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 can’t believe you’ve been so let down and misinformed by professionals. 3 is so low.

I know you've said this isn't iron deficiency anaemia but if you look at the following link it has some associated clinical papers that might be helpful to you in reading up about the consequences of anaemia and how it's mishandled in women.

Dugan C, MacLean B, Cabolis K, Abeysiri S, Khong A, Sajic M, Richards T; Women's Health research Collaborative. The misogyny of iron deficiency. Anaesthesia. 2021 Apr;76 Suppl 4:56-62. doi: 10.1111/anae.15432. PMID: 33682094.

pubmed.ncbi.nlm.nih.gov/33682094/

GP referred me to haematologist but insurance says no, iron levels are low due to my lifestyle choices

What on earth does this mean?

A haematologist can prescribe an infusion which works faster than oral supplements

But it’s pointless having an infusion if you don’t plan on keeping up with taking supplements, waste of everyone’s time!

I have been anaemic many times, always with a ferritin of less than 3.
When my HB was 5 I was rushed to hospital for a 4pt transfusion (this was years ago), when the HB was 7 they were not to concerned until I begged them for a transfusion, thankfully my doctor was lovely - it wasn't easy to convince though!
At HB9 (during covid) I had to fix it myself with the prescribed medicine - honestly, the tummy ache is appalling, but better than the threated heart attack - and yes, they said that at HB 5 I could have easily had a heart attack.

If you want to get better, take the Ferrous 3x a day with a glass of orange juice, really look into what you can and cant eat (grapefruit and Tea and anything with tannin) Research yourself how to fix this as it can be done.

Breakfast Cereal contains a lot of Iron, Dried apricots, nuts etc and Ovaltine, You can do it, but you have to put the effort in.

With a ferritin level of 3 your functioning will be hugely impaired- fatigue, breathlessness, brain fog etc. It's super important you treat it. An iron infusion is the fastest way to do this, otherwise a large dose of iron with a glass of orange juice or a vitamin c pill every day.

Iron from non red meat sources is not readily available for humans. Calcium blocks the absorption of iron, so do tannins. Do you drink tea? The vegetable sources of iron also contain calcium which makes them less bioavailable. I recommend the website diagnosisdiet.

Even Ayurvedic diet will recommend eating beef as a treatment for certain cases!

@Bagelsandbrie

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.

You don't need a prescription to buy 200mg ferrous sulphate tablets, you just have to ask at the pharmacy counter. They cost about £2 for 28 tablets.

You can buy 312mg Ferrous Fumerate over the counter in Boots and it is cheaper than prescription charges.

OP - ask your GP to refer your for an iron infusion. You must be feeling awful.

Definitely get it sorted out OP. You won’t realise how bad you’ve been feeling until you’re better. Feeling tired etc becomes normal because it’s been normal for you for so long.

I have IV iron frequently (it’s only $83 in Australia, I can not believe how expensive it is in the Uk). I feel a million times better after.

Spatone sachets are also amazing as they’re more easily absorbed- the pills are higher mg but a lot of the contents just pass straight through (black poo!). Before I ever had an IV I used to take a spatone twice daily in a cup of pure orange juice. My levels were lower than yours but improved - it’s not the same as an IV but still made me feel a lot better.

@milkyaqua

GP referred me to haematologist but insurance says no, iron levels are low due to my lifestyle choices

What on earth does this mean?

They won't pay to treat a condition that is common in menstruating women that can be treated with iron supplements from the pharmacist or if the OP collapses, as an emergency by the NHS.

Though the OP will still need to take iron supplements after an infusion unless the cause can be dealt with properly.

@bumbledeedum is right. Every time I've been anaemic and had a prescription I've been told by the pharmacist it is cheaper for me to pay for them myself.

"They won't pay to treat a condition that is common in menstruating women that can be treated with iron supplements from the pharmacist or if the OP collapses, as an emergency by the NHS."

Gosh, that's a bit rough, isn't it. I thought 'lifestyle choices' implied some sort of judgement. Is it, perhaps, c/- not being on the pill?

Anyway, one's 40s are an excellent time to give the body (and lifestyle if necessary) an MOT. Only one body, and one life, after all.

Something like 'The Age-Well Project" book/blog is one place to start. I really think there is a better way of living than being dizzy and exhausted all the time, for starters. At some point, you have to take your own health into your own hands.

@Catkitkat

And no, I have no idea why my iron is this low. Periods haven’t changed. I used to have normal or slightly low iron at times but never like this. Three pregnancies maybe explains it? And I sort of went off my food, it’s been hard to eat properly but I’m making an effort to get at well

Might be diet then, or an absorption issue (developed coeliac disease for instance), pregnancies can really fuck up your body so who knows what might have changed since them. If your periods haven't changed then I wouldn't bother dealing with periods as stopping them might improve your levels but mask the real issue. Increase red meat and especially liver (have pate if you can't stand eating proper liver)

Has the GP referred you to investigate your anaemia? Appreciate you’ve been told you can’t be treated but you are very low and usually they would want to rule stuff out.

Also for what it is worth I couldn’t ever take iron tablets, medicine as would cause massive headaches, stomach pains etc so ended up having quite a few infusions. My anaemia was caused by heavy periods and was still given iron infusions.

I’m absolutely shocked that you haven’t been given one with your levels as they are.

Also for what it is worth I couldn’t ever take iron tablets, medicine as would cause massive headaches, stomach pains etc so ended up having quite a few infusions.

Think I'm the only person who tolerates iron tablets really well, in fact they help settle my stomach down quite a bit as I've always had stomach ache and unsettled feeling and very bloated, not sure why iron tablets would help with this but they seem to. I do remember taking them around 10 years ago and getting constipation and stomach aches but strangely they've not had that effect at all the last few months I've been on ferrous sulphate.

I'm a vegetarian with quite a poor diet so I started on iron tablets for dark circles under my eyes and hair thinning-doesn't seem to have helped those yet though :( They do make me feel less irritable, not sure about energy levels. I was put off at first by all the talk of side effects so I count myself very lucky not to get them. I even take them just to settle my stomach down sometimes!

Christ this makes me glad my Gp and hospital are amazing. Op you do know that a hemoglobin of 8 or below and you’d have a blood transfusion. You need to demand to be referred to a hematologist and fast. Taking low dose vitamins and eating veg doesn’t cut it. For my anaemia I’ve had 4 iron infusions and countless blood transfusions and my bloods are checked every 4-8 weeks. My anaemia is slightl different as I have hemolytic but my lowest hb was 7 so I can imagine how tired and ill you are. You don’t need to go private for this.

@Hairyfriend sorry if it’s already been said but most ‘prescription strength’ iron tablets are in fact P meds which can be bought under a pharmacists supervision, not prescription only. Ferrous fumarate 322mg is POM but the rest are P meds.

As PP said you need a stronger iron supplement designed to treat anemia, preferably a liquid one as more easily absorbed, take it with vitamin C, make sure you don't take any calcium supplements or dairy around the same time as calcium can decrease absorption. You tend to absorb more on an empty stomach. Eating a heme iron source at the same time as non heme source can increase intake from the vegetarian sources, adding a food source of vitamin C to your food when eating iron rich foods can help absorption. The times I've needed iron infusions, I had to show that I couldn't get my levels up from a few months of prescription iron supplements first.

Did he or she also test if you have ceolics disease? I had low iron and the cause was ceoliac. Its a misconception you need stomach problems to have ceoliacs - some of us are silent ceoliacs and don't have obvious stomach problems except the low iron. I would fall asleep after eating,

I struggle to absorb synthetic vitamins - (have a look what they are actually made of! ) And despite eating red meat and taking iron supplements, my iron levels were low and I was always exhausted. A couple of weeks ago, I started taking beef organ (heart etc) supplements in capsules - as I won't eat offal. It's like night and day with my energy levels. I have not had my levels tested but I feel like I'm absorbing it. Worth a shot?

I had an ablation. It worked very well and my iron levels went back up. My hair thickened up again. It was well worth doing. The doctor in theatre discovered a fibroid that hadn't been visible in the scan and removed that as well before the ablation. While waiting for the ablation I did make a concerted effort to eat red meat and that did help a bit.

Your NHS GP sounds like s/he needs to do something. They could presumably prescribe ferrous fumerate since their referral didn't come off. Honestly, that sounds the worst type of private medical insurance I've ever heard of. Almost everything could be a lifestyle choice. You'd have to eat tons of green leafy vegetables (probably literally) to improve your iron and what would exercise have to do with it.

Please treat it I have anaemia they've never found a cause I just have an iron infusion every year and also take supplements daily.

My hb got so low I was at risk of a cardiac arrest, I had no idea it was 4, but had odd symptoms that I didn't add up or mention to anyone.

Please at least buy OTC iron

I had chronic anemia and after months of treating it with iron tablets it turned out my kidneys weren’t working properly. The kidneys make a hormone, erythropoietin, that make red blood cells. Not all anaemia is iron deficient. Despite my kidneys actually failing and being on dialysis now, I still feel better than when my anemia was untreated!

For me 1 ferrous glucomate (glutomate?!? I'm not sure!) tablet has worked at steadily building up my iron over time. Anything stronger gives me all sorts of issues. GP prescribed first pack but it's cheaper to buy straight from pharmacist. I was told to take with orange juice, away from dairy, and only every second day.