Anaemia: ferritin levels 5. How low is this and can it cause depressive symptoms?

[dontrunwithscissors]

My GP finally tested for anaemia this week. I've been complaining of extreme fatigue for at least 9 months, but it kept being put down to lingering symptoms of depression as I have bipolar. My GP ignored the fact that I'd also developed: heart palpitations, fainting, dizziness, weakness, brain fog, breathlessness, cracking/dry/bleeding in the skin around my eyes, finger-tips and corners of my mouth, losing hair.

My ferritin levels came back as 5. How 'bad' is this? I feel so utterly drained. I can barely climb the stairs due to the weakness and breathlessness. I'm now on iron supplements. I'm really hoping that the ongoing 'depression' is actually the anaemia. Can anyone shed light on the likelihood of this?

How long will it take for me to feel any benefit from the supplements? I'm barely functioning; I'm working from home as I'm too exhausted to leave the house, but I can't concentrate enough to get anything done.

That's a very low ferritin level. But ferritin is only the storage component of iron, to get a fuller picture it would be good to know what your haemoglobin level is as well. Iron is required to make haemoglobin, and although the body tried to conserve it, if you lose blood regularly (bleeding from somewhere, or heavy periods, or both) then of course the body can't reclaim the iron and re-use it.

Iron deficiency can indeed cause depressive symptoms, as well as all the other physical things you have going on. Depending on what supplements you're taking, you should start to feel better fairly soon, but it will take a while to build up your iron stores again.

Do you have your haemoglobin results as well?

Many thanks.

I'm not sure about the haemoglobin results. I was not really 'with it' when my GP rang. I know she mentioned the figure 110 and I've written next to it 'blood count', but I'm not sure what that means.

dontrunwithscissors I had similar recently. I went onto irons supplements (its best if you can take them with Vitamin C daily, as that helps keep the iron in your system longer). Also started eating lots more dark green veggies and some red meat. You can also get iron in beans and cherries.

Really hoping you feel better soon. It might take a couple of weeks.

Try to avoid caffeine and alcohol if you can as they will make the anemia worse.

www.mumsnet.com/Talk/general_health/2188965-Ferritin-is-2

Some advice here, would explain a lot of your symptoms.

That is shockingly low.

Thanks for the responses.

That link is helpful. Thanks MC. It's a relief to read about how other people felt as I've been so worried that the fatigue is 'in my head.' My bipolar meds have been pushed up and up on the basis that I'm depressed, but not made any difference.

I think I'm going to see a GP soon to clarify the situation. I'd like to know the full picture and ask how I might have got to this situation. I have light periods so can't blame that.

I've remembered that my GP said my ferritin levels were 131 when they were tested 18 months ago. I wonder how long this has been going on. I'm a bit pissed off that all these symptoms have been put aside on the assumption that it's depression.

CP: I've been drinking a lot of coffee over the last few months to try to wake myself up so maybe that's made things worse.

Yes, that 110 sounds like it's your haemoglobin level, using slightly different units to those I'm used to (gorn American by the looks of it!) - I'm used to them being a factor of 10 lower, so 11! But working with what you've got - 120 to 170 is a normal haemoglobin (Hb) level for women, so yours is a little low, but not disastrously so. If you were down to say 70, you'd be looking at a possible blood transfusion which would make you feel hugely better very quickly; but as your Hb is only a little low, then feeding you iron supplements is the way forward.

Re. those - if you've been given ferrous sulphate, then that's the least effective (albeit cheapest) option - even with concurrent vitamin C, you still only absorb probably 20% of it? And it can have nasty effects on your bowels, giving black sticky poo etc.
If you can get e.g. ferrous fumarate, then it might work a bit quicker.
Definitely still take it with vit C though because that helps to increase the absorption of the iron.

Don't get too carried away with the green leafy vegetables though, they also contain phytates which can inhibit iron absorption; your best source of dietary iron is through meat because it's "haem" iron, more easily absorbed. Unless you're vegetarian of course.

My ferritin levels have been as low as 5. Certainly made me feel shitty (was pregnant) but not depressed. That's just me though. I was on 3 tablets a day (120g) and my ds is 9 weeks old I feel a whole lot better for it

Thanks for the replies.

I've just checked and I've got 'Ferrous Fumurate 210 mg', 3 tablets a day.

Oh that's excellent, good stuff :)

My ferritin level was 3 and I was exhausted but the iron tablets and iron rich diet did help quickly. I took tablets with orange juice and avoided tea and coffee for a while. I also had a course of injections when I was pregnant and haven't had a problem since.

You might find this useful as well:
patient.info/doctor/non-anaemic-iron-deficiency

My ferritin levels were 5 a few weeks ago. The doctor reckons it was down to heavy, 3 week cycles and giving blood. I think my levels did drop further because I got to the stage where I could barely stand. Within a week I started feeling better and am almost ready to get back to the gym etc.

It defo caused depression type symptoms with me as I was just always so exhausted! I'm meant to be getting retested next week, but with it being xmas I think it'll be postponed a while!

Mine got down to 3. I felt utterly shit. My hair was falling out, my nails were flakey, I slept all the time, I think I only managed work because I was embarrassed to phone up and say I couldn't come in because I was tired. It was going on for years, at least 8, I've been borderline normal so the GP always said I was fine. The 'normal' range used by the NHS is low. They will say you're fine if your level is over 17, when really optimal levels are over 70.

What's the cause of your anaemia?

I did the same with caffeine, I was having a strong cup of tea before bed to "warm me up" and it didn't help in the long run.

Also with symptoms, I had the shakes terribly one day,got myself into a bit of a nervous state and threw up. A friend of mine explained that the body sometimes does that.

I have to say I was struggling at 50, though hypothyroid. Wow that's low.

One tip I was given by many people was to take with vitamin c.

I took a lunch time iron with berrocca (sainsburies own with no calcium which blocks absorption) and evening one with a fizzy vit c tablet. You could split a tablet up for your three doses.

Try to avoid calcium and calcium foods (milk) near taking it.

It could take a few months to get it up but stick with a good plan like this and it should help.

My GP and endocrinologist commented that really normal is over 70. Many are fine below this but everyone is different.

That ferritin level is way below range, so low in fact that you’d be much better off having an infusion and then being monitored, rather than faffing about with iron tablets, which are notoriously hard on the gut.

As Clarella says, to be optimal, your ferritin level needs to be at least 70 and preferably mid-range. That way you have enough of the stuff to support all sorts of biochemical processes in the body.

You can minimise problems with the iron tablets by starting off taking one a day for a week, then adding a second and, after another week, adding a third, but if you have any problems with them ( some people get constipated, I had constant explosive diarrhoea) I’d suggest you go straight back to your GP and ask for a referral to a haematologist for an infusion.

More to the point though, if you are not having bloodbath type periods, they need to be looking for the cause, starting with checking out absorption issues and testing for coeliac disease.

When mine was 3 they wouldn't send me for a transfusion, said its not the done thing anymore

Thanks for the suggestions. I've got some vitamin c.

As DH has pointed out, I stop eating when depressed and I've spent about 40% of the last year in deep lows so it's probably down to that. Sounds easy to remedy, but I really struggle to eat anything.

Anyway, the fact that I have a (physical) 'reason' for the ongoing fatigue and lack of concentration is helping me to pick up. I was getting desperate--thinking that I wasn't going to pull free of the depression. It makes sense now that I can link the fatigue with the other symptoms.

I have hypothyroidism and a kind of phobia of tiredness! Because the exhaustion is crippling and stops you participating in normal life. So it leads to anxiety and depression. But it's not the full story as I perhaps focus too much on it and so it gets magnified iykwim. So I'd say when you feel better you will be able to do more to distract, exercise, get on with socialising (not being able to alienates and disables you so leads to low mood) but at the same time there might be a few tail end down patterns that might need addressing (cbt for example)

For example the frustration and invisibility of fatigue puts a lot of pressure on me, and I do on myself, which isn't great for mood! But the primary cause is chemical, in your case iron. So fix that and you should be 70- 90 % there.

Thanks clarella. I also have hypothyroidism and remember the tiredness from that very much. I had my TSH tested and the levels are fine.

Ah.

It's very important to get it much higher then.

Are you 100% sure you're levels are ok? I have to keep my tsh around 0.5 to be ok. As you know that messes with your head too!

It's taken a long time to recover I must say, but my thyroid levels were a bit off too.

You mustn't take your iron within 4 hours (check with pharmacist) of the thyroxine as it inhibits the thyroxine absorption.

From what I've gathered a good ferritin, vit d, b12 and folate level are v important to support the way thyroxine is converted into t3 in the body, as you are missing the 20% t3 a healthy thyroid makes. Hence needing a suppressed tsh.

(All explained (the 20% t3 bit) in the British medical association book "understanding thyroid disorders" by Dr A Toft - I heartily recommend getting it)

And do double check there isn't anything else going on eg coeliac as there is a slightly higher incidence of the two going hand in hand.

Thanks. I need to check with the GP about my thyroid levels. The check done last week was 0.65. But the check done three months ago was 4.11, which is obviously quite high. It's been five years since I started thyroxine and all of my other tests have been 2-2.5. I want to check with her why I've had such massive differences in the space of 3 months.

Mine was 10 and I felt terrible- OCD symptoms and low mood, anxiety off the scale.

I couldn't believe how much better I felt only 2 days after starting iron.
This is really underdiagnosed in women.