Low iron, folic acid and B12. Help!

[ScotsLamb]

Hi all

I'm 29 weeks and at 28+1 my dr took bloods as I was wheezy for no reason. She suspected low iron.

At 28+3 my midwife took my 28 week fasting bloods.

Midwife results are Hb: 12.0 g/dL WHite cell count: 6.00 10 9/L Platelets: 224.00 per μl. When I have looked these up it says these are normal.

Doctor phoned today to say my iron, folic acid and B12 are dangerously low and I've to start on 3 iron tablets per day, 3 B12 tablets per day and one folic acid per day.

Is it worth me phoning the midwife tomorrow to ask what's going on? I don't want to have to take iron tablets if I don't need to.

I would go to see your doctor as you received the call from the doctor. Folic acid helps iron absorption and my midwife told me to take folic acid and vitamin D throughout the pregnancy (and when breastfeeding). The doctor will be able to give you other alternatives if there is a valid reason you cannot take iron tablets.

Your haemoglobin is normal for now but it won't stay normal for long if you are really iron deficient. Your body needs iron to make haemoglobin, you may not see the effects now but being chronically iron deficient will eventually lead to anaemia. Being pregnant makes it worse because your baby is also taking some of your iron for its own haemoglobin so you're using up even more than you normally would. Iron tablets can be annoying because they give some people constipation but if your doctor says you need them then he's probably right. Also it may seem a bit drastic but if you lose blood during your delivery then it's much better for you to have had sufficient iron levels before that because you're less likely to need a transfusion if you bleed. Transfusions are obviously life saving but if you can avoid having one especially with something easy like taking iron tablets then you should, they are not risk free.

Thanks ladies. So none of the midwife measurements are actually for my iron level?
I just didn't want to go through the whole "iron bunged up stage" if I really didn't need to. I'm happy to take it if need be.
Will see how it goes and if it doesn't agree I'll ask to swap to liquid iron.

The results they gave you are not directly your iron levels but that doesn't mean your iron levels haven't been tested they just might not have told you the result for some reason call them and ask! I would assume it would be standard to do iron levels for all pregnant women because of the implications

You need to get tested for Pernicious Anaemia. If you have it you need B12 injections as you cannot absorb B12 in tablet form. Your blood results might be showing this.

I had low B12 in pregnancy and again when tested 6 weeks after birth. The GP got it totally wrong and told me to drink more milk. I had actually developed Pernicious Anaemia and could not absorb B12. I was breast feeding. Babies are born with a store of B12 but it can run out if the mother does not have enough B12 in her milk. My baby stopped growing at 5 months, she got very ill and her bone marrow stopped working. She needed a blood transfusion and 2 weeks in hospital and a very long recovery. All because I had undiagnosed Pernicious Anaemia.

Research this and get all the right tests. You might have PA and need B12 injections. I wish I had as my daughter really suffered.

Ask for an appointment with the doctor you spoke to. I had low B12 so had a course of injections, but now my iron is low. I've been taking iron tablets for months and months but they haven't actually improved my iron levels, so now having iron infusion for the last few weeks.

If my iron level is borderline like then I would rather take liquid equivalents as they absorb better and don't have the side effects. But they give 90% of the iron in the three tablets I would be taking from doctor.
I have no issue with the b12 and folic acid. Just not wanting to end up constipated for no reason when I could be taking the liquid iron.
I'll call midwife and doctor today.

I would ask to see the results of whatever the GP is referring to. There is no way he could infer that from the results you posted here. Did you have other bloods done? Hb is a measure of your hemoglobin, which is your red blood cell count. It's not a direct measure of blood iron levels, but an abnormal Hb is indicative of low iron. But yours is perfectly normal. Mine was 12.1 at my 28 week bloods in my first pregnancy and they thought that was fantastic. It's always good to make sure you are getting adequate iron, b vitamins and vitamin d in late pregnancy and I take Floradix plus a multivitamin just to be as sure as I can be, but I wouldn't start any high dose supplementation without actually speaking to the midwife. I would get the results of whatever he is referring to to make that recommendation and take them to her.

@mindutopia thank you. I had bloods done by GP on Monday last week then fasting bloods by midwife on the Wednesday (they are different health boards so needed individual results). The only info I got from the nurse at GP surgery was very low iron, folic acid and b12 and to pick up prescription. Phoning midwife to see what she makes of it.

Thank you everyone. Phoned midwife who said my levels are normal and that she doesn't want me on iron tablets if I don't need them. I've to phone GP at 8am tomorrow to see why they have me on such a strong dose when levels seem normal to midwife.