Iron deficiency anaemia

[PigeonPairinSomerset]

I’ve had a full blood count done recently. The notable figures that are not normal are:

Serum ferritin - 8 ug/L
Hb - 106 g/L
Haematocrit - 0.353 L/L
MCV - 78.4 fL
MCH - 23.6 pg
MCHC - 300 g/L
Red blood cell dist. Width - 17.6%

all other parameter including serum folate and B12 were normal.

I’ve had colonoscopy and gastroscopy to rule out GI bleeding. They removed a few very small polyps during the colonoscopy and took some biopsies from my stomach to check for absorption issues (coeliac?) but I haven’t had the results back from those yet.

My question is, should I be getting an iron infusion with levels this low and now causing anaemia? I think the plan is just to prescribe iron tablets but I’m already so tired, no energy, thinning hair, and apparently they take ages to work? I just want to feel better.

GP said she may investigate gynae symptoms next. My periods aren’t too heavy but they are regular, once a month now. Until I had my second child 6 years ago, they were very irregular. So I do physically bleed more often now.

Final thing that was mentioned is possible thalassaemia trait? I’m white British so not sure I’m the right demographic for this.

appreciate any advice or anyone who’s experienced similar.

'I think the plan is just to prescribe iron tablets'

Why a plan and not an immediate prescription with ferritin of 8? Tbh infusions are a bit of a postcode lottery but worth asking.

Just buy some ferrous furmarate otc and get on that while the prescription is being processed. Alway take with vit c as it helps absorption.

You wouldn't meet the criteria for infusion in my area. These are -

1. Severe anaemia i.e <80g/l
2. Rapid response needed ie pre op.
3. Intolerance of oral iron
4. Failure to respond to oral iron

Iron tablets can work within 2-4 weeks and you won't necessarily by waiting months to for your levels to rise and to feel better.

As poster above said I would order some ferrous fumarate and start taking one tablet a day (or even every other day). Less is now more when it comes to iron replacement.

https://cks.nice.org.uk/topics/anaemia-iron-deficiency/management/management/#treatment

I think the GP’s thought process is that I’ve likely had low ferritin and been anaemic for quite a while, so although I don’t feel great, I’m still functioning (full time job, two kids age 10 and 6). So she wanted to rule out other things first.

No your iron and hb are nowhere near low enough for an infusion unfortunately

sorry to jump on this but do you happen to know what constitutes intollerance of irin? I have been pput on this due ti hb of 105 and ferritain of 5. This was 9 two months ago while no action was taken have been taking an a to z vitamin with 76 rda of iron. My blood test also shows low calcium and magnesium. The prescriptiiom strength iron is leading to cramps and diarrhea. Am unsure if it will improve. When sed to it or f should go back to gp @

I would check in with your GP. You might do better on a different preparation (i.e fumarate instead of sulphate) or a lower dose. Once or alternate day dosing is now thought to be more effective , than the 3 times daily dosing that used to be prescribed.

I had an iron infusion last week and my Ferritin was 15. Everything else was normal. I have Crohns so am under a gastro team and high is how I got it easier. But at the point where my ferritin is that low I can’t function, short of breath, palpitations etc. I’ve been having them yearly, for years, and my job is always normal.

I think if you’re not under a hospital team you’d need a referral to be able to get one though.

I also don't see why you should wait to take iron tablets.

Fundamentally your issue is missing iron. The treatment is going to be replacing it and it's almost always try oral first.

While you also need to know why the iron is missing, it could take ages to answer and all the while you'll feel rubbish.

She can rule out other things while still treating the low ferritin. Either buy it or get a prescription but get started on ferrous furmarate.

Has your iron incrreased? Still really struggling. No longer anaemic but iron only gone up by 1 after a couple of months.