Low iron and b12 advice please

[Imstickingwiththisone]

I had very low iron and b12 when last pregnant, and since it was so early on in pregnancy, and therefore not caused by the baby, there were some investigations made to discover an underlying cause. None were found and as I got further on in pregnancy a referral to blood people at hospital was a quick in and out job and told to go back to gp when no longer pregnant.

I had b12 injections and iron supplements. Once dc was born I had another blood test and my b12 was ok so no more injections were thought to be needed but my iron was low so I continued with that for a few months.

This was 2 years ago now, and after feeling rubbish I asked for a blood test at the drs. Results show my iron and b12 low and telephone consultation advice was to buy some tablets from the pharmacy. The consultation wasn't a booked appointment and so I was at work so didn't feel like asking for more details but now I'm thinking...I eat a meat diet. I eat meat and green veg everyday. I don't understand why these would be low, nor where to begin to get levels back up.

I'm having a few unconnected things looked into at the gp at the moment and feel a bit silly asking for further investigations about this, especially as I wasn't given the actual results just that they were 'low'. I'm conscious of looking like a moaner and having other issues not looked into.

Should I push for this to be investigated more? If not, any tips for b12 and iron. I find the vitamin aisle in boots overwhelming!

Definitely go for the liquid iron. Either Floradix (more expensive) or Boots on Ferroglobin liquid. It is much easier to absorb than the tablets and doesn't give constipation. Can't advise on anything else (except in case it's relevant, dairy intolerance can cause low iron. Maybe get that checked out.)

I had spatone when I was pregnant but I hated the taste and did nothing for my iron levels. Is it the same as that?

No. It's a brown liquid and slightly treacly. It's not very nice but it's not bitter like spa tone. It's sweet. And much much stronger. Spatone doesn't really work that well to bring your levels up if they are too low. It's more for maintenance.

I'll give that a try thanks. Hate the tablets that are normally doled out.

Anyone recommend a b12 supplement? Apparently I have an intrinsic factor so tablets are fine and injections not necessary

I believe the tests for pernicious anaemia are not completely reliable. There are also other tests that can be run - not just the intrinsic factor antibodies test.

I would take a look at the Pernicious Anaemia Society website and post on their forum on Health Unlocked for advice. Please do this before supplementing with b12 as this can skew further tests.

Have you been tested for coeliac disease? This could be why you aren't absorbing nutrients.

You mention other health issues? What are your symptoms?

Have they tested your folate and vitamin d?

Drink orange juice when you take iron tablets. It helps with absorption.

I had a horrendous year before I was diagnosed with p a. After lots of visits to the Drs it wasn’t until my sight was severely disturbed on the motorway that it was taken seriously. Injections changed my life within weeks. Push for full blood tests and make sure a Dr or phlebotomists reads them, not a Drs receptionist as was my case a year prior to diagnosis.

Get a nutrition app to log daily foods surprisingly hard to get enough iron but the app helps figure out good sources.

Interesting that p a can't be fully ruled out then. I'll make an appointment with the gp I think, as these results were given by the receptionist too (although I assume the advice to just get tablets must have been from the Dr).

I've been tested for coeliac. I think all usual testing was exhausted when I was pregnant which is why I was referred to hospital but as I said, by this point I was heavily pregnant and being iron deficient wasn't very surprising.

My diet is normal. I eat meat everyday, green veg (literally lots of Brocolli as it's what the kids like), cheese, eggs, tuna. If this is down to diet then most people would be deficient so there's gotta be something affecting absorption right?

My main symptom is feeling so tired. Sometimes my muscles ache as though I've torn them but I've not been exercising. I feel tired and a bit out of breath going up the stairs at home. I went for blood tests because I had funny sensations in my head for about a week, like a little fuzzy episode every now and then. They've passed now (it was a stressful week so could have been that) but the tiredness is still here.

The other health problem is recurrent UTIs which I've been referred to hospital for so unconnected and don't want to seem like I'm anxious and making up multiple issues.

I'll hang fire on any supplements until gp appointment, hopefully get my actual results to compare with online stuff, I'll ask about p a also. And then advice on supplements. Apparently lots are rubbish so I don't want to waste time and money on something that will be ineffective. Also, how long I should do this before and should I get another blood test after a certain length of time.

My main worry about Lon term deficiencies are the links to damage to the nervous system when you're older. Don't want it to be something that's brushed under the carpet because my symptoms are mild.

I have b12 injections every 3 months life. I also take iron tablets just to be on the safe side.

You are entitled to a copy of your results from your GP. You need to know your B12 levels as well as folate and ferritin and if they have not checked your vit D levels get these checked too as well as potassium and magnesium. Don't be fobbed off as your long term health can be affected. I am not an expert but have had similar problems and found this group very helpful www.facebook.com/groups/PAB12DSupportGroup/

I came to also suggest coeliac disease. Sounds unlikely as you've been tested but this is worth reading. Hope you feel better soon.

www.coeliac.org.uk/information-and-support/coeliac-disease/getting-diagnosed/blood-tests-and-biospy/if-your-tests-are-negative/

The website on that Facebook group is very informative! I don't have any of those symptoms really, just lethargy/fatigue. I'm going to contact gp and get full results over the phone so I can read up on it more before I get an appointment.

I really don't think I'm coeliac as I have literally no symptoms for it and I know it's an awful thing to have.

Holland and Barrett sell B12 that you spray in your mouth, I've been told it absorbs better that way.

I take Active Iron capsules which are easy to swallow, & I take a vit C supplement at the same time.
I try to be more mindful of how I eat things (vit c on/with iron rich foods - often a fair bit of lemon juice!). I used to eat a lot of eggs with veg but apparently eggs hinder the absorption of iron, so I usually have them as a standalone snack... that kind of thing

I've had a dull headache and fuzzy/tingly scalp at one side for about 4 days now, is this common of b12 deficiency? I've bought some tablets while I wait for a doctors appointment

I ake the co-methylcobalamin form of B12, 1000ug a day, it is a small melt that dissolves in the mouth and is absorbed by the mouth mucose, so if you have gut issues, you still absorb it.
Iron absorption from food can be 90% blocked by tea and coffee, even decaf one, so if you have a cup of tea with, before or after your meal - some studies suggest up to 2 hours prior or after - you basically absorb zero iron.
Not all the greens will provide iron in the same way. Some , like the famous spinach, are very high in iron in a lab, but because of they are high in oxalates, you won't absorb it. Switch for kale, or add kale

Wow lilles I hadn't realised it could affect the absorption if you drink it within two hours, I drink a lot of tea! Can it affect b12 too? I wonder if that's where this is all stemming from.

Itwentinmyeye - there seems to be so many symptoms. I recall one is pins and needles in your hands and feet so I thought similar when I had odd tingly sensations in my head but it's stopped now.

Well the higher figure is for plant based iron absorption, from sources from meat it is around 60% inhibition.
B12 and iron are strongly linked, anemia causes b12 deficiencies. But how low are they?
Because I am a heavy coffee drinker, I now have my iron-reach meals in the evening as I don't drink any form of coffee or tea after 4pm

First thing I'd do is actually find out your levels. I have a condition that means I can't absorb B12. I have injections for life but also have iron infusions when needed. Get your B12, Hb, iron and ferritin levels at the very least

I was on a bad line with the doctors surgery and completely missed out iron which is what I'm meant to be low on alongside b12 but got the following results.

B12: 173
Ferretin: 11
Hb: 123

It was repeated that I'm just a bit low in b12 and iron so should pick up some supplements. Should I be bothered by these results or can my tea drinking explain them?!

Wow, your ferritin is very low!

I would recommend buying iron tablets OTC from a pharmacy as they will have higher dosages - the standard products you can buy on a shelf at boots/Holland and Barrett won’t be strong enough to raise your levels. This includes the liquid iron products mentioned above, the amount of iron they provide isn’t enough to raise your ferritin. Speak to a pharmacist about other suitable forms of iron as some (eg ferrous sulphate / fumarate) can be heavier on your stomach than others.

Your B12 is low too, particularly if you have been supplementing before taking the blood test. I would go back to your GP and ask for injections again.

Thanks browz. I've not supplemented for a while but my gp said that my intrinsic factor was checked and I'm ok to supplement b12 with tablets as there's no problem with absorption ( this was before this last test, she arranged for my bloods to be taken and checked my last blood results from 2 years ago to get this info.)

I think I'll focus on a good supplement for both and ask for another test in 3 months time and see how I go. Hopefully I'll feel really good and won't need to follow up 😁

Hopefully! Having low ferritin can make you feel awful.

I would recommend avoiding hot drinks when taking supplements. Tea/caffeine definitely affects iron absorption but can also indirectly affect b12 absorption.

They tend to ignore ferritin levels (even post infusion I barely get out of single figures) in favour of HB. That level of haemoglobin says you're not even anaemic but you can be highly symptomatic with ferritin levels below 50.