Fatigue and dizziness - what to look at next?

[Drawahandmum]

Just looking for some advice as I really want to feel human again! I've been struggling with fatigue and dizziness for the past few months. It's really impacting my work and parenting - I'm always so exhausted and sleeping a lot. I'm also having lots of muscle twitching and issues with my left leg and hip (but I know this is probably unrelated).

Dr said I looked pale and took bloods - results now back and all seem normal except ferritin and serum folate, which were both borderline (23 ug/l and 3 ug/l). I've been given ferrous fumarate and folic acid.

Could slightly low ferritin and folate really be causing me to feel so bad? I thought they'd need to be considerably lower to be the cause of these symptoms. I don't know if I should be pushing for further blood tests, or just wait and see if the supplements help. I don't want to waste NHS time but equally want to feel normal again and make sure there's nothing more serious going on.

Yeah, they could be causing those symptoms.

If you've not improved in a few weeks, then look back into it again. But right now you need to get those levels up before you really know if there's another problem.

Thank you @MaMaMaMaBaker I'll keep up the tablets and hopefully they make a difference. I had significantly lower ferritin in pregnancy and didn't feel this bad but perhaps it's the low folate causing the symptoms.

@Drawahandmum Hope you feel better soon and that you can get to the bottom of it 💐. Don’t worry, you’re not wasting NHS time. I was removed from my local GP surgery because I haven’t been in almost 6 years so I had to join another one because my previous one is now oversubscribed apparently. I thought I was doing a good thing by not going to the doctors 😅.

Yes, low ferritin (iron) can cause restless legs, breathlessness and palpitations amongst other symptoms.

Ferritin needs to be around 70 for healthy hair growth so try to aim for that at the very least. It could take you up to a year to raise your levels sufficiently as it can be quite hard to do.

You need to take Vit C with it. No caffeine (coffee tea, chocolate, cola) or dairy products two hours either side of taking it.

low ferritin and folate both cause dizziness and fatigue. Yours are borderline ok but definitely not at optimal levels at all. They can both be quite slow to increase even with high strength tablets but keep at it and you should hopefully see a good improvement within 3 months. I felt like absolute crap when both of mine were your sort of levels

If it turns out not to be ferritin and folate, look into ME/CFS. I have it and they are my main symptoms.
For more info, see meassociation.org.uk/

Have you had your B12 tested?

Yes, B12 was normal. That was the one I thought could be low based on symptoms.

Do you know where abouts in the normal range you were? I was only just in the normal range, right at the bottom, but had quite bad symptoms?

B12 was 128 pmol/L and described as 'adequate' in the notes. No range supplied so I'll look and see if this is in the lower normal range.

Low B12 has all those symptoms. What was your B12 result ? The NHS will often tell people their b12 level is ok when it’s not. The NHS is rubbish in their treatment of b12

low b12 can be linked to low folic and low iron.

128 is rubbish! Very low. Please check the NICE guidelines and join knowledgeable b12 FB groups for info. In your shoes I’d try high dose b12 sublingual tablets and if that didn’t work, I’d source private b12 injections weekly till I felt stronger. You’ll need higher folic levels to make the b12 effective

Of course it depends on the lab ranges but usually B12 needs to be around 300.

This.

Thankfully my GP realised that a ‘bottom of the normal range’ blood result plus my symptoms meant I needed treatment - 2 injections per day for a fortnight , then 3 monthly injections for life. I’d be tempted to read up on this as suggested, then go back to the surgery and have another chat. Not all doctors are clued up on this. If you start self treating then you’ll skew the picture making it harder to get NHS treatment.

That said, if you can’t get anywhere with the doctors then private B12 shots are quite easy to obtain for around £30, but you’d need the 6 loading dose shots first to make it all work.

The B12 result is for 'active' B12 which should be over 25. So by that measure I probably am (more than) adequate?

This is precisely why you need to post the lab ranges with the result. You aren't giving the correct information but expecting others to read your mind, your GPs mind and the laboratorys mind. If the lab range is, for example, 20 - 40 then you are too high which will cause its own problems, with different diseases/causes.

Until you can post the lab ranges with your results i am out.

As I said previously, I didn't have the range which is why I looked it up. I'm certainly not expecting anyone to "read my mind". My question was if borderline ferritin and folate levels were a likely cause for my symptoms.

That was unnecessarily rude.

Apologies, I've been on several blood/vitamin threads and some of them can get frustrating when the poster won't give the relevant information and I think I took that frustration out on you.

Short answer, yes they can. Extra supplements can take anywhere from 2 weeks to six months before you notice a marked difference and I hope you start to feel better soon.