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.

That’s interesting @Flibbertyfloo Was it difficult to go through your private healthcare? I have BUPA through work but have never used it.

Iron supplements on NHS but they are hard to absorb. If you can afford don't bother and take spatone with vitamin C twice a day then repeat ferritin. It really works and for me quicker than iron tablets. Went from 7 to over 50 quickly.

When my ferritin was 6 I was given two infusions, but that was after I told the doctor that I don't tolerate iron pills. Infusions were amazing, got my levels up hugely and I felt so much better.

My ferritin was 4 a few years ago and I was prescribed an iron supplement and a blood test scheduled for 3 months later. That seems like a reasonable follow up as a minimum.

When my iron began to dip this autumn, my GP told me that the new group of practices they've joined does not prescribe iron supplements as a matter of policy, but rather signposts people to buy their own OTC iron supplements.

My ferritin is 8 as well and my old GP sent the awful tablets to the chemist that I've already said I can't tolerate. They don't listen. I've just changed GP's so I'm hoping I'll get somewhere with them. I was using a supplement a while ago that was 50mg iron bisglycinate and I managed to get up to 38 but I then went through a phase of horrific palpitations in October 2024 and stopped all the supplements I was on.

So it's dropped to 8 in less than 18 months, that's with being on the mini pill for 7 months now and having no periods. Bit scared to try the bisglycinate again but I need to do something so am going to try a lower dose. My bowels don't cope well with anything so god knows how I'll be. I'm also deficient in B12, vitamin D, calcium and sodium, ie a total mess :/

Have they run stool tests and checked for coeliac? If not push for it. You need to find the underlying cause. Worth a read of the NICE guidance I posted earlier in the thread

@Flibbertyfloo had stool checked for various things, including coeliac, and nothing found. They basically said 'it's probably IBS, bye bye'. I'm getting persistent abdominal pain on my right side now though (not appendix, that's gone already) so I'm going to ask the new gp for more tests and an ultrasound when I see them. I suspect one reason could be far too many antibiotics because I've had loads over the years due to recurring uti's, wisdom tooth issues and other things. I've got quite a restricted diet because of it all, which doesn't help and I'm vegetarian. Thinking about introducing fish/meat again out of desperation.

Can you pay pay privately for an iron infusion

I was feeling really dreadful but decided to wait 5 weeks for an appointment with my chosen GP as she listens and is not dismissive. My HB was 66 and ferritin 3. I was referred to the hospital the evening she got my results flagged and I got a unit of blood, folic acid and ferrous fumarate 210mg prescribed the same day. I’m old post menopause so was referred for colonoscopy and endoscopy, despite 2 x negative fit’s. Nothing was found so likely an absorption issue. I’ve been on iron for 7 months and latest ferritin is 15. I’ve been prescribed another 3 months of iron. I, obviously, feel much better but still hoping for a bit more energy when it comes up a bit more. I couldn’t get 210mg tablets (or the 5mg of folic acid) over the counter when I asked (Scotland) so had to get another prescription.

Are you having a second infusion? I was told by my consultant that if you're very deficient sometimes you need two.

I am back after a month of taking ferrous sulphate. I can definitely tell the difference, mostly with running. I have so much more energy and it doesn't feel as much effort as it used to. I can't believe I had rationalised that the way I felt was normal!

However I am now getting really bad side effects and gut issues from it, despite only taking it every second day
What do you think? Should I get a different type of iron? Move to every third day? Will it be enough? The cramps are killing me today!

Have you condidered iron bisglycinate? Although most capsules are only 20mg they are much easily absorbed than other forms of iron and there is always the option of increasing. It’s the only one I can tolerate. There’s a lot of info on Reddit about it. Most people tolerate and absorb it well. I wish I’d known about it sooner. It would have saved me a year of having a ruined stomach!

I had an iron infusion a couple of weeks ago via my work private health care and feel like a different person. The haematologist told me to wait a week then restart iron supplements so I’ve been back on the Three Arrows heme iron. I take two every other day and have had no gastric side effects at all. I thoroughly recommend them @Clutterhater5