Severe iron deficiency causing issues

[jamjar2025]

Hey all, desperate for some advice here!!
I've felt awful for the past 8 ish months- got a round of bloods done privately around last December- including Ferritin, which was the only thing found to be relatively abnormal. It was 19, but I literally felt horrendous. Like barely functioning.

I got prescribed ferrous fumarate tablets which I've been attempting to take since late Dec, but they give me awful constipation and stomach issues. For an idea, I had six straight days of them and had horrific constipation- the worst I've ever had in my life, so can't possibly stay on them for longer.

The trouble is, I'm still really struggling with the iron deficiency symptoms. My hair is falling out in large amounts (which I'm devastated by), I'm dizzy whenever I stand, I'm constantly exhausted, I'm always short of breath when exercising (much more than I ever used to be- and I'm really quite fit), I'm very pale, and have lots of headaches. I don't want to sound dramatic but it's honestly awful.

I'm desperate for a solution but I know if I go to my GP and ask for an infusion etc because of the side effects of the tablets they most likely won't be interested. They're not helpful at the best of times, and I know my Ferritin is technically over the NHS bare minimum, but it's clearly not enough for my body to function normally on.

Any advice would be much appreciated, please help! Thanks in advance x

Did you try the tablets with lactose?

If you have the funds you could do a private iron infusion.

Anecdotally my ferritin increased when I went onto a higher fish and a meat protein diet.

I'd personally go back for more bloods anyway and see what GP suggests.

Nope- without lactose as apparently it's meant to prevent absorption? I always take them with orange juice though as vitamin c is supposed to help?

ALSO: I've tried gentler iron supplements like Spatone too, but they didn't really make any difference and still felt exhausted and dizzy on them. I assume they're not as strong?

Have you tried taking them every other day? That usually works best

Yeah- @spikefaithbuffyangelunfortunately same side effects, but thanks for the suggestion!

If you have anaemia serious enough for a prescribed iron supplement then Spatone isn’t strong enough. It’s barely any iron in comparison. I wish people here would stop recommending it in cases of diagnosed anaemia.

I have long term anaemia. I take 210mg ferrous fumerate every day long term. When I was pregnant I had to have daily iron injections. I’ve always had it and they think it’s part of my autoimmune issues I have (lupus, Addisons all sorts). I’m now 44 and despite not having periods at all for 15 years - early menopause- I’m still anaemic if I stop the ferrous fumerate.

If it gives you constipation you need to treat the constipation, not stop the iron. Fybogel or (next step up) laxido are good - you can take them at a different time of day than the iron tablets. It’s really important you don’t stop the iron if you need it. Iron deficiency that is untreated is actually very dangerous and can damage your heart long term (I’ve had issues with this).

I've been really trying to take the ferrous fumarate but it's almost unbearable when the constipation is that bad I've not passed a proper stool in nearly a week (despite many HIGH doses of Calfig, Lactoluse and every other suggestion that usually works fine. Thanks for the advice x

They can prescribe other iron supplements. Certainly in my area, you'd start on F. Fumarate, then could try f. Sulphate and also f. Gluconate. At least the 1st one you can buy from a pharmacist.

You should also be figuring out why you're iron deficient. Heavy periods, bleeding somewhere else, poor dietary intake, poor absorption, another reason.

That's the guidelines, anyway. The reality (my reality!) is I've tried all of those 3 tablets and REALLY CANNOT STOMACH THEM. I've tried all the take with this and not that, try every other day tricks. I get to the point where I can't eat at all and struggle to take other meds.

But there are significant risks of doing iron infusions too, so it's not just a case of the nhs not wanting to give us the good drugs.

I don't know what the answer is, but maybe start with reading the nice guidelines if you haven't already here , make sure you're doing all the absorption tricks and consider contacting gp and seeing if another iron tablet suits you better.

It's not that low - I would be pushing for more tests. I speak as someone with a much lower level than you and i don't have any of these symptoms though I appreciate we are all different.

I had an emergency blood transfusion last year because of my iron levels. Tablets make me severely constipated so I tried Floradix and it’s helped a lot.