To not treat anaemia/ iron deficiency

[Catkitkat]

My ferritin is 3 and hb is 9, so it’s on the low side. GP referred me to haematologist but insurance says no, iron levels are low due to my lifestyle choices so I should exercise, eat leafy greens and take supplements to raise my energy levels. NHS says I should get birth control which reduces periods, otherwise just get on with it.

The thing is that I’m already taking supplements (when I remember) and I eat a lot of iron rich vegetables on a daily basis, I really love vegetable so this is not an issue for me. I’m also not a vegetarian so I will have red meat every now and then.

So what more can I do? I can’t really change much on my own to improve my energy levels elsewhere or wellbeing. I feel wiped out, I can’t even explain how tired I am all the time. It’s not fair on my children to have a mother who is this low on energy.

And also, what happens if I leave this untreated? Is there a long term risk associated with these levels, am I risking something by not seeking a second opinion?

I would
Take a proper iron supplement like ferrous fumarate every single day with a glass of orange juice or vitamin c tablet
Avoid drinking tea with meals
Up the leafy greens

And then see how you feel. Untreated it can cause heart issues, you might be breathless, tired and get chest pain

Are you in the U.K.? You shouldn’t need private insurance to see a specialist your Gp has referred you to? Confused.

Over the counter iron supplements won’t be strong enough to treat anaemia. You’d need prescription strength ferrous fumerate or ferrous sulphate. I take 210mg ferrous fumerate daily for long term anaemia due to lupus.

Untreated anaemia is very serious indeed. In its most advanced stages it can literally cause your heart and other organs to stop working. Of course that’s extreme though and most cases are treated way before then.

Most cases are treated through the Gp without needing to see a specialist.

A ferritin level of 3 is very serious and an iron/hb of 9 is well on the way to serious. A few more heavy periods and you’ll be feeling even more fucked to be honest.

Also, non-heme (i.e. vegetable based) iron is poorly absorbed by the body in comparison to heme based (red meat).

If it’s periods that are the cause of the deficiency then getting a Mirena coil or using birth control pills for a year or so will allow your body to try and replenish your iron stores (ferritin).

Long term, left untreated can and will have very serious implications to your heart and brain.

You can buy a proper iron supplement over the counter for cheaper than a prescription charge in the UK.

You only need to take it once a day with some orange juice.

Veg is not going to cut it. The amount of leafy greens you would need to eat to raise your Hb, an elephant would struggle with. You need meat, proper iron, sorting your periods out.

There are lots of health conditions that are made possible or worsened by anaemia. No one can make you treat it but you'd be a fool not to.

I had iron infusions in the summer. It's made a difference with my energy levels for sure.

You can also start cooking with cast iron because it does impart usable iron to your food and something like blackstrap molasses one tablespoon has 20% of your daily iron. It's not very tasty but you can put a spoonful in hot water and drink it like tea.

You have iron deficiency anaemia. You say you're taking ad hoc iron supplements and you aren't testing the suspected cause of your anaemia - you mentioned periods. I'm interested in knowing what you think a haematologist will do for you at this point? Unless I'm mistaken, you've stated that you're not actively treating (regular treatment dose supplements) or preventing this issue (managing periods)?

A doctor told my great aunt to drink half a Guinness a day for iron!

What do you mean by when you remember? And what supplements?

You can’t admit defeat and carry on feeling awful or you can start with the basics by taking a proper iron supplement twice a day and following the detailed advice on the NHS site about how to take it to maximise absorption.

If you have heavy periods you can take tranexamic acid to reduce the heaviness.

• treating not testing

I personally would. Having anaemia can have serious impacts on your energy and overall well-being if not properly treated. Having iron supplements has definitely had a huge positive impact on me.

Or you could just feel a bit shit with a chronic condition for years and wait and see if it becomes acute

Ugly

High dose iron tablets are really cheap online ,(Ebay or Amazon,). Why would you want thin hair, no energy, brittle nails, breathlessness etc ?

@AnnaMagnani

You can buy a proper iron supplement over the counter for cheaper than a prescription charge in the UK.

You only need to take it once a day with some orange juice.

Veg is not going to cut it. The amount of leafy greens you would need to eat to raise your Hb, an elephant would struggle with. You need meat, proper iron, sorting your periods out.

PLEASE don't follow this incorrect advice about over the counter iron supplements! You need a prescribed dose of iron supplement (often ferrous fumerate 312mg or similar). An over the counter iron supplement in the UK is FAR lower that this and for maintenance only- not for correcting a severe deficit. They are correct in relation to meat sources of iron though being much easier for the body to absorb. OP- what do you mean by insurance though? If you are in the UK as a resident, you should be seeing a specialist without insurance?

Long term anaemia can cause all manner of issues! Hair and nail loss and thinning, heart irregularities, menstrual irregularities or them stopping all together, fertility issues and long term health issues!

In my early 20's, I had a ferritin of 4 and Hb of 9. I felt dreadful! Knackered all the time, recurrent UTI's, short of breath and light headed at doing even light exercise.

It takes 3mths for red blood cells to replicate, so correcting anaemia is not a quick fix at all. I was starting to feel better in about a month, but it took longer for a full recover. My nails grew back stronger and there was an obvious line where they had been thin. My hair got thicker and I eventually felt back to normal.

Set an alarm to take your supplements, eat more meat (even if just for now), cut back on all tannins, increase Vit C rich food and consider additional things like seaweed and spirulina supplements.

Thanks everyone for taking the time to respond.

In answer to come of the questions:

I’m in the U.K. This came up following a visit to the A&E for something else, they noticed that I had normocytic anaemia and iron deficiency and also elevated platelets and suggested I follow up with my GP

I did, and she confirmed these findings and referred me to a haematologist with a view to organise an iron infusion and ask to get to the bottom of what is causing this. The insurance declined this as they felt that these concerns were linked to poor lifestyle choices and also my age which is 45+, so all perfectly normal if perhaps not ideal. They suggested leafy green veg ad exercise to feel better.

Paying for an iron infusion myself is not an option as it’s in excess of £900.

I tried the NHS who also did not feel that any of these findings required a referral to a specialist.

So the A&E and my privat

You would probably need to be put on ferrous fumarate the correct dosage and as pp said maybe tranexamic if periods are heavy .

Store supplements were no use Gp told me , I let mine get really low , I’m useless at taking tablets every day always forget .

Due to anaemia and not treating it , I would have random days where i would wake up and Struggle to get up and dressed due to foggy dizziness, didn’t feel safe to drive the only thing that helped was to lie down and close my eyes sometimes it would last for an hr or two or best part of a day . One day at work couldn’t concentrate had to go and sit down getting all panicky it was happening quite often , so made extra effort to take tablets and touch wood been ok . I take tranexamic now for 3 days at start of period .

The A&E and private GP felt that this should be looked at, and the insurance Cosby and my NHS gp disagree

This was all before covid so when the panic struck I just left it. Now I recently had my bloods done again and it’s slightly worse than three years ago, ferritin is now 3 and hemoglobin 9.

So I was just thinking about what to do. The insurance still won’t cover any of this so my options are to live with it and keep trying to improve my health (thank you so much for all the suggestions) or to try to get a second opinion I honestly have no energy to do this).

So my question is if I am somehow putting myself at risk if I don’t manage to improve my iron levels? I guess not, or the insurance and my NHS GP would have referred or treated me? It’s just hard to find an answer when I Google this. Of course it’s not ideal to be tired all the time etc but if it’s not dangerous I guess I I have to get on with things.

So sorry about all the typos. Apologies

Having read your follow-up, as I see it you can go back to your GP and push for iron infusion referral, OR ask your GP to prescribe ferrous fumarate, take it as religiously as you can, with vitamin C to aid absorption,
And also take something to reduce heaviness of periods (I take tranexamic acid, others may favour the coil to reduce period heaviness).

I am in similar situation to you, in that I have been anaemic. my GP asked my hospital to consider me for iron infusion and they said no. I haven’t tried the private route. So the above is pretty much what I have done.

Oh and I wouldn’t just ignore it! It will just get worse and affect your life far too much, it’’so unpleasant and can have serious effects yes.

Don’t just ignore it!!! Your GP won’t follow up with you (they are far too busy sadly), it is up to you to advocate for yourself.
Asking for prescription iron and something to reduce period flow is NOT a big ask of your GP. It is not expensive. It will cost the NHS more to treat you if you become seriously unwell than to prescribe you stuff now.

@Sallydimebar

You would probably need to be put on ferrous fumarate the correct dosage and as pp said maybe tranexamic if periods are heavy .

Store supplements were no use Gp told me , I let mine get really low , I’m useless at taking tablets every day always forget .

Due to anaemia and not treating it , I would have random days where i would wake up and Struggle to get up and dressed due to foggy dizziness, didn’t feel safe to drive the only thing that helped was to lie down and close my eyes sometimes it would last for an hr or two or best part of a day . One day at work couldn’t concentrate had to go and sit down getting all panicky it was happening quite often , so made extra effort to take tablets and touch wood been ok . I take tranexamic now for 3 days at start of period .

Good to hear your symptoms improved. I guess I just have to get better at remembering to take my supplements.

My periods have always been the same, and this iron deficiency issue only started a few years ago, so I don’t think they would be the only reason - either way I’m sure menopause will soon sort it out for me

I was told by an A&E nurse that a ferritin level that low inhibits clotting. I was told by another nurse that that level requires them to have blood on standby during certain medical procedures.

@ImAFraud

You have iron deficiency anaemia. You say you're taking ad hoc iron supplements and you aren't testing the suspected cause of your anaemia - you mentioned periods. I'm interested in knowing what you think a haematologist will do for you at this point? Unless I'm mistaken, you've stated that you're not actively treating (regular treatment dose supplements) or preventing this issue (managing periods)?

A haematologist can prescribe an infusion which works faster than oral supplements. I have normocytic anaemia which is different from iron deficiency anaemia, and also elevated platelets, so there were a few more questions to potentially look at as well.