16yo with low b12, ferritin and vitamin d

[KickBishopBrennanUpTheArse]

Dd has been run down all winter and started getting patchy hair loss. Gp ordered lots of blood tests and they came back with low b12 (134), low ferritin (9) and low vit d (48).

She's started a loading dose of b12 injections and vit d capsules. It's early days but she does seem more herself.

My worry is they are not treating the low ferritin. From what I've read this is most likely to be causing the hair loss. She had a follow up test to rule out anaemia and that was ok. We've just been told to manage it through diet but she already eats most of the things that are rich in iron. And there's no way she'd eat liver or green veg

I'm not sure whether to get her some extra iron supplements, or wait and see if the b12 makes a difference. Would that increase her ferritin?

Also I keep worrying there's some underlying problem that has caused so many issues all at once. Is there anything else we should be looking out for? She eats a healthy varied diet although she doesn't go outside much.

Keep going with the supplements.
You can buy sachets of liquid iron in Boots. I cant remember the name but you could ask. They are very low dose, but if you double the dose and put them in fresh orange juice they do help a bit. Take them every day. Cut out tea and coffee as they stop you from absorbing iron. Eat as many iron rich foods as possible.
GP should prescribe iron for low ferratin, I dont know why some wont.
Is your dd anaemic because of heavy periods? If so, that needs sorting out as a priority.

Your poor DD. ☹

The pp was probably referring to Spatone. It's much more absorbable than iron tablets. I second the advice to limit tea and coffee consumption. She should not eat too much wheat or dairy either as these hinder iron absorption.

When my DD had low ferritin she was advised to take 2 sachets of spatone twice a day away from the above foods.

Thanks. She doesn't drink tea or coffee but she does have a bit of a coke habit (the drink variety) so I assume that's the same?

She actually went on the pill for painful and heavy periods a couple of months ago. Looking back I think we were blaming them for her tiredness because she was worse around her period but that was before she realised how bad the hair loss was. Hopefully that will help.

If her B12 is low she shouldn't also be supplementing with folic acid - quite a high dose

And magnesium will help the vit d be absorbed

It takes a while to build up stores of iron, several weeks at the least.

Special k has b12 and vitamin D in it if she can add that to her diet perhaps.

Did they test for pernicious anaemia as her b12 is so low? She needs high dose iron and she'll absord it better taken with vit c. 9 is very low.

Spatone is easy and palatable

katymac do you mean she should be having folic acid?

imagine I'm a bit confused about the followup test they did tbh. We haven't seen the gp again. The nurse did a second blood test when we went for the first b12 injection. She said it was to test for intrinsic factor but then when we went for the second injection she said that it had come back ok so she wasn't anaemic. Now I'm not sure whether they tested for iron or IF or even if they are the same thing?

Surely if her ferritin is 9 she is anaemic or heading that way?

Eek yes is should read

If her B12 is low shouldn't she also be supplementing with folic acid - quite a high dose

Aneamia is about the active iron being low - ferretin is stored iron

So she is using all the iron she gets and probably any stored iron she had

Ferritin can take years to be built up but GP's regularly ignore it

Does she go out much in the sun? I was discussing this with a GP friend who said there is a higher rate of children/teens with vitamin D deficiency because they are inside more than a generation before.

Vit D used to be supplemented in cereal and flour/bread (can't remember which) but they stopped supplementing

It's really hard to get enough sun in this country tbh

No she doesn't go outside or even get up without persuasion

We're working on it!

I also had low vit d last year and I run outdoors several times a week. We do live in the cloudy north though.

On vit d deficiency, it really can affect your mood as well as physically. DH has to take supplements and was prescribed a very high dose for a while.
I have B12 injections but didn't know about the folic acid. I'm going to check next time I go to the GP! I try to remember to take iron with vit C.

The negative result for intrinsic factor means she doesn't have pernicious anaemia but still has low b12. Reasons for that could be following a vegan diet or undiagnosed coeliac disease.

The heavy periods could have caused her ferritin to be low maybe? So hopefully now on the pill her stores might build up?

I had ferritin of 9, but Hb was normal. My GP still prescribed iron. I actually felt fine. Didn’t take the iron and still feel fine. Never had a repeat test so no idea what it is. I used to have heavy periods but had an ablation to stop them.

It can take months to get Ferritin levels up so keep taking the iron especially if she had heavy periods.