Blood test shows low haemoglobin, normal iron levels, but I still feel tired. What can I do?

[schroedingersdodo]

I'm 10 weeks pregnant and have been exhausted for weeks (feeling a bit better these last few days). Went to the GP and had a blood test that showed my iron and ferritin levels are fine. TIBC levels are low (just noticed that now).

Haemoglobin levels are low (minimum is 11.5 and my test was 11.6), haematocrit and RBC also low.

(no thyroid problems or anything wrong with the while cells)

Doctor didn't bother to explain anything. Said my exhaustion is probably due to pregnancy (doh!), there was no treatment and sent me home.

I have had low haemoglobin for years. A few months before I got pregnant I went to give blood and my levels were just the necessary to donate.

It's my second pregnancy and I don't want to spend most of it feeling rubbish, specially because now I have a toddler to deal with.

I know I'm asking a lot, but it would be great if someone could please explain why I've had these results, what do they mean, and what I can do to improve my haemoglobin levels?

Thanks a lot!!!

I can only say about the ferritin - it's borderline already and some people feel v tired when it's that low. They are your iron 'stores' so if your body needs more iron, it won't have much to take. How about trying spatone (it's a mineral water high in iron) as a natural and gentle way to increase iron stores, plus looking at eating more iron rich food
Are you already taking a good pregnancy multivit? You could also top up vit d

I can only say about the ferritin - it's borderline already and some people feel v tired when it's that low. They are your iron 'stores' so if your body needs more iron, it won't have much to take. How about trying spatone (it's a mineral water high in iron) as a natural and gentle way to increase iron stores, plus looking at eating more iron rich food
Are you already taking a good pregnancy multivit? You could also top up vit d

Hi Merci, I'm already taking spatone, as well as Pregnacare. And trying to eat meat, nuts, eggs, green leaves, all those things. However, it costs a fortune to eat like that, and timing the iron rich food with all the stuff that is bad for absortion (tea, milk, etc etc) is a PITA. I spend all day thinking about iron levels...

And I'm still not sure what is wrong with my blood! Maybe there is another reason or treatment that the doctor can't be bothered thinking about? He said that since iron levels are good, there's nothing to worry about the iron at all.

Did your doc test your b12 levels? I was always knackered (still sometimes am so it's not a cure all) and turns out I'm b12 deficient. My haemoglobin is ok it just my b12 so I don't have pernicious anaemia.
Anyway, I now get b12 injections every 2 months and it's changed my life.

If you always take spatone, I wonder if it's an absorbtion problem like gluten intolerance?
if you feel knackered stll, go back and push for more tests or iron tablets. You can also buy food grade iron to sprinkle on food - easier on the digestive system than the kind the gp prescribes

Born, no I didn't test for B12, but I've read about it already. It didn't occur to me to ask for that. Maybe if I ask the midwife to test for that?

Merci, but that's the bit I don't understand. If my iron levels are good, how can it be an absorption problem? I feel a bit dim but I really don't get how the whole thing works...

And where can I get this iron sprinkle thingy? Never heard of it! (iron tablets don't work for me, apart from making me very constipated!)

Hello
Your results are normal, albeit low-end-of-normal, for this stage of pregnancy. Haemoglobin (Hb) and related blood tests usually appear lower in pregnancy: it's termed dilutional anaemia of pregnancy.

This happens because plasma (blood) fluid volume goes up a lot, even in early pregnancy (and by 50% at 30 weeks). Although some more red blood cells (RBCs) are made, their increase is much less. So, in your blood tests, the same amount of RBCs with similar amount of Hb is present in more fluid thus overall diluted. Because Hb is expressed as a concentration, it is lower.

I wouldn't therefore be worried by these results: they're normal. But you do need more iron during pregnancy, as does everyone, so the supplements are a good idea.

See this webpage for more info (is aimed at doctors):
www.patient.co.uk/doctor/Physiological-Changes-In-Pregnancy.htm

By the way, schroedingersdodo, did you use to be ...meow? If so I met you in hospital before you gave birth last time! Good luck!

My 2nd pregnancy I just felt so tired for the first 3 mths. Progesterone is the cause & I read somewhere it can have a hypnotic effect. By 9.30 I had to go back to sleep until lunch time. I've never known tiredness like it. I had it a bit with my first pregnancy but not at all with my 3rd. If you are taking supplements & the Dr isn't concerned then I wouldn't worry.

Hi Magenta, thanks for the link. I know my tests are "normal" and I'm not at risk, but that's exactly what p**s me off about the doctors. They don't care if I'm feeling bad! If there is no risk of death, they don't care! I think this is just disrespectful.

(I feel as if they're saying "Oh woman, stop moaning, go home and suffer, it's your role. Your feelings are not important, just breed this new person for us, will you please?")

And by the way, I'm not meow... :( Are you in London?

Hi Julia, that's interesting, I've never heard it would change so much between pregnancies. Hope the rest of this one will be a bit easier.