Hemoglobin levels/anemia

[Aberdeen2]

Hello, I was severely anemic in my final trimester of my last pregnancy. I’m trying to avoid the same with my current one, but my midwife is being a little unhelpful with terminology. She has said my Hb level is currently 121, looking online the range starts at 120. Is anyone able to advise how my HB levels relate to my iron count (which I thought was ferritin?) and how get I might get some comfort i woll be ok this time around.
Sorry for the essay, I’m a little confused!

The healthy range for non-pregnant women starts at 120, but there are lower ranges for pregnant women and this varies by trimester. So by the third trimester I think you can have much lower numbers. What trimester are you in with your current level of 121? Google the appropriate level by trimester?
Ferritin is different. My mw wasn't sure about it either, and I've struggled to find out whether Hb can be converted to ferritin or whether it's a separate blood test. I did read that you can have good Hb level but low ferritin so maybe it's not possible to convert. Hopefully someone else will be along who knows more!

121 is good, I was advised they would treat as under 105g/l with iron, I narrowly avoided iron tablets post delivery with an Hb of 106 post section and advised a iron rich diet🙂 I had booked at 144g/l though so I definitely knew it was low for me, never heard it rechecked but also not symptomatic so assumed it’s made it’s way back up.

Ferritin is your iron stores, sometimes they are are checked, you can have a normal Hb but low stores, but unless symptomatic they don’t tend to check your stores

Thank you, that’s helpful! I am 10+2 so early days, but anxious not to go the route of my first pregnancy. I have also asked for a c section as I had a traumatic birth so I think I’m just overly worried I will have issues with iron throughout and afterwards. I’ve been told to take liquid iron but I’m not sure that will improve matters when I have morning/ all day sickness… I feel a bit stuck

Worst case scenario there is the option of an iron infusion in the pregnancy, or some trusts do iron injections I believe. 121 is an absolutely fine place to start, once the sickness improves then start trying to eat a iron rich diet, to keep your levels up as best you can and then try and introduce the liquid iron🙂

What were your levels in your first pregnancy @aberdeen2?

Mine this time around are hb 9.7 and ferritin is 4. My midwife tried to refer me for an infusion but they wouldn't until I'd tried the various tablets. Find the pills really hard to tolerate!

Ferritin needs to be checked separately to haemoglobin.

@Oodlesofdoodlescockapoodles That's shockingly low! I'm surprised they're insisting you try tablets first as it can take a long time to build up again and I'd have thought such low levels should be treated quickly! If I were you I'd try to push for it, especially if your mw agrees.

@ginnybee i think they said the hb level isn't too bad, I'm not sure what it's supposed to be but i vaguely remember them saying 7 for an infusion 🤔 I've only got 3 weeks left now anyway so probably too late!

Thank you all. My iron level, which I think was ferritin was 7 in my last pregnancy, I had a blood transfusion shortly after birth. I will definitely keep eating iron rich foods once I am able. Do you think it’s possible to have Ferritin levels checked too? I wonder why they don’t do that as a matter of course like Hb levels.
@Oodlesofdoodlescockapoodles all the very best with your little one, I hope it all goes well!

I had normal bloods at my booking appointment (which I think they use as your baseline). Hb 120 I think and ferritin over 70.

Then when I had my routine bloods done in second trimester I dropped to 100ish first time and 91 second time, can't remember what my ferritin was but I think it was only slightly low, or low end of normal. Both times I was given iron tablets and this brought my levels up to near normal by birth. Never needed a transfusion though I really felt like crap for a while.

Do they routinely check at second trimester in your area? If not might be worth asking.

They don’t routinely check ferritin because if someone’s anaemic in pregnancy then it’s almost always due to iron deficiency and so a trial of treatment is used (diagnoses and treats the problem). Old fashioned 3x a day oral iron replacement is more likely to cause side effects than 1x daily or every other day replacement and the newer regimes do often improve iron stores pretty quickly. Infusions of iron aren’t completely risk free so a good go at oral replacement is usually encouraged if there’s time.

I’ve just had to have an iron infusion because my iron levels were 85 and apparently they like them over 130, to qualify I also had to have my ferritin stores checked - anything less than 30 is severe and mine was 4! Not sure if they are reluctant to do infusions but they told me my levels would not increase with tablets in time for the birth
I was previously prescribed ferrus fumerate and sulphate and I couldn’t tolerate either and made this clear to gp/midwife and consultant!

@Aberdeen2 did you lose a lot of blood or was the transfusion because of anaemia? And thank you, i am very ready for him to arrive now!

@ameteurmum how close to the birth did they do an infusion? Do you feel better for it?

@Oodlesofdoodlescockapoodles - had it done yesterday and I’m almost 32 weeks. Thought I would run home from the hospital but I came home more tired than ever. Today I do feel a lot more alive! They said it would take a few days to kick in x

@ameteurmum ah pleased it seems to be helping, I'm almost 38 weeks now so probably just have to accept feeling like crap until its over!