Low ferritin levels

[RhinestoneCowgirl]

I started HRT patches 3 months ago, GP arranged a blood test at the time to make sure there wasn't anything else up with me and it came back with iron reserves of 30. She said this was low and prescribed iron tablets for 3 months. I dutifully took these and just had a repeat test, whereupon my ferritin levels have fallen to 14. 3 months of black shit for nothing...

Just what is going on with my body?! I do have mostly vegetarian diet.

Welcome aboard @HumbleWarrior I have added black pudding (never had it before, bit apprehensive) and steak to the shopping order for tomorrow.

Well yes 49 is going some via diet alone but post menopausal women only need 29 points. Supplements and infusions are needed when ferritin and iron are low but every mg of iron eaten helps boost levels so if people can easily switch a few things in their diet and get an extra 5-10 points a day then it all helps.

I was under the impression all protein was a good source of iron so was eating a lot of salmon and chicken which are actually quite poor sources of iron.

@RhinestoneCowgirldo you know your B12 and folate levels were? As GPs may say levels are ‘fine’ when really they are suboptimal and can be causing symptoms.

Good luck with the black pudding. I think it’s a love it or hate it thing.

But some women who are post menopause still use cyclical HRT (out of choice if they are intolerant to daily progesterone) and have a monthly withdrawal bleed.

The table posted shows that the only way to be really sure of getting enough iron easily is through red meat, yet we're always being told it's a carcinogen and should keep it to a minimum.

Recent research has indicated iron absorption is higher if supplements are take every other day, worth looking into to see if this may help.

I’m so sorry to hear you’re experiencing long covid and low ferritin. The latter will certainly not be helping your energy levels. It makes me feel so cross when GP says ‘iron fine’ when it clearly isn’t. NICE guidelines (as someone helpfully posted above) indicates anything under 30 is deficient. Everyone is different but you’ll likely experience low iron symptoms even under 100. Could you see a different GP, I would go armed with a print out from the NICE guidelines too x

Yes! Good reminder on this, thank you

I wondered about taking iron in the evenings (with orange juice) to see if that makes a difference.

So sorry to hear about the difficult time you're having with your dd RhinestoneCowgirl - it all has a cumulative effect, doesn't it? I have poor sleep too and it's normal for me to be quite wide awake at some point in the night, so I take my iron and vit c tablets then (every other night.) That way I know absorption isn't affected by anything else.

I rang the doctors yesterday to chase up my request for another blood test. Was told the doctor won't agree it because apparently my levels are now 'fine'. (50 at the last test, 2 months ago, but I wondered if that was artificially boosted by something else as it seemed like a big rise from 16 a couple of months before. Hair still falling out, symptoms persisting, but random doctor's computer says no to another test... 😡)

Thank you @HumbleWarrior, DD is in a much better place now, but it has been extremely stressful. Hope you get some answers too. Not being able to sleep properly is just horrible.

I have now spoken to the GP practice pharmacist. We think that the low reading may have been affected by my giving blood two months before the second blood test. Some people take longer to rebuild their reserves. We agreed that I'm going to pause blood donation for now, take another three months of iron supplements and retest. Then if it's still low it's back to the GP.

I can report that I found black pudding quite tasty (once I'd got my head round it) and last night had a really lovely steak. I'm trying to incorporate as many of the iron rich foods from the lists posted on here too, so thank you for that.

Thank you. GP suggested the coil, but I’ve heard such horrible things including the wait for removal when it goes wrong. I’ve never responded well to pill etc, chlomid changed my body shape and I was an utter cow, I went from 0-60 when induced etc. I am so utterly exhausted from all the weird things happening to my body that I can’t face another health thing going wrong and the iron seemed like a fix that could start to help. I feel after all these months ferritin should be going up, plus I’ve been on transaxemic acid tablets which has reduced the bleeding alot already. The tablets make me feel very nauseous too though and a bit dizzy and spaced out. I feel better without them and would rather have the heavier flow, but obviously need to continue to take them to reduce bleeding.

I asked about iron transfusion but they said that’s for people with really bad anaemia who are collapsing etc. They also said at some point my periods will stop when I reach menopause and if heavy bleeding is the cause the iron should sort itself out. They’ve suggested going back to see them in three months or so.

Forgot to say it’s a different GP each time.

I was sceptical but this was what really helped me.

What is your current ferritin level @Bluntedscissors ? This new GP also doesn’t seem particularly helpful… it really infuriates me. I don’t suppose you have access to private health? And infusions are not just for when ‘you’re close to collapsing.’ I agree that boosting your iron is low hanging fruit, if only you could get it boosted

It’s 18 I think, possibly 19. It’s been a fight for them and the long covid clinic to even accept it was low when I eventually got sight of my blood tests. The blood test threshold is fifteen (which I’ve never understood the reasoning for anyway), so I was coming in close to that - higher than 10, lower than 15. Collapsing is such a low threshold.

Yes you need to get your ferritin and haemaglobin up so you feel well before you even consider giving blood again. My own low haemaglobin was I think caused or at least exacerbated by giving blood. I don’t know what it does to ferritin but I read it can reduce your haemaglobin by 10-15 points and, if you don’t have enough B12, folate or ferritin you can’t easily build your haemaglobin back up.

Did you discuss how much iron to supplement with the pharmacist? You mentioned 200mg of ferrous sulphate which per the table I shared from NICE equates to about 40mg of elemental iron. I have been taking 150mg of elemental iron per day along with a high dose Vitamin c tablet to aid absorption.

In 3 months of taking this daily my ferritin has gone from 75 to 128 although my haemaglobin has only increased from 123 to 132 (so I can’t afford a drop of 10-15 points by giving blood yet as I felt tired all the time before starting my supplements). Are you having side effects from your iron or do you think you could manage a higher dose because your ferritin is much lower than mine was. It’s a shame no one has tested your haemaglobin as well.

I’m not medical but wanted to comment @Bluntedscissors I had a womb ablation due to heavy periods, my periods stopped, ferritin continued to decrease. I had further investigations then got iron infusions. I think telling you to wait for menopause is unreasonable. I was also offered the more a coil and refused due to concerns on how it would affect my mental health based on my pill experiences.
it seems to be getting harder to access iron infusions here, they used to be through haematology but now a hospital consultant has to refer you for them. But how do you get access to the consultant?

Thank you @Freedbagforlife. Dr said it’s important they tackle the cause of the symptoms (bearing in mind they ignored the cause and symptoms for ages), but did want to offer me bloody antidepressants. I don’t even know if when I reach menopause if this will help that much. Wait and see for however many years doesn’t feel great. Perhaps I’ll try through my long covid clinic, but appointments are normally spent trying to track down and rechasing updates and referrals. They are not that long and only once or twice per year. They also didn’t comment on ferritin levels and when I’d finally tracked down their blood results had to show them. Person I saw couldn’t even see ferritin on there and I had to point it out. Maybe I should ask if money was no object and there were no limits to health resources, what do you recommend I do for each symptom?