Very low Ferritin level !!

[duckhouse]

Hello Ladies,

I am concerned about my low ferritin level and not happy with MW response - 'Lets hope it doesnt go down further' without any proper plan of action to monitor it.

I am on iron supplements for approx 5 months and despite of it my ferritin level has dropped from 60(@16 week) to 40(@28 week) to 29 (@34 weeks).

1. i am not anaemic so wondering what is the cut off level when i should be concerned. ( MW says below 15)

2. its highly likely the level will go down further in next few weeks before labour - should i push for transfusion ?

3. what are potential complications for the baby ?

My ferratin was 11 at 31 weeks and 15 at 36 weeks, and they still don’t seem hugely concerned. They put me on sulphate tablets though, have you been prescribed those? It doesn’t seem to have made much difference either in my tested levels or energy levels. But you’re right that lower than 15 is when they take action so assume you’re above the limit, and as I’ve said even when I was very below they were pretty relaxed about it.

Maybe ask MW about the supplements?

And to answer final question, my midwife said low ferratin doesn’t impact the baby at all, they get all your iron which is why your levels drop so it’s just you that’s impacted.

My ferritin was 17 at 23 weeks and I was put on ferrous fumarate. My haemoglobin was 112 as well though.

Ferritin is your iron stores, which as a previous poster said, is why your level has dropped throughout pregnancy because the baby takes the iron. I don’t believe they would do a transfusion for ferritin, but they would if your haemoglobin levels were low (around 70-90).

I was anaemic after the birth of my first child and they didn’t tell me or recommend any iron supplements. I think that is why my ferritin stores were already low at the start of this pregnancy (just over a year from my last).

I would just make sure to ask about your levels after birth to ensure any supplements that need to be taken can be prescribed.

My ferritin has gone from 4 to 7!! I was happy with that 🤣 ferrous fumerate helps, take any iron supplements with OJ or vit C to aid absorption, aim for iron rich foods. I’d be delighted with your result though!

Thanks @Gennia for your response. Not sure how to know about my Hb level in the unit you mentioned.

Below is what is captured in my app -

FBC - Hb: 11.6 g/dL FBC - WCC: 10.30 10 9/L Platelets: 188.00 per nl Haematocrit(HCt): 0.34 MCV: 85.4 f/l

Is my HB level ok ? This was taken at 28 weeks.

That Hb is ok for your gestation. It’s very normal for Hb to decrease in pregnancy. You have increased blood volume and haemodilution. IV iron infusions aren’t uncommon in pregnancy either, they’re usually more efficient not you have an issue with absorption. Do you feel symptomatic of anaemia? Breathless, dizzy, racing heart? If you have concerns you could contact your midwife, it’s a shame she didn’t explain a bit more rather than increase your anxiety.

*if you have a problem with absorption, that should read 🙄

@Peacefulspirit do iron infusions make you feel sickly in the same way iron tablets do? I'm due an infusion after tablets haven't improved my levels, but I suffered horrible side effects from the tablets (nausea, both bowel problems etc!)

I was told that the 112 (so would be mg/dL) is the new unit description but I believe it translates to 11.2 g/dL. My readout only had the numbers with no unit volumes.

11.2 for me was anaemic and so I would say 11.6 g/dL is anaemic too. My mum is a nurse and she told me that the average for a woman is around 13, with good being around 16. 7-9 is the limit for transfusion. She translated my 112 to 11.2 when I told her my figures, though my GP said they use 112 now. 🤷‍♀️

I’d probably check with your midwife about your HB levels to be sure. I’d like to think if it was cause for concern they would have acted, but you never know and no harm asking. Could also contact your GP? At least for me I needed them to prescribe the iron anyway and my GP took my numbers and decided I did indeed need iron.

Hopefully all will be good.

The “normal” range is adjusted in pregnancy for the reasons I mentioned. I think most trusts use 115 (old way of saying it would be 11.5 g/dL) as a cut of for treatment. Iron transfusions are often used for people who can’t tolerate oral treatment @MumOfThreeToBe2021, there’s none of the grim bowel/stomach side effects.
A blood transfusion is quite rare antenatally, more
common postnatally when Hb drops below 8g/dL but it depends how the person feels, some people can wander round with crap Hb and be asymptomatic others feel rubbish.

@MumOfThreeToBe2021 I had no side effects from mine, felt great afterwards.

Op your levels look okay to me - certainly compared to what mine were. Drinking orange juice with the tablets is supposed to help absorption.