Ferritin level - 8 - follow up?

[Clutterhater5]

I just got the results from my last blood test on the NHS app and ferritin is at 8 (normal level btw 15 and 150).

Hemoglobin, hematocrit, MCV, MCH, and MCHC are all below normal level too. I understand it is all linked and due to anemia/low iron.

The GP commented "no follow up needed". Would you request one? I feel a bit fobbed off but to be fair I don't have debilitating symptoms (though have hairloss and brittle nails which are annoying) and expect it is just due to heavy periods so they probably won't have anything to suggest.

What do you think?

Worth noting I had a blood text exactly 12 months before and these results were all low too back then and I had no follow up either. As they were all a bit borderline then I just left it. Results this time are lower than last time across the board. Not a huge drop but it is definitely on a downward trend.

My ferritin is 11 and I’m going for an infusion next week after a private consultation.

No action on 8 is dreadful.

The NICE guidelines have recently changed. Print them out and quote it back to your GP. You should definitely be having iron supplements and maybe even folic acid too.
@Zanatdycan I ask how you accessed a private infusion? My DD’s level is 7 and the GP said she couldn’t refer her for an infusion as her Haemoglobin is 117 (+2 over the lower limit 🙄)

I was having gastric symptoms and was taking loads of antacids which unbeknown to me at the time prevent iron absorption, so perhaps that’s why I got an endoscopy. I actually found my periods got lighter when I sorted out my iron levels and when I did a bit of research this seems to be a common symptom of low ferritin that isn’t well recognised, it’s a bit of a chicken / egg. I hope you get sorted, I’d not actually realised how symptomatic I was (I’d gone to the doctor about the gastric issues) and was just soldering on until after a few weeks after I had the infusion.

I can’t tolerate most iron supplements either. Have you tried Iron Bisglycinate? It’s literally the only one I can take. It’s a much lower dose than the prescribed iron, but most of it is absorbed in the body, so you can’t really compare the doses. I got mine from a health shop and it’s the brand Solgar.

I sent her blood tests to the Iron clinic and they said she was deficient and to arrange a consultation. That was NYE and she had it yesterday. Her TSAT was 14% so said she was deficient. It cost £590 total, as she had 500ml due to her low weight.

Well I’m incredibly pissed off with my GP surgery. Had a text message to say my iron was a little low and to eat more iron rich foods. I logged onto the app to see my results, my ferritin is 5 and my serum iron and haemoglobin are all below the reference ranges. It’ll take years to get back up to decent levels by diet alone!

I have used Iron Bisglycinate in the past @wannanamechange but it didn’t make a huge difference to my levels. Perhaps I could see if I can tolerate two a day 🤔

You need iron. Go to pharmacy and they will advise

That's mad! Definitely everything I have read says that at that level it is not fixable by diet alone.

I did open an online request this morning and have a phone call with GP later this week in the end. Let's see what they say!

I know @Clutterhater5 The range for ferritin is 30-336, mine is 5 and the GP has marked it as borderline!

Come back and update us on the outcome of your phone call, hopefully your GP won’t be so incompetent 🤞

Mine was 4 and I was put on 1200mg a day for 3 months. Food alone won’t cut it!

I'd email them the NICE guidance and politely point out they seem to have made a mistake.

I honestly don’t think they’d care @Flibbertyfloo I’ve been struggling with my iron/ferritin levels for over 10 years and have been dismissed by the GPs repeatedly during that time. I could probably write a book with all the stupid things I’ve been told by them over the years. I’m going to buy some iron supplements to try and hopefully they’ll help.

Update: I've had a call from the locum GP who said that level is very low and prescribed me some tablets straightaway. We got to the right outcome in the end but it is a bit mind blowing that if I hadn't proactively checked my results on the app and requested a follow up, I'd be carrying on with iron deficiency and anemia.

I've been functioning with low levels for at least a year so I'm actually pretty excited to start the tablets and see if a whole new world without hairloss and fatigue opens up to me!

Definitely follow up and make a fuss. This is something you will have to fight for. I don’t know why GPs dismiss low iron, they must be taught that it’s a often a woman’s issue and they should just pull themselves together, eat spinach and carry on because otherwise I don’t see the reason for this attitude.

Even the threshold is low. 15 will make you tired, possibly breathless, will make your limbs feel like led, give you brain fog, make you feel like everything is uphill. But the nhs GP will tell you it’s fine.

When it’s below 15 and you hit the jackpot with someone who cares they give you tablets. Their choice of ferritin is a poorly absorbed pill that will give you stomach cramps. If you suffer from constipation ask for lactulose or your remedy of choice. They give you a month worth of tablets or 3 at the most. One time after three months mine went up to 30 from 3. Fabulous according to the GP, still low.

I have felt shite for years. My iron has always been low. They’ve told me to “google iron rich foods” and go home. You should definitely do this and concentrate on meat because there is no human quantity of parsley you can have that will make a difference. they’ve given me one month and once 3 months worth of ferritin.. still in the teens and slowly going to single figures for years

one of the problems low iron causes is restless legs syndrome. It can go from half and hour annoying kicking before you go to bed to a tiredness that is debilitating. My tiredness got so bad I needed a cpap machine and was diagnosed with severe restless legs. It’s like a feeling of tense electricity and fizziness in your body. You wake up needing to rest from waking up, fall asleep in the afternoons, get depressed because there’s so much to do and even lifting an arm feels hard. Every morning you wake up like you have walked a marathon and the physio tells you your problem is you need to move more.

so I saw a private consultant because the nhs didn’t care and he tried the ferritin for three months and then agreed to give me an infusion. The problem is that the private hospital won’t do it so it took me six months to get referred to him via the nhs and for him to arrange it at my local hospital. He wanted my GP to refer me for an infusion and it was like playing tennis with both. The GP said they categorically can not refer people for infusions, the consultant said his guidelines allowed it and wtf.

anyway the difference is amazing. I felt better in a week but it really kicked off a few months later. For restless legs the iron needs to be over 100 and mine was 110 for the first time in over 20 years.

problem is the iron doesn’t last and people need infusions regularly, maybe every year, and this was a battle.

im having tablets on top of this to keep it up there because i dont think im at risk of going over 200 and having at least one steak a week

we are used to talking to our gp and trusting them but this is something they get wrong. Women don’t function well on iron levels below 10. Please make a fuss

Great post @Postsynapticdensity it pretty much sums my experience of the NHS attitude to anaemia/low ferritin. It’s a ‘women’s’ issue therefore they don’t give a shit.

Having had some pretty awful medical experiences as a family over the last few years, the recent dismissal by my GP of my levels is just another nail
in the coffin of my trust in doctors.

Not sure if you are a vegetarian @Clutterhater5 but I’ve just ordered some iron tablets from a company called Three Arrows. It’s heme iron so meant to be more absorbable and with less side effects than the usual NHS offerings. Expensive but I’m desperate!

Ive recently had blood tests to check for anaemia but nothing was mentioned about ferritin?

I’ve had my RBC checked, my heamoglobin and my Haematocrit, but not ferritin?

Should I go back and ask for this to be checked too?

@LondonLady1980 Ferritin is your iron stores, you can have low ferritin even if your other blood results are okay. I think it’s called iron deficiency without anaemia. If your levels are low it can make you feel awful.

It’s not the odd nhs GP, they all follow a guideline. If you fall under the already super low threshold they give you the cheapest worst tablets. A lot of women don’t take them because they’re so hard on the stomach. They give me cramps, like it literally hurts and the constipation for me is horrendous.

I imagine that if a man turned up with low iron they world be worried he has internal bleeding and run checks and take it seriously. For us it’s.. 14 ferritin? Meh, I know you are tired dear, sometimes life is hard isn’t it? oh you are making a fuss? Let me give you four weeks of the shittest tablets I can find for this and I’ll see you with the same issue in six months to a year tops? Ta-ra now

so many women could do with infusions but there is real resistance. One reason I think it’s because there’s a danger of a rare but very serious reaction to it so they prefer to do it in a hospital setting. Also having so much iron in one go puts the liver under a bit of stress so my bloods came out a bit funny six weeks after. They were fine in 3 months.

to me the most important lesson I’ve had with this is that I don’t have blind faith in my GP anymore. A huge part of their job is to read guidelines and follow them to the letter and navigate their instincts against the restrictions they have to work with. There’s also the culture issue, the low iron problem is so widespread it looks like they learn it in university.

my other new fear with the nhs is pain relief. They are all been told that paracetamol adequately treats pain like that caused by a bone fracture for example and if you believe them you are in for a good time. L

Which supplemenrs are you using?

Edited - never mind i see you already answered. Thanks!

What the hell is wrong with your doctors?!! Yes, it's way too low.

My blood results are through:

RBC is border line deficient.
Haematocrit is below normal range.
Ferritin is 12.

The surgery has sent me a message and asked me to phone them and discuss my results with one of the doctors.

I’ve already been on iron supplements for 6 years so who knows what will come next.

I just thought I’d follow up to say that I’ve been taking heme iron supplements for a week now and haven’t had any stomach issues at all. I‘m on 6 tablets a day which equates to 120mg of iron, which would have absolutely floored me with extreme nausea and vomiting on all the other tablets I’ve tried. The capsules are quite large so I blend them into a smoothie.

Not feeling a huge amount better yet but have noticed a slight increase in energy levels. Hopefully it’ll continue to improve.

@LondonLady1980 have you seen your GP yet? Six years is a long time to be on supplements and still have such awful results.

For the first 3 years I was taking 630mg a day of iron, but then they dropped it to 210mg a day as apparently “recent studies” showed that taking that dose was just as effective 🙄

I’ve got a phone call consultation with a GP next week.

So I will discuss the dosage with them again but ultimately I’m going to ask for a referral to gynaecology because unless my womb is taken out of me and I no longer have to ensure my horrific periods I don’t think anything will ever get better!

I hope you get some help when you see your GP @LondonLady1980 If you are bleeding to that extent, there is no way you’ll be able to get your iron levels up on tablets alone. I had an iron infusion at one point but my periods were so horrific during peri-menopause that the effects didn’t last long. I was refused a hysterectomy until I’d jumped through many hoops and tried numerous other options. I gave up in the end.

Fingers crossed you have more luck.

Going back to the infusion discussion, I've been looking into it and it would appear that the Iron Clinic in London generally considers an infusion appropriate for ferritin below 30 even where haemoglobin is technically normal.

I was also pleasantly surprised to discover I could get it all covered by my health insurance by having a virtual GP appointment to ask for a referral, virtual appointment with the consultant then infusion.