Iron very low! What do I do!!

[Poppy1989]

Midwife has only just told me at 29 weeks that my iron is only 10, in April they tested and I was 9.7 but nobody told me until now!!!

Been told I need to get my iron higher!! I have been taking 14mg of iron tablets a day, I eat red meat, drink orange juice, eat lots of green vegetables ect.....

I'm worried my iron is still too low and I'm due any day!!!

You’re not due any day at 29 weeks... you could have three months left.

Take the tablets... 👌

Yeah you've got ages left. I used Spatone iron supplement to get my levels up from lower than yours from about the same point in pregnancy. Took 3 sachets daily and it worked great! No nasty side effects like with ferrous sulphate / fumarate.

Oh but if the iron tablets aren't causing you issues (made me horribly sick) you could stick with them or maybe take one spatone sachet daily in addition. Some people like another iron product called floradix.

@NotAsGreenAsCabbageLooking @Jestem

Sorry I'm 39 weeks!! Not 29 (wrong button)

Oh!! Thought you were being dramatic! 😂

I suppose at this stage there’s not much left to do except take the pills (or spatone) keep up the orange juice and avoid milk etc (look up what else aids/inhibits absorption).

That’s all you can do I suppose. I’m guessing if the midwife wasn’t too fussed it doesn’t have too much of an effect on the baby?

@NotAsGreenAsCabbageLooking
Midwife should have told me back in April that my iron was low but said she "missed it" so probably why I have felt tired mire than I should as my iron has been low for so long now.
They told me that my HB is now 10 but that still isn't enough to go on a low risk ward. So no water birth for me now either.

I don't want a blood transfusion and I am honestly upset as I have ate so well and made sure that I have all the right vitamins ect.

She should have, i’d not be happy if it were me.

Would of gone to a blood transfusion? I’ve had a quick google and it doesn’t seem to be that big a deal? The only effect on baby Is that if iron was low in the first/second trimester there could be a risk of low birth weight, but surely they can check that with scans?

It’s common, easy to fix and definitely nothing to worry about.

I get anemia on a monthly bases because of horrendous periods and constantly throughout pregnancy.
Last pregnancy I just took Ferrous Sulphate constantly because there was simply no point being off it.

Iron drops in pregnancy, it happens.

That’s annoying OP! I would take the tablets and ask for an blood test at any further appointments - you never know it might make a difference if you are taking the suppliments

A blood transfusion would come into play if OP lost blood - if your iron levels are high then it is less likely you would need a transfusion and you would just be monitored to make sure hb didn’t drop (I lost 3.5 pints but due to ok hb levels I wasn’t given a transfusion)

I don’t see how that would mean you couldn’t use the pool though - could you see if the MWs would compromise and let you use the pool for pain relief and give birth out of the pool?

My iron was 9.1 when I had my second DS and I had been on ferrous sulphate since about 28 weeks.
I had a elcs so they had blood on standby but I managed to escape a transfusion.
This time around I’ve been on ferrous sulphate again since about 5 weeks.
Can understand your frustration but it shouldn’t cause massive issues. Best of luck when the time comes!

You could ask for IV iron/B12/folate to have a more immediate effect?

You need liquid iron, I'm sure it gets into the system quicker than tablets!

Bung frozen spinach in everything, dried apricots, a decent iron fortified cereal, look at easy ways to incorporate it into your diet.

Spatone worked wonders for me, had one each morning in a glass of fruit juice. You can but it in Boots, Superdrug and Holland & Barrett.

When you say 14mg iron, is that just the amount in pregnacare etc? I'm on ferrous fumarate and my ferratin was 14 and I'm sure it's 250mg a day so surely you can have a stronger prescription to at least bring you up a bit? That is very frustrating that you weren't told

With an HB of 9.1 neither iron rich foods, nor Spatone will cut it. Although they are great suggestions.

Ferrous Sulphate is what you need.
Spatone is good if you’re borderline or preventing anemia and iron rich foods are great but we manage to take just a small amount of iron in from that.
Don’t drink tons of milk because that inhibits iron absorption in the gut, but liquids high in vitamin C such as orange juice can facilitate the absorption of iron.

Oh and there’s a significant difference if people are talking about HB levels or Ferritin levels.

Ferritin levels are the stores, you’re not anemic if they are low.

Which one was it OP?

I have low iron, my level is 72 and had a blood transfusion. My iron store level is 1. I'm on liquid iron and spatone but it's not making much of a difference. I have to have another blood transfusion of 3 units at 36 weeks 😖
Waterbirth will be a big no no due to you being so tired, they won't risk it

I always had anaemia during pregnancy and it is rubbish. I was borderline as to whether I could go on the MLU but I did get my levels up enough just before birth for the midwife to say it wouldn’t be a problem (in the end that didn’t happen because I had premature rupture of my waters so had to be consultant led). I believe one of the reasons for saying no delivering in the water is that you are more likely to have a PPH. They should talk to you about whether you need to have the injection to speed up the delivery of the placenta (that was recommended to me) which I believe can reduce your risk of a PPH. They will want to keep an eye on you in case but you can still have a nice experience on the consultant-led unit and lots of people (for different reasons) won’t get to be midwife led. I’d had my heart set on a waterbirth but what mattered was the safe delivery of my baby rather than the experience.

Iron tablets do work quickly and you could still be another couple of weeks yet to get your levels up.

Also if it makes you feel any better, I did have a minor PPH (may have been nothing to do with my previous iron levels) but still didn’t need a transfusion. The threshold for that seems to be very low (7 ish?).

You could request an iron infusion (ferinject)? If you speak to someone at the assessment/day unit, they may be able to help. 100 is borderline but obviously as it’s so near delivery, it might be better than just hoping ferrous sulphate tops you up. Have they checked your ferritin, folate and b12 levels?

Nothing else has been checked, only iron. The tablets they put me on were 200mg and made me violently sick so they advised not to take them and just go back to the 14mg that I was taking before.
I eat all the right foods to bring my iron up, and drink lots of pure orange juice ect to help with absorption.

Midwife hasn't explained anything to me, just kept ignoring my questions when I asked about low iron and giving birth. I'm 39+2 so will just keep trying what I can for now.

Thank you all for advice

If you can't tolerate the tablets I'd definitely recommend spatone, at least they will help you after delivery even if there's no time to do much before.

I asked about anaemia whilst I was actually in labour, and the midwife told me that the risk comes if you haemorrhage, you are more likely to become severely anaemic as a result, as you are starting out with low iron. They would give you a blood transfusion. My level was 96 and they said this was not terribly low, with 100 being the cut off to home birth/use midwife unit.

OP they weren't very helpful.

As someone who has had iron deficiency anaemia on and off for years due to heavy periods there are at least 3 iron compounds - ferrous sulphate, ferrous fumerate and ferrous bisglycinate - the NHS can prescribe which come in large doses to get you iron levels up quickly. The first two are the cheapest and some people do better with one compared to the other for unknown reasons.

Also if they don't want to prescribe them to you, they can tell you what to buy from the pharmacist behind the counter though you probably have to get someone else to buy them for you if you are pregnant. I've brought them when not pregnant simply because it's cheaper than on getting a prescription.

Iron deficiency anaemia and non-anaemic iron deficiency are very common so HCPs have a tendency to ignore girls and women who are just under the levels unless they have other signs and symptoms that go with it e.g. affecting other blood cell numbers. Even then you can be ignored until levels are low enough to be very serious.

And 14mg won't do anything to raise your levels you need something like 200mg 2-3 times per day.