Low iron all the time

[Peonyyyy]

I always seem to have low ferritin/iron whenever I get it tested. I get put on ferrous fumerate and then nothing else happens until I arrange a follow up test. It’s never low enough for an infusion.

i have a healthy diet, eat meat and dark green veg, and last fave birth over a year ago. I also don’t have very heavy periods. I do have PCOS and also have had elevated cholesterol a few times (managed by reducing dairy).

I have asked for a follow up appointment which will be over the phone and not until May!

jusg wondered if anyone else has chronic low iron and why it happens for you, and how you treat it. Thank you

I’ve been on GP prescribed iron supplements (210mg a day) for 6 years now and my ferritin levels are still borderline deficient. They have never risen.

They have assumed it’s down to my heavy periods and I’m just left to keep taking the tablets and getting on with it 🤷‍♀️

Have they ever looked into why it's so low, as opposed to just assuming its period related?

I’ve been seen by gastroenterology and gynaecology and had scans and scopes, 101 blood tests and everything comes back normal.

I had some issues with iron after pregnancy. I was able to get my iron back up to double figures with tablets. Covid then gave me a whole host of health conditions - several years on various iron tablets/liquid sachets and I still can’t get above 19. I don’t know what you have to do to get iron issues and the impact they have taken seriously.

I hava PCOS and low ferritin. I had extensive private blood tests through thriva and now Do Health and I found my GP surgery uninterested after years. I am in early stages insulin resistance (HBA1C and fasting glucose fine but fasting insulin poor) as ferritin levels are connected with insulin resistance and diabetes I was very keen to manage this.

I did get GP to test for coeliac, bowel cancer (stool sample) and these were fine fortunately. I was also tested for cortisol level this was low but us currently being repeated too ensure correct result.

I take iron (ferrous maltol prescribed but if you can tolerate other iron supplements these are fine) and lactoferrin (held absorb iron) together on empty stomach.

Have you found your iron is still an issue despite being GF? The gastro consultant told me some coeliacs just don't absorb iron well despite changing their diet.

Im still waiting on my gastro referral to come through, but I'm back to gynae soon. Im thinking endo, so going to push for that to be investigated.
Hope you get sorted

I think it just takes a really long time to raise iron levels. I only got mine up by a few and I took them on and off for months last year. So will be on them for most of this year now. Been given fumerate now as opposed to sulphate. I'm vegetarian and have put it down to that mainly. Been like it 10+ years, my ferritin was incredibly low in my 20s.

Doc seemed quite worried and wants to do pelvic scan if I don't get my iron up by next blood test! But I will not be doing that. Thankfully I tolerate iron tablets quite well.

'the thing I’m wondering is, why do I need to take them? What is the underlying reason? Surely there must be women out there who don’t need to take them'

Some people just don't absorb iron well for no particular reason. As long as hb ok so you aren't anaemic they rarely do further tests, other than a coeliac screen.

You need to be on meds long term and just book yourself in for 6mthly ferritin checks. GPs don't push on stuff like this we have to take the lead.

When supplementing, it is critical not to take a dose every day. There is very good evidence that a daily dose is counter-effective since it's suppressing absorption.

There are many other factors that impact iron absorption, including inflammation, and with your PCOS, it might be the case. Therefore, there is scope to look not only at supplementing but also at overall diet quality and managing systemic inflammation, if this could be the case.
In terms of supplementation, the recommendation is a dose every other day and a diet including some heme iron from sources such as liver and red meat.

12 isn’t bad!

I think you should not take iron with vitamin B/D/omega 3, only vitamin C.

If that poster is talking about ferritin then 12 is bad, 15 is the lower limit, which is already far lower than the reasonable lowest limit for ferritin.

If talking haemoglobin then it depends what measuring system, if g/l then 12 would be pretty much dead!