Q about iron levels/ferritin/transferrin and symptoms (hair loss)

[Mykittensmittens]

There are a few prior old posts when I search about this subject, and some really knowledgeable people have responded - kind of hoping someone can do the same.

I have very very heavy perimenopausal periods (flooding, clotting etc). I am also a vegetarian and have been for 40+ years.

I have symptoms which led me to think I have either low iron or anaemia. I have permanently cold hands and feet, my inner eyelids are very pale, I am pale, I can often hear my heartbeat/whooshing (BP is normal), and the biggest one is that I am having increased diffuse hairloss - it's so thin now I can see my scalp, and it's really distressing.

My GP is fecking useless. Regarding the periods, I have a close familial history of hormone triggered cancers, and i'd rather not have HRT (it would cause me more good in terms of anxiety frankly, so please no suggestions along these lines). GP won't suggest anything else other than at 52 I am probably near menopause now anyway (!!)

They did run bloods for me - no other flags (thyroid etc all fine) but indeed, as I suspected, my iron isn't quite right. However, GP has said they are 'low but not abnormally low - go away and take a supplement and improve your diet' (I am already doing those things).

From what I am reading, these results ARE low, very low. Just because they are marginally above threshold, doesn't mean they aren't causing the symptoms I have?

Does anyone agree or know that with levels like this, they could be responsible for my symptoms and hairloss?

I have also read that for hair loss to stop, and re-grow, my ferritin would need to be c.70+ result. How the hell am I supposed to do that with result?

I am taking a multivitmin with 14mg iron in it and an additional iron bisglycinate supplement with 28mg in it, but I have been for a month and these bloods were only taken on Friday so I'm not sure it's helping enough.

Results:
Ferritin (range of 30-150) I am 31
Iron (range of 10-30) I am 10.5
TIBC range of 45-81) I am 61
Transferrin Saturation (range of 25-45) - I am 18.7

Can anyone advise please what I can do, myself, to get this better and stop my hair falling out?
Thank you

Small bump? Anyone?

There are loads of things that can cause those symptoms and your iron studies suggest you’re a bit low but not desperately so. Presumably your GP has also checked your Hb and thyroid function? Supplementing may help or may not (you can buy more hefty iron supplements from a pharmacy). FWIW for comparison, I’m a middle-aged veggie blessed with torrential periods. My hair’s never been a problem (even when I was anaemic and had a ferritin of 5). Getting my ferritin into the mid-teens (which took 3 months) is all I needed to feel superhuman! There will be a wide spectrum of what people experience with similar blood results.

Yes all other bloods fine including thyroid.

I got my bloods done in December as was shattered, hair loss etc. My ferritin was 21 and I was told the range is 13-150 - that's also what it says on my NHS results. Anyway, the GP said it's low & to take supplements. I started one that was 14mg & she said to take it still (it has zinc, vit c etc for absorption) and to also take slow release ferrograde. That is much more iron & she said I should start to feel better in a few weeks. She said to get repeat blood tests in 2-3 months as it will take that long to see in the numbers.

Hope this helps!

I'm a fellow anaemia person, recent bloods were,

Serum Ferritin 2ug/L (range 11.0 - 306.8)
hb 89 g/L (range 115 - 164)

Symptoms - SOB on exertion, ectopic beats and general exhaustion. My hair is fine and my nails split a lot but I've not got hairloss as a symptom. I'm on ferrous sulphate (prescribed iron tablets) and my numbers are slowly improving. My symptoms aren't really improving yet but with the numbers above, I wouldn't expect them to.

I am no expert but I have low iron results due to being veggie and v heavy periods. No hair issues. My hair is and has always been a long thick healthy mane.

I just feel fatigued.

Try ferrous sulphate. That is what the NHS prescription type is.

It does (and others too) thank you.

I suspect in as much as it takes a while to ramp it back up, it also takes a while to ramp down, and the lasts bloods I had before this were YEARS ago so it could have been declining for ages.

I’ve already been taking the additional iron for about 4 weeks, and these bloods were only a few days ago, so it may have been my ‘lowest starting point’ was lower than that shown, if that makes sense.

I tool ferrous sulphate in both pregnancies (a decade ago) but didn’t tolerate them well. Tried spatone and that was better but expensive. but I am taking this additional 28mg iron bisglycinate (easy to tolerate apparently) supplement with orange juice and avoiding tea etc 2 hours either side.

i’ll keep it up and request repeat bloods in 12 weeks I guess….but at this rate I’ll have hardly any hair left!

Feretin -

Snack on blue berries and dried apricots every day

Take iron med with orange juice

Have wheatbix
And saltana bran - alternate..

Both high in iron ^^

Broccoli - lots - peas - lots

Not everyones body absorbs iron tablets - my medical records state body bad @ absorbing iron..
Im on 30 mg tablets - prescription as a semi experiment but expecting them to of not made much diff to feretin num

Beef = good 4 iron

Eat kale too
And strawberries

Have u had your vit d tested ?

Have u had vit d test ?

For me, ferritin at 20 or above is normal. I’ve been down to 6 and felt awful (initially gp suggested I was depressed… nope, just needed iron).

Its important to look @ the cause of low iron
Rather than ' just ' treat symptoms

Have u done a qfit test // poop test ?

I had multiple bowel polyps that needed removing / urgent colonoscopy

I also had gastroscopy - stomach checked

Also low vit d and low b12 that are now fixed

Do ask 4 a poo test / q fit test ?

Benign bowel polyps can bleed and cause low iron

When mine got to 252 after iron iv - i felt ace

Take your iron with vit c and avoid caffeine for 2 hours.
ditch any diet juices - they strip the iron.
I bought galfer liquid - spoonful a day was easily tolerated - much less than instructions.

iron tablets like you had in pregnancy have about 200mg ferrous sulphate or fumarate in them in comparison to the diddly amount in supplements. Much better with a small amount of galfer or liquid replacement.

my hair took a while to recover even when my ferritin was up, probably 3 months later for any change.
also worth checking your gluc/hba1c are okay, diabetes makes my hair awful!

think of your iron as bath water, you need to keep the tap on, but plug the loss as well. Would you consider the progesterone only pill to reduce the heavy periods or a mirena coil to help your ferritin/hb levels?

@worldwidetravel2017 guidance is not to do iron infusions for low ferritin anymore (I assume it’s a financial decision and I can’t afford private). Gp tells me it’s due to my heavy periods… I don’t have heavy periods but gp knows better 🙄

If your feretin is below 10 - u can often push 4 them.
Mine was 8
I also had other significant illnesses
My body really needed help

Re gp - you can say - we need to look at the cause of low iron - have u ever had a qfit test ? - maybe you have bowel polyps

Ask 4 a second opinion?
Swap gp ?

Thanks so much.

I am fairly sure that my veggie diet and my horrendous periods are the cause. I’m good with food in terms of proteins (pulses) and veg and fruit, so considered it ‘okay’ but I’m quickly learning that my lack of loving the green stuff wasn’t ideal (probably a portion or two of rocket a week was about it - I despise brocolli, kale, etc) and never eat breakfast cereals, so it’s no wonder. Add 3 years of horrible periods which are now getting closer together (35 days, steadily dropping till I have a 21 day cycle with a 6 day bleed) it’s hardy a surprise.

I have started to eat weetabix, I’ll get some sultana bran too. I’ve also found that I can easily shove a really big handful of raw spinach in my lunch sandwich, I can handle brocolli in soup, and I’ll also add some dried apricots to my weetabix too.

i’m going to repeat the bloods in 12 weeks and if no improvement, ask for further, alternative tests. I could indeed change GP. This one is not at all good and not understanding.

i just have no idea if the regime I’m doing myself is enough. 14mg in a multi vit and them 28mg with orange juice (and nothing else 2 hours either side). 200mg ferrous sulphate sounds enormous compared to that!!! But I can’t tolerate it, it gave me horrible stomach pain. I wonder if I should double the 28mg dose for a few weeks - but will that do harm?

You take "30mg". 30mg of what? Iron, I assume but what form?

My prescription iron tablets are 200mg ferrous sulphate (standard prescription), which contain 65mg of elemental /ferrous iron.

Yes, though @Mykittensmittens , worldwidetravel is right, anaemia is a clinical sign of something else going on. Can be related to nutritional deficiencies, GI absorption issues, blood loss or systemic inflammation (some of those things can overlap). Depending on your blood count results and medical history, I'd expect your GP to do some investigations into the underlying cause.

If you are clinically anaemic, bog standard supplements will not do enough as they don't contain enough elemental iron. They are fine to top you up from a standing start but not if you are starting below par.

IV iron infusions are a last resort, they are invasive and expensive. If you can't tolerate oral iron and cannot bring your numbers into normal range with dietary changes or you don't respond well to oral iron (your body doesn't absorb it, for instance), it may be your only option and your GP may prescribe it.

I'm sorry you are going through this. I suffered hair loss and similar symptoms when I was only "borderline anaemic" due to extremely heavy periods (I'm sorry I can't remember nos). My GP suggested multivitamin and mineral tablets, but I just got worse and ended up on ferrous sulphate with much worse anaemia after tests (I agree they are horrible).

I'm not a Dr so obviously don't take my word for it, but two thoughts came to mind. I was told not to take supplements for 2 weeks before tests as they can skew the result and that anaemia is notoriously slow to correct and not to expect anything for 5 or 6 months ...

I did eventually get there but it took an awful long time. It's really horrible and you have my sympathy.

My recent ferritin was 11 - I’m peri-meno and just been taking ppis so that’s probably why my iron sores are low. Have been taking ferrous fumerate but it’s bad for reflux so I’m trying to have more iron rich foods and am off ppi now as of a couple of months ago.
31 is on the low side, but not mega-low. I was also one point off anaemia too. Take supplements for if you can tolerate them.?

Take food state iron supplements with a glass of orange juice. Also supplement with vitamin d mouth spray.
If you have heavy periods, vegetarian or not, you will need to supplement with iron.

i am not surprised you are low in iron with having heavy periods and being a vegetarian. I was very low in iron due to heavy periods and I eat meat. I took heme iron and that got my level up pretty quickly but I am guessing you won’t want to consume iron from animal sources? Non heme iron (vegan) will help but is not ans good unfortunately. Regarding how I felt once my ferritin levels increased i definitely had more energy and felt better generally. I didn’t notice any difference with my hair but everyone is different. Really you need to look at getting some help with your heavy periods, that’s your priority and then look at your diet and supplements

Forgot to say - re ferrous sulphate. I saw advice somewhere suggesting you take it with a full glass of water rather than just swigging it down, and start slowly - eg half the dose they give you every other day and build up to full dose. I'd have to come off it for a couple of days at a time every so often ...

Obviously the vitamin C is great advice too. Big smoothies where you pack in about 75% dark leafy greens to 25% fruit ratio with some chia seeds helps too ...

Also, I notice you are vegetarian so presumably eating dairy which I understand can mess up hormone balance as it contains so much oestrogen. Have you thought of going plant based? Dr Neal Barnard has written book on Balancing Hormones with diet if that is of any help ...

I wish you all the best OP! xx

again, thanks.

the supplement I take is the most absorbable form of iron you can get, because it’s chelated (not that I fully understand what that means). From what I’ve read this eve, my daily 42mg of Iron Bisglycinate is equivalent to double the dose of ferrous sulphate or fumerate in terms of what is absorbed. Even so, 84mg equivalent is still poor!

The GP never mentioned PPI interaction, despite me having an 8 week stint of Omzeprazole during the autumn last year as I have always had acid reflux on and off for years. Again, an improved diet and lifestyle effort meant once I stopped the PPIs the reflux was no longer, thankfully. But it won’t have helped this situation, will it?

Here he is talking about it ...

https://www.youtube.com/watch?time_continue=8&v=133n0BTYXOQ&embeds_referring_euri=https%3A%2F%2Fwww.bing.com%2F&embeds_referring_origin=https%3A%2F%2Fwww.bing.com&source_ve_path=MjM4NTE&feature=emb_title