Low ferritin but GP says "normal"

[DisappointingAvocado]

I've not long had the contraceptive implant out after it caused several months of near-constant bleeding. Been feeling awful - hair loss, exhaustion, headaches, breathless, all classic anaemia symptoms. GP ordered full blood count and told over the phone "all normal". The thing is - I also ordered a private blood test (delivered to home and taken to local pharmacy for bloods then posted off) as was getting distressed with the wait times, and wanted as much info as I could get as quickly as I could get it.

Private tests indicate ferritin of 22 and the tests only taken a couple of weeks apart so can't have been significantly different. I don't get it?! NICE guidelines say ferritin of <30 warrants treatment for iron deficiency so I'm confused as to why my GP says results normal. Any idea how to approach? I'm going to have to argue my case and come clean about the private tests but I don't want to come across like I'm telling GP they are wrong (which never goes well).

Is the only way to improve iron stores by prescription strength iron? I have some 20mg tablets from Holland and Barrett and not sure how many I can safely take or how long it will take to feel better on OTC stuff. Still feeling like death and really struggling, albeit my hair has stopped falling out. Thanks if anyone can help.

Literally just got blood test for this and results here: you can see they state normal < 30 not 10 as some have suggested

Labs have different reference ranges. Our local lab has ‘normal’ as 20-300.
Nice guidelines say to treat under 30.

No, it's not but I started feeling better within a few weeks and less as if I was being walloped by a wet sandbag the whole time.

I had really bad hair loss and saw a private dermatologist. She told me to have my ferritin checked via blood test with GP and come back to her with the result. She said it should be minimum 70 to maintain healthy hair but closer to 100 is preferable.

Mine was 42 and GP said was satisfactory (I viewed my test results online). I started taking 300mg ferrous fumerate nightly. I was getting stomach ache though so added high strength vit c which helps it absorb and it went away. A year later and my ferritin is 126 so I've reduced iron to one every third night and will ask GP to continue testing every three months. My hair stopped falling out too.

Place marking with interest.

Use the NHS app to look at your blood test online , the you can see what was checked . You should go by how you feel rather than GP anyway

And here is mine from last month which shows normal range from 10. Clearly other posters weren't lying

Mine was 25 in February so they gave me FF as I was feeling tired a lot. Increased to 30 after a month so they told me I didn't need it anymore. Had to argue for further prescription.

Increased to 45 by June so stopped. Bsck down to 20 four months later.
Think it is periods with lots of clots which is causing it (sorry for TMI)

Going to ask for further prescription. I kmknow I could just buy it but I have other health issues and medications so want to be on safe side

Make extra effort for iron rich foods in your diet folks

Iron rich cereal daily.
Snack on strawberries - apricots - raisins

Lorsa peas and broccoli

Just looking at some recent tests for me, my ferritin was 80 and the lab I had mine at had a range of 13 to 150 as normal

Blue berries help - a super food & iron!! I only started eating them this yr

Youd likely feel bit better with it over 100

Well I wouldnt say Im not feeling ok, these were standard checks following surgery as whole wellbeing check, but having had surgery I am losing hair, which should start coming back after new year or February but if its going to be helped by more iron (is ferritin Iron?) I will look into it

One of the problems was that my levels of iron absoportion was too high, the trans saturation levels etc, so I was advised not to take iron supplements specifically (I am on all round bariatric supplements which contain iron)

My GP told me I was ‘normal’ for our area’s parameters but low borderline for other places she’d worked. As my hair is falling out (probably partly to do with a VLCD) and hormone, thyroid and other vitamin bloods normal, she put me on a dose of ferrous fumerate.

Yes same here due to low calories (and peri menopause), what was your ferritin level?

Ive just checked the iron level on the test which is 22, normal range is 5.8 to 34

Not sure I understand the differences between ferritin and iron

Echoing this. Blood test last week measured my ferritin as 6, but because my Hb was just within the normal range the GP said I "shouldn't be symptomatic". Thanks, so I'll just pass that message on to my restless legs, palpations and insomnia then!

I'm in the fortunate position that my health insurance covers me for annual iron infusions, which relieve the symptoms almost instantly.

That's lousy, you shouldn't have to rely on health insurance. 😕 my haemoglobin was normal, but apparently I was lucky that my GP recognised low ferritin itself is a problem. NICE guidelines I think say they should consider treatment when ferritin is below 30. I think sometimes they need reminding of the guidelines as they do change, might not like being reminded, but would probably then actually try to treat the problem!

Mine was 5 and not picked up for 12 months by GP who never thought to check. Like many was suffering from massive hair loss and breakage, palpitations, fast heart rate and breathlessness. Only reason it got discovered was because I presented in A/E feeling extremely ill and they happened to check it as part of an anaemia screen (ferritin, folate and vit b12). Got a worried phone call from GP a few days later telling me I needed a 3 month course of Iron and a stool test for occult blood.

With that ferritin level you need to religiously take 2 ferrous fumerate tablets a day each with a vitamin C tablet to aid absorbtion

on an empty stomach as well as dairy inhibits absorption. Take one in morning one in evening with a 250mg or 500mg vit C. You’ll feel better within 1-3 months. I noticed a difference in just 3 weeks.

ferrous fumerate constipates you. Vitamin C loosens you up. So I was a bit too ‘loose’ on 500mg but C tablets so dropped to half a tablet with each iron tablet.

With that ferritin level you need to religiously take 2 ferrous fumerate tablets a day each with a vitamin C tablet to aid absorbtion

guidance is now every other day for better absorption, although iron bisglycinate has better bioavailability than ferrous fumerate or sulphate.
https://www.nature.com/articles/s41598-023-29034-9

Buy the ferrous fumarate from the pharmacy but be careful as they cause mega constipation and I ended up quite unwell with the constipation so had to stop taking it even though my numbers were still low.

But I do have stomach issues anyway so I may have been affected worse.

I was feeling awful, dizzy, couldn't drive. Bloods came back with normal blood iron but ferritin was 4. GP refused to accept that could be causing my symptoms as blood iron was normal. Asked to see a haematologist who said it absolutely caused my symptoms. He said the body uses iron for all sorts of functions, only a minority of which are blood related. For those you need iron stores.

Felt like it again recently so got tested again. Was down to 2! But now generally anaemia as well. So they took it a bit more seriously.