Why is it acceptable for pregnant women's iron levels to drop so low?

[agoldcup]

The healthy Hb 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 they don't mind if your level drops to 105.

Why are they seemingly happy for pregnant women's iron to drop so low, especially at a time when side effects such as tiredness, shortness of breath are naturally present anyway by virtue of pregnancy alone - and then exacerbated by having lower iron?

Why isn't it the case that we expect pregnant women to have a level of 120+?

My HB was 90 and my ferritin 5(!) before I was taken seriously. I wasn't just tired, u was home achingly exhausted. Felt like I was wading through water. I was eventually given 2 IV iron infusions. I had new my iron was low (as it was during my first pregnancy) but it still took months before I was taken seriously and treated.

Sadly and frustratingly, a lot of recommended medication and measurements are for the average man. White, mid 20s to late 40s male. Everything is measured on this; paracetamol dosage, normal thyroid TSH levels, blood glucose… you name it! As everyone knows, men do not have an average of a 28 day hormone cycle (their’s is round about every 4 months and doesn’t peak and trough like a woman), so it’s none comparable. However in pharmaceuticals and medicine, no one cares.

I have been particularly frustrated at having thyroid disease and had many recurrent miscarriages. I was told by my GP many times my thyroid levels were fine and in ‘normal’ range. They weren’t at all, they were ‘normal’ for a white, mid 30s male, but not a woman TTC or pregnant.

Sadly things have been this way for years and will always be this way. It takes an expert in the field to actually know what they’re talking about to address what is ‘normal’ for a woman and a pregnant one at that.

I’ve always said; if it was men who had the 28 day cycles and who carried the babies and who went through menopause, things would be a hell of a lot different medication wise.

It’s so frustrating.

I was tested over six weeks ago, it was low (below 110) so they said I was anaemic and gave me tablets.

I was retested a few days ago, and, despite the tablets, my level is exactly the same as it was. The GP has refused to give me a higher dose, even though clearly it’s not working! If I was anemic six weeks ago I’m anaemic now!

Haemoglobin and iron aren't the same thing.

A large part of the fall in haemoglobin that happens in pregnancy is a normal, physiological process which protects to some extent from developing anaemia as a result of blood loss at delivery. In normal pregnancy red cell mass does increase, but it doesn't increase as much as the blood volume does and the measured haemoglobin falls, hence the different normal ranges at different gestations. At delivery this means that for a given volume of blood loss you lose fewer red cells than if you weren't diluted and historically that would have given a survival benefit (there used to be a vogue for artificially diluting people before surgery with significant anticipated blood loss with the same intention). Correcting iron deficiency isn't going to get rid of the dilutional element of the anaemia in pregnancy. HTH.