to think my docs should act a little faster?

[HackneyHoney]

28 weeks pregnant. Bloods came back with (VERY) low hb levels. I'm breathless just talking and wake up breathless in the night and attributed this to my bump, but was told that level of breathlessness was not normal and due to my blood results. I'm exhausted and feel so utterly unwell. Midwives weren't able to write me a prescription however told me I needed to get one from my gp that day (Tuesday just gone) as my results were so worrying.

Phoned my GP and it just redirected me to 111 all day. Phoned them yesterday and they said the bloods hadn't come back yet. Phoned them today and they told me to try again on Monday. No docs appointments and I'm struggling.

I know how shit it is for GPs. My dad is one. Even he said they should write me the prescription.

I also find it unbelievable that nobody has mentioned diet. All the way through my pregnancy and even now. First thing Dad told me was to eat green leafy veg, eggs etc. That's another matter but he said it needs raising as I could've started to increase hb levels already without the prescription by eating these things and at least helped a little in the mean time. Nobody has ever advised me of this.

AIBU to wish for a faster prescription considering I don't need an appointment? Or am I just pregnant and miserable and need to wait my turn?

With an Hb of 70 here I’d give you an iron infusion (ferrinject). Oral iron takes far too long to work and depending on how well you absorb it, isn’t that great anyway.

Can you cook in cast iron pans? That (surprisingly) can help maintain iron levels. Leafy green veg, eggs and red meat are good dietary sources too. But mostly right now what you need is an iron infusion.

If you dad is a GP, he can do you a private prescription that you can bring to the pharmacy. He literally just writes it out on a page with your details, what you need and signs it with him gmc number. You will have to pay for it and the cost of the drug.

@HicDraconis I'm worried now! Is 70 really awful? Dad seemed concerned and said I needed to see gp today but he has this way of staying so calm as he knows I worry!

As long as baby is okay I will wait. Funny they're very blase about it. Strange they couldn't prescribe it when I got my bloods back at the hospital...

I’m not a health professional but even I know that although anaemia is often due to low iron, there are other, often serious causes.

I agree and try to get a telephone consultation to start the ball rolling, after all the receptionist is not medically trained to understand the significance.

If it is due to iron, you can help by not drinking tea with or soon after meals as it inhibits iron absorption, and drinking orange juice with meals, as vitamin C helps with iron absorption. Red grape juice and beetroot, and eggs are also good sources I understand.

And also a hb of 70 is very low, and with you bring so symptomatic as well I would wonder about going to your maternity hospital and getting seen. And running round from pharmacy to pharmacy isn't going to help your breathlessness

I’m a doctor ..... don’t panic. Your Hb will have dropped gradually. No harm will come to you or your baby but you the sooner you can get the iron started the sooner that you can start to feel better. It will take a while for your body to make the new Haemoglobin.

@MrsRyanGosling15 he did say 'if I was there I would prescribe it for you' but it's logistically not possible and got the idea that he thought I really needed to see someone.

@MapleLeafRag thank you! I will try the orange juice thing (been avoiding as the heartburn is real!)

My hb went to 4.5. The iron tablets made me so sick. Given liquid iron. Then two infusions. Baby is now 5m. And my iron is only just back to normal.. They never gave me any explanations or advise.
I ate A LOT of green veg and my diet was good 90% of the time..

Maple’s advice is good regarding Vit C at the same time as iron and avoiding tea to help you absorb the iron.

Iron sulphate tablets, which you can get from the chemist without a prescription, are fairly inexpensive. They made me a bit constipated, which I understand is a side effect for some people.

You must feel awful, I felt absolutely horrific when mine was 7.5.
No sinister causes for mine by the way, just a combination of pregnancy often leading to depleted iron and sickness meaning I hadn’t absorbed much from my diet. I’d also thrown up most of my pre natal vitamins. I had no further issues after taking the prescribed tablets and had straightforward births in the MLU.

I’d check with your Dad iron sulphate is ok for you.

Ferrous Sulphate 200mg is a prescription only medication, so you would need a script. Ferrous Fumarate 210mg is available to purchase over the counter however. Like other pp have said it is unlikely to raise your iron levels quick enough though.

It was a while ago pinprick!

I actually feel a bit stupid because I'm so breathless. Even talking makes me breathless sometimes and I've put it down to being pregnant this whole time. Actually it's because my hb levels are so low! Argh.

Any iron is better than no iron, OP. Ferrous fumarate is better absorbed than ferrous sulphate, and as your stores are so low you will absorb as maximally as possible. As PPs have said, vitamin C increases absorption. If orange juice makes you queasy, take a vit C tab with the iron. You can certainly buy iron otc, even if not the high concentrations. Get some into you, from every possible source!

Agreed with pp’s about taking the iron alongside vitamin C. Ideally drink some fresh OJ alongside the tablet and don’t drink caffeine at least an hour either side of the tablet. The tablets are really hard to digest for most people so I would actually recommend spatone, it’s a liquid iron supplement. I took two sachets a day towards the end of my last pregnancy and my iron levels were great.

As for diet, kale and spinach are great sources as is red meat if you’re a meat eater. Try green smoothies if you can stomach them.

Totally agree with you OP. Patients have to be ridiculously proactive these days to get anywhere with decent comprehensive treatment. You're lucky, you have a good standard of education, intelligence and support but there must be thousands of people who are missed and overlooked simply because they can't advocate for themselves to the high degree necessary to actually be listened to.
Whether your iron is up/down/sideways or longways is almost a side issue here. In my view the practice has failed to provide straightforward information, failed to communicate your results effectively and failed to follow up adequately.

If you're feeling breathless and can't get a GP appointment can you walk into your nearest EPU? Or maternity triage?

I've got low ferritin but my Hb is fine. I went to try and buy ferrous sulphate last night, the junior pharmacist was about to give it to me when the senior one overheard and asked if my MW had told me which one I needed, I'd not spoken to her at this point so I was refused - but it definitely seemed like I was able to get it without prescription. I bought some spatone instead, the leaflet says it's ok to double up so I've started doing that in the hope it will increase quicker. Hope you get sorted soon.

Memories from when mine was low - cut down on the dairy and increase the Vit C (but check that with a medic).

Hi folks. I've managed to get some prescription strength from a friend as she has a huge supply as needs them constantly! I'll just give her some back when I get my prescription (though she says she doesn't want them). Dad has OKd this and said it's exactly what he would prescribe. Thank goodness for him eh! Buying a smoothie maker tomorrow and a tonne of orange juice and kale and lots more veg. We'll see how it goes...

It’s strange that they told you the 200mg is prescription only because it’s absolutely not.
Very few vitamins tablets are prescription only and off the top of my head I can only think of vit D tablets and high strength folic acid that you can’t buy.

@Beingginger they told me that my iron levels are extremely low so they can't prescribe me what they think I need otc. I suspect they wouldn't prescribe me 200mg as I actually need more than this due to such low levels. Told me to see my GP ASAP. Got the tablets from my friend in the mean time until I can see doc. Didn't leave me with much choice but at least I have something now.

I had to get the liquid once upon a time. As soon as you opened the cap there was an overwhelming strong smell of rust. Smelling it was bad enough, putting it my mouth made me gag. Hopefully things have improved.