Ferritin, folate, B12 - please help me understand my results

[SoIronic]

I’ve felt absolutely awful since I had my first child 5 years ago. I am exhausted, I’m achey, I feel hungover all the time (I’m not!), I get every infection going, I have pins and needles in my feet, I have no energy and I just feel rotten. I’ve had some bloods taken. Most results are ok, but three stand out:

Folate - 2.4
ferritin - 16
B12 - 2133

I have been prescribed folic acid for the folate deficiency. I’m three weeks into that and feel no better. So far no one has mentioned that my ferritin is low. I only noticed it was low after scrutinising the results myself.

I am now waiting for an appointment to discuss why my B12 is so high. And I am waiting for blood tests to rule out celiac disease.

I feel totally clueless about all this…. Could these results be the reason I feel so rotten? Why don’t the doctors care about the ferritin? And what do I need to ask at my next appointment?

My ferritin was 14 and I was out on iron pills twice a day so you need those! All the symptoms you’ve described were resolved by the iron pills

You need iron supplements. Low ferritin makes you feel awful. You have an appointment to discuss the B12 level, which is appropriate. You should also have your vitamin D level checked, so you could discuss all of those when you see your GP, In the meantime, go and speak to your pharmacist about a suitable iron supplement that you can start while you wait for the appointment. Look up iron rich foods and review your diet.
I am sorry you have been feeling so unwell for so long. I hope your GP will refer you for further investigation.

Thanks for the replies. My vitamin D was checked and that is fine.

And my diet is pretty good… I have no idea why my ferritin and folate would be so low. I will now look at supplements. Still scratching my head as to why the doctor hasn’t picked up on the ferritin!

Do you have the reference ranges for those results please? They vary from place to place depending on the lab equipment used and it is not possible to accurately interpret your results without them.

However, the NHS Clinical Knowledge Summary says that ferritin under 30 is proof of iron deficiency and there is a protocol for its treatment. Dig that out and show it to your GP. You need iron supplementation without delay.

Your folate is very low indeed. Folic acid will help. Buying your own methylfolate off Amazon May work more quickly. Taking folic acid alone will probably result in your B12 dropping a bit. That is a serum B12 result though. It tells you what is going round in your blood, but gives no clue as to how much is actually being absorbed.

Posted too soon.

Any of these results alone has the potential to make you feel awful. Your symptom list sounds about right for the results you have posted.

The thing that concerns me most is the pins and needles.

Agree with others, iron tablets will help to get rid of what you're experiencing. I was on iron tablets towards the end of my pregnancy with DD1, then after she was born I had awful chest pains and felt like I couldn't breathe; my iron was through the floor and I was put on three tablets a day for 9 months. After DD2 I had the chest pains, tingling hands and feet and felt like I didn't need to breathe if that makes sense, I was put on B12 3 a day for 6 months I should have finished them in June but keep forgetting to take them and have one bottle left!

It'll take a good few weeks before the tablets kick in with your levels being so low

Oh I was told also to take them with a glass of fresh orange juice as the juice helps to absorb the iron more quickly

Do you have heavy periods? My ferritin has been low for years, I've been on and off of iron tablets. It's only now that I've started making a bit of a fuss about it that somethings been done

Thanks everyone. I did have years of heavy periods. Then I had two pregnancies and C sections in pretty close succession. So perhaps this is what’s caused it.

Now I’m concerned that it will take months on supplements to feel better. I don’t want to lose anymore of my life feeling like I’m recovering from an all night rave.

reference ranges:

Serum ferritin level (XE24r) 16 ng/ml [10 - 322]
Serum folate level (42U5.) 2.4 ng/ml [5.4 - 24]
Serum vitamin B12 level (XE2pf) 2,133 ng/L [211 - 911]

It does, unfortunately take a few months until you're feeling more like your usual self. Ask your doctor to prescribe iron tablets for you, I think they're a higher dose than over the counter but not sure. Really hope they work for you

If you want to address the low ferritin quickly - then you could get an iron infusion from a private clinic (I went to the Iron Clinic in London) but it's v costly.

I think an iron infusion might be the way to go here.

is there a rapid way to increase folate?

My ferritin was 15 but they've done nothing about it. I really struggle with the prescription iron tablets so I asked if they could prescribe anything more gentle but apparently because it's "within range" they won't give me anything :(
Just been using ferroglobin and a multivitamin but no real improvement yet.

Even though ferritin in ‘normal’ range, we prescribe iron replacement if under 30. What was your haemoglobin?

@SaveFerris1 it was 117 I think.

There is a very good organic supplement called Floradix but @DeedIDo has great advice, I would heed that.

Apparently spatone is good for increasing iron levels if they won't prescribe? I was going to get some while waiting for my results but my ferritin came back at 4 so didn't need to fight for tablets haha. Lots of people recommended spatone or floradix though. Hope you get the numbers up soon, you'll be amazed at how rough you actually felt when you start feeling better because it just becomes the norm until then!

That’s slightly low too - should be over 120. You’re anaemic with low ferritin. You need iron tablets. Did they say that was all ok?

@CreatingHavoc It might be worth trying Ferrograd if you struggle with prescription iron tablets. I can’t take any of the usual ones the GP prescribes so tried this taken at night with some orange juice. Have had no side effects so far and it’s a bit stronger than Spatone and Floradix.

@Iheartmysmart is that the slow release stuff? I'm pretty sure I tried that and it was just as bad if not worse. Weirdly I was given slow release antibiotics once and they ruined me as well, whereas I was ok with the normal ones. My digestive system is useless!

It is slow release, but now you mention it I had a slow release one on prescription and that made me very sick within about half an hour. This one is a red tablet and the prescription ones were a capsule. Can’t for the life of me remember what they were called though!

Why is your B12 so high?

Thanks for everyone’s input.

my haemoglobin seems ok. - Haemoglobin concentration 127 g/L [115.0 - 160.0]

So I guess I have iron deficiency without anemia?

@ArcticSkewer I don’t know why my B12 is so high. I’m seeing the doctor next week about that.

The only thing I know for sure is that I feel absolutely shocking all of the time and am constantly ill. I just need to get to the bottom of it now

@SoIronic i feel very similar. Constantly ill. Once I've recovered from the stomach bug I currently have I'm going back to gp to demand some more investigations.

Ok well I am glad you are seeing the GP about it. Wondered if you'd just had an infusion or something. They need to look into that a bit.