Low iron levels but not anaemia?

[EoinMcLovesCakeJumper]

I was found to have low stores of iron in my body back in late November, and I was given a course of iron tablets to take for a month. I finished them just after Christmas and generally felt a bit better, but not amazingly so. I've just had another blood test and it's found that my iron levels haven't significantly improved, although apparently I'm not anaemic.

I'm back at the doctor next week, and am back on the iron tablets in the meantime, but what could be going on here? I don't have heavy periods and I don't experience a lot of pain, so I wouldn't expect it to be fibroids or endometriosis. I'm a bit worried about internal bleeding from somewhere else now

Do you drink a lot of tea or coffee in the 2 hours prior or after meals/ supplements. These drinks inhibits iron absorption.

Do you take herbal supplements such as curcumin ( turmeric) It is a potent iron chelator, which means he removes iron from cells . Google any supplements you are taking to see if they impact iron levels

I think they're meaning your ferritin levels are low? Ask them to be specific. Iron stores are ferritin.

You can have low ferritin but borderline anaemia. Do you give blood regularly?

I stopped drinking caffeinated drinks while I was taking the iron tablets, and I don't take any other supplements.

Yes, I think it's ferritin they meant. I don't give blood.

Some other medications can interfere with absorption. Or conditions such as coeliac disease.

A month isn’t really long enough to get them up properly. Try taking them with vitamin c to aid absorption.

What’s your diet like?

I wasn't taking any other medication at the time, but I am now on sertraline. But yes, I have another month's worth of tablets now so I'll just keep taking them. And try having orange juice with them.

I'm sure my diet could be better. I did up my intake of iron-rich foods when I was told I was deficient. I just worry that a month of iron tablets hasn't made a noticeable impact on anything!

Eat some red meat, don’t eat dairy at the same time as calcium inhibits iron absorption.

I’ve been on iron tablets for months, they are fairly useless on their own. the only thing that has helped me is adding red meat, vitamin c and cutting down on dairy when eating iron rich foods. FYI Plant based sources of iron (non-heme) are useless.

It sounds like you are talking about your ferritin levels, which are your iron stores. Do you know what your score was?

I have a ferritin score of 6, which is extremely low, due to fibroids and heavy periods. The dr seemed to think I would need iron tablets for at least 6 months as it can take a long time for them to have an effect. I've been on them for nearly 2 months and am only just beginning to feel a difference. I'm going for a blood test at the end of the month to see if there is an improvement. I'm surprised that you were only given them for a month.

I think they say that a ferritin score of 70-100 is optimum for energy and wellbeing.

Did your dr give any opinions on what might be the cause? It could just be a matter of improving your diet. I certainly needed to improve mine!

Ps I think it is the tannin in tea and coffee that is the issue - not the caffeine. If you are drinking lots of decaffeinated tea it may still be hindering your iron absorption.

Hmm, interesting. I don't know what my score was either time, but I will definitely ask when I go back to see the GP. It can't have been as low as yours, or surely I would have been given a longer course?

I do drink decaf tea so that's annoying. Does rooibos have tannin in it?

My ds1 wasnt anaemic but had low iron levels. Apparently if you have low iron levels for a period of time then you become anaemic. Weirdly his iron levels are now slightly higher but he's now anaemic. Paediatrician said it would take a minimum of 3 months of supplement and it should be taken with orange juice. He's possibly coeliac so this is his reason

OP - I think that Ferritin levels in general can be very slow to build up. Sometimes it is impossible to get them over a certain level. I'd find your level out and then request a blood test every few months or so and monitor it for yourself (with the advice of your gp). You can buy iron over the counter, so if you have the info on what your levels are and what you're aiming for you can just keep taking it as long as you need to.

I take a supplement called Ferrograd (bought over the counter), it is supposed to be a slow release pill, so in theory gentler on the stomach. My sister takes Ferrograd C which has vitamin c included in it - I am thinking of switching to this but the pills are a bit bigger, and I'm a bit funny about swallowing pills.

Not sure about the tannin contents in different teas. Google will probably help.

There are quite a lot of helpful previous threads on MN about ferritin.

Ps - I found talking to a female GP about this very helpful!

Rooibos is ok, apparently, because it's a completely different plant from black tea. I read that both caffeine and tannin hinder iron absorption so tea and coffee are equally bad. With that and the calcium, it's a wonder anyone manages to keep their levels up at all.

I'm taking ferrous fumurate with orange juice now. I've been lucky in that my stomach tolerates it ok so I don't need to take it with food. It's a real minefield, isn't it?

It's a total minefield!

I feel so much better at the moment - will be very interested to see what my levels are at the end of the month.

Good luck!

My feritin levels were 6 last year and the GP gave me 3 x iron tablets for three months. They went up to 40 after a repeat blood test. I was similar in that I have no periods but my diet wasn't iron rich so I've tried improving that!

Definitely ask your GP re levels - it takes months to increase so don't worry!!

I was also tested last year, found to have low ferritin levels (8) but not anaemic and put on iron tablets for a month. Now been given a second months worth (no new blood test) because I am still feeling tired.

My GP also did a blood test for coeliac and a poo test for blood, both of which came back clear. No reason for my low levels as far as they can find out - no heavy periods or anything. Not sure they can think of any other causes.

No advice but I'm in a similar boat. My ferritin levels were non detectable. I've been taking iron for 3 months. I was feeling better but I've been a bit lazy with them in the last fortnight and I already feel awful :\ I feel like they've not gone up much.

I'm getting a repeat blood test next week.

No idea either why they're so low, don't have heavy periods and I eat meat. xx

I stopped eating any dairy or calcium containing drinks during the day, as well as caffeine when trying to get my levels up.

I actually managed better through diet and spatone than the pills.

Always have iron rich things with orange juice or Vit c.

I had some cheese or yogurt before bed as I often crave them!

There was recent research around iron tablets; taking a lower amount alternating days is more effective as the body stops absorbing a lot of iron in some sort of reverse loop.

Which maybe why some people find being really strict with diet is more effective.

www.ncbi.nlm.nih.gov/pubmed/31413088/

^ that's the follow up study looking at anaemia, the one around iron stores was a year or two earlier.

This is the right one.

They used only 60mg of iron, single dose, alternate days.

www.ncbi.nlm.nih.gov/pubmed/29032957/

It's so difficult to get the balance right, isn't it. I can't stop eating calcium altogether, especially since I'm perimenopausal, but I have to avoid having it with anything iron-rich, so no butter with my steak or yoghurt for pudding. Do some people just struggle to absorb iron as well as others?

This is interesting as I'm waiting results, my ferretin has been low on and off over the years. In my case I'm a strict veggie (no eggs but I do eat cheese) so I guess that's the reason. I'm usually given a 3 month supply of iron tablets and they seem to get the levels up.