did in the first. After a lot of pushing I finally got the blood test and then the result today. Bit of a relief to know it's not all in my head tbh! Lol.

Was it ferrous sulphate that was actually prescribed though op?
I was low few weeks ago and was prescribed that, it didn't work and im now on my third different type of iron compound tablet. Fingers crossed this one is working!
I do understand though.
I don't yabu.
I know the difference between exhaustion and when im just low.
I can't stay awake. I try to fight it but it's impossible.
Im lucky that i have a doctor who will prescribe me them.
Shes knows i can tell the difference.

My understanding is that ferritin is a protein that stores iron in our body and releases it in a controlled way into our body, we then use the iron to make haemoglobin which is the component of our blood that carries oxygen around our bodies. Low haemoglobin causes us to feel tired and even breathless and can be dangerous if extremely low. (sorry this is a bit long winded) The reference range for ferritin is very broad. This is because research has shown that in well people we can store large amounts of ferritin with no adverse effects, however ferritin stores above the reference range can indicate a number of serious medical conditions that should be investigated. It is not because the upper limit of the reference range is the optimum level of ferritin we can have in our bodies.
At 25 your ferritin levels are within acceptable levels for a women of child bearing age and this should be reflected in your haemoglobin levels.
If however you remain unwell you should encourage your GP to investigate further.
In the meantime though I would take an iron supplement like flurodix daily with vitamin c 1,000mg. Do not consume caffiene an hour either side of taking the supplement. I would also take a good quality multivitamin including vitamin D and B. Eat plenty of red meat, always eating a vit C containing food with it and never eat red meat with leafy green veg like spinach as this can prevent you absorbing the iron in the meat.
After my third child I left hospital with a Hb of 70 and a ferritin similar to yours. I did all of the above on the advice of my wonderful naturopath and felt better in about 8 weeks. I am also a healthcare professional.

Thanks Padthai I knew about the Vitamin C but had no idea about the leafy green spinach + red meat. That's v useful.

Buy vitamin D as well, it's a frequently missed problem...

Agree with Vit D, it helps with so much. And if you can get your hands on Floradix then do so. That stuff was a little miracle for me, much more gentle than tablets. You're right to rant though... boosting yourself to a meagre 26 still indicates a medical issue that should have been better addressed.