Excess tiredness - just pregnancy or iron/thyroid/other issue

[JacksonStreet]

Hi there
I have been feeling quite out of it for a few weeks. Excess tiredness, dizzy, easily out of breath, brain fog and v poor concentration at work... had a blood test and was told my results were normal for a pregnant woman:
ferritin 15
red blood count 3.56
Haemoglobin 122

I felt the ferritin and RBC were low but the midwife said they were fine as haemoglobin well within range, lots of things might be making me feel tired including pregnancy, and iron would not normally be prescribed for such results... I am 27 weeks so understand pregnancy will be playing a role but I feel dreadful and was having quite an active pregnancy until recently. Walking a few mins to the shop is a struggle right now. Cant manage any proper walks or even my pregnancy yoga class at the moment. Feel tearful over how weak I feel a lot of the time. I am sleeping well and eating a well rounded diet plus with a pregnacare multivitamin.

Anyone else have similar experiences?Would it be worth asking for thyroid function / B12 / folate levels to be checked (Google tells me my symptoms could be linked to issues here)? I felt completely dismissed by the midwife.

Many thanks all

Hi OP, sorry to hear you are feeling so awful!
Whilst those blood results are normal for a female, it does seem like the symptoms you are having are extreme for pregnancy tiredness at 27 weeks. I think it's worth pushing for further blood tests, but I would go via GP as the midwives usually can only order certain blood tests to be taken (and she doesn't sound all that helpful). It is normal to feel wiped out in third trimester, but considering you've been active up until now I would say you could have something else underlying.
Hope you feel better soon x

Hi, I was experiencing very similar symptoms at 17 weeks - excessive tiredness, breathlessness, dizziness - I couldn't walk my son to nursery which is less than a 10 minute walk without having to stop multiple times. My midwife tested my ferritin levels and they came back as 25 and she said that was low and immediately recommended iron tablets (ferrous gluconate), which my GP prescribed. I've been taking them for three weeks and feel a lot better for it (although still tired - but the breathlessness and dizziness are much better).

I would try and get a second opinion - perhaps try your GP? I understood that ferritin levels reflect your iron reserves and that they should be higher than that - around 100 is I think ideal? I thought they wanted ferritin levels to be high before delivery due to the risk of blood loss, but may be wrong - it may be haemogloblin that they use as the benchmark.

I just found this:

www.southtees.nhs.uk/services/pathology/tests/ferritin/

FERRITIN guide to interpretation:
Low: Less than 15 ug/L
Borderline: 16 – 40 ug/L
Normal: 41 – 400 ug/L
High: Greater than 400

Thank you @ireneadler101 I'm sorry you experienced similar but great news it sounds like things resolved themselves with the supplements. Wonder why guidance varies so much on this midwife to midwife! It is quite frustrating when it effects us so much during day to day activities.

Link is useful to see, thank you! I would be inclined to agree with what you've pasted. The 'normal' range for ferritin on my test results was 5-85, so quite different to your linked results although the units are the same.

The midwife said my results markers had been amended to reflect a pregnant woman, not sure what that means

This is also an interesting read:

b-s-h.org.uk/media/2891/uk_guidelines_iron_deficiency_in_pregnancy.pdf

It states that "Non-anaemic women identified to be at increased risk of iron deficiency should have a serum ferritin checked early in pregnancy and be offered oral supplements if ferritin is <30 ug/l" and "The serum ferritin level is the most useful and easily available parameter for assessing iron deficiency. Levels below 15 μg/l are diagnostic of established iron deficiency. A level below 30 μg/l in pregnancy should prompt treatment (2A)."

I would definitely query why you're not being prescribed iron tablets with a ferritin level of 15 - it seems that ferritin levels fall before haemoglobin and is an early indicator of anaemia. I know how dreadful you can feel with low iron so you have my sympathy!

Thanks again. That's an interesting read @ireneadler101 , I really hope my symptoms are low iron related and an iron supplement sorts me out. Feel so weak and spaced out, I have no idea how I'd cope with labour feeling like this

Fingers crossed you can get your hands on an iron prescription. I was looking into over the counter iron tablets before I got my prescription, but the stuff you get from the docs is much stronger (I take two 300mg iron tablets a day). I think stuff like Spatone, which I had heard recommended, is about 30mg and apparently good for keeping levels topped up but not enough to restore low levels. Can you tell I did a lot of googling? :-)

I have experienced both of these things in my current (2nd pregnancy) low iron, and not enough thyroxine (I have no thyroid gland)! On both occasions I just blamed feeling tired on the pregnancy, work stress and looking after a 2 year old! But glad I had both tested by my midwife (not in the UK) Now managed to balance my thyroid, and had iron intravenously, which made me
feel so much better! I would say certainly worth asking for further tests!

I don’t think I have the same level of exhaustion as you but I’m similarly 27 weeks pregnant and struggling with energy levels, feeling a bit breathless at times, and have brain fog. This pregnancy is harder because I’m working, caring for two children and life is just incredibly full on. Definitely worth getting all health concerns checked out with doctors/midwife but I suspect at this point, for me, the extra weight and just busy life are contributing to my tiredness in pregnancy. In my first pregnancy - life was easy and I could rest when I wanted! Trying to rest as much as possible in the evenings. Good luck!