Ferritin level of 9, GP not concerned, but I feel awful

[cutefluffyunicorn]

I recently had bloods done after contacting GP about experiencing extreme dizziness and fast heart rate when standing up. Bloods were all mostly OK. I'm not anaemic as haemoglobon was fine. Only real abrnomrality was a ferriting level of 9. reference range from the lab was 10-291, so GP described it "borderline" rather than abnormal result. BUT from my own research it suggests that this is actually really low, and you can get symptoms, even without anaemia, when levels are really less than 50.
I am jsut recovering from a severe depressive epsiode , but although my mood is now much better I am expereincing a lot of physical health symptoms inluding lots of dizziness, tiring more easily, overall fatigue, brain fog, thinning hair which just wont grow, palpitations and excessively fast heart rate with any sort of activity (for example vacuuming the lounge the other day sent my HR to 130 and left me breathless and dizzy) I was previously fairly fit, running 5- 10K fairly regularly so I definitely feel something is off.
I did manage to pursuade GP to (reluctantly)prescribe some ferrous sulphate but there are no plans to recheck bloods or follow up at all.

Any expereince of low ferritin without anamia? Did it make you feel awful? What dose of ferrous sulphate (or other) did you take? How long did it take to levels to rise and for you to feel better? Should I push for GP to recheck bloods at some point to see if improved?

Thanks for any advice

Eyrenotair - That B12 level is rubbish, no wonder you’re breathless and have brain fog. Needs to be much higher. Go get a course of private b12 injections (1 a week for a couple of months) and then move on to b12 tablets.

Where was this please?

My ferritin is at 4 and I feel like shit constantly. 😒

Folate was 4.9 (range 5.4-9999 !) so it was low, but GP of course called it "borderline" and felt not worth treating (I've now bought some folic acid)

b12 was 271 (range 211 - 911) so lower end of normal range. I've bought some b12 too!

I am slightly concenred though as to why all were low (ish) and wondering about possible causes of malabsorption, which of course GP never mentioned.....

hmm, ok so actually Ive now realised that according to NICE my b12 was also in the "possible deificiency" range......(180-350)
so that b12, folate and ferritin all low, and GP not bothered or even suggesting it would be a good idea to find out why.......

for anyone that wants to read more about iron deficiency without anaemia I have come across this really good article. It is quite lengthy and a bit technical but has some good summaries of what iron does (apart from make HB) and possible symptoms of deficiency. (and yes, I have spent the past few days down a rabbit hole of reading about iron, folate and b12 deficiencies!) 😂

https://pmc.ncbi.nlm.nih.gov/articles/PMC8002799/#:~:text=Causes%20of%20iron%20deficiency%20can,inflammation%20and%20chronic%20blood%20loss

@B2B25 The vitamin clinic in Nelson, you'll need to show them your bloods and they advise on how much you need. Even though my ferritin was really low my HB was ok so I only needed 500mg

Infusion via iv? I don't believe this for a second. I have heavy periods and don't eat meat and my ferritine was at 7. GP gave me iron + vitamin c supplement. If hemaeglobon is fine nobody will give you a transfusion!

@cutefluffyunicorn I had exactly the same symptoms as you when low ferritine. Take your supplement religiously and you will feel better in a couple of weeks!

You certainly can be given an iron infusion for low ferritin without anaemia (ie when Hb is fine), even in the UK on the NHS in some cricumstances, depending on where you live and how good your docotor is!
Not everyone can tolerate oral iron supplementation, and in cases of malabsorption it may not even be absorbed.
The trouble is standard first line NHS treatment is oral supplementaion, which can take months to raise ferritin, which is not ideal when you feel absolutely awful and youre trying to get on with a busy life!
Im actually very tempted now to go the private route and just get it treated......

Mine was 3, I felt awful and had bad mouth ulcers.
It actually didn't take long to improve and I changed my diet and it's been low but fine for years now.

@cutefluffyunicorn its concerning your GP isn’t educated on this. Were you offered a qFIT test?

a) they should have prescribed ferrous sulphate immediately. 9 isn’t borderline!

b) And this is why your GP might be lovely but maybe not a great doctor.. if there is no proof as to WHY your iron stores are so depleted you may be bleeding internally. You should be offered a qFIT test to screen for blood in your stools. I had a qFIT with ferritin of 10, cause unknown. It came back positive… and off I popped onto the two week cancer pathway to check for bowel cancer. It likely saved my life. I had no symptoms other than those relating to the ferritin being low.

That is a really good price. I feel a day trip coming on!
How long did it take for you to feel better after the infusion. I'm actually very tempted.

Had bloods done due to various symptoms among which were poor sleep, painful legs at night and a lack of energy. Ferritin was slightly lower than yours, everything else was ok or at low end of normal. GP said to take Ferritin supplements and retest in 3 months. I buy it OTC as it’s half the price of a prescription for same thing. After doing some reading I take 2x210mg tablets every night before bed. It’s worked well and I felt a lot better within a few weeks so I’m looking forward to seeing my next blood results. I prefer Fumerate to Sulphate, no discernible side effects thankfully.

@cutefluffyunicorn probably about a week: it wasn't instant like some people say

NO, I wasn't offered anything in terms of investigation. Which is worrying me tbh. I was only given ferrous sulphate because I had seen my results on the NHS app and specifically asked her at the end of the consultation - she wouldnt have even mentioned it otherwise. 😒
And yes, you are right sadly. My GP is lovely and has been very good in terms of mental health stuff (and much better than the GP at the practice I saw first) but I am very reluctantly coming to the conclusion that in terms of phsyical health she is maybe not that great 😔Given that I have also recently expereinced significant unintended weight loss as well, this is worrying me (although to be fiar this had been attributed to lack of appetite due to depression which may indeed be the case, so although unitntended, not entriely un explained....but still)
It all feels such an uphill battle though.
I suspect I may have to once again attempt to navigate the ridiculous AI triaging system at the practice to attempt to see a diff GP and ask for further investigations. 😣

@cutefluffyunicorn please get a second opinion. Iron deficiency without anaemia is something they consider as important as with anaemia now and if there is no cause you should push for investigation. The qFIT I’m trying to find the info for for NHS. If I can find it I will link. The weight loss along with low iron should also be a red flag to them for qFIT I think so make sure you mention this. I don’t want worry you but it feels like they have been pretty rubbish.

As an aside, my GP referenced the evidence for taking FS every other day but I don’t think the guidance is official yet. So I did that as I think it’s coming in soon. Took a month to start working.

yes, I know you are right. I will have to see a dif GP and get everything properly checked. 😥Thank you.

I've seen some studies about using iron every other day. I think the rationale is that sometimes using daily absorption is slightly reduced ...... but yes not sure how conclusive that is.

@arcticpandas why would I make it up?

I know many women who are low in iron due to heavy periods and eating habits. One got prescribed an iv infusion but she's anorexic and anaemic. If ALL other values are good and it's only a case of low ferritine in anotherwise healthy person I would like to see the doctor who prescribes an iv infusion. Blood is saved for operations/accidents/ illnesses when you can't just give an oral supply. If we all went to get a blood transfusion when just low on ferrritine there would be none left for emergencies.

@arcticpandas infusions and transfusions are 2 different things though.

You can get an infusion when you have low ferritin but ok HB

She didn't say she got a blood transfusion, she had an iron infusion which is completely different. I think you need to do a bit more research on this to understand what you are talking about.
And yes, plenty of people agre given iron infusions for low ferritin levels without anaemia.
Maybe check your facts before accusing other people of lying and then arguing with them.

Similar symptoms, turned out my b12 was on the floor to
had to ask my gp to check!!
had weekly then monthly injections
which was a complete game changer

@prawn100 thank you! I have messaged them to enquire!

So fed up of just being prescribed iron tablets when I keep saying I don't tolerate them well.

@B2B25 Fab! They are so lovely there, hope you feel better soon!

I never said I had a blood transfusion 🙄
it’s literally iron in a bag into your vein.

Yes. You need to be 70+ just to have healthy hair growth. Some belive you need to be around 100 to be optimal.

Remember to take it with Vit C. Don't have caffeine (tea, coffee, chocolate, cola) 2 hours either side of taking it. I take mine at bedtime so I only have to "worry" about the 2 hours before.