Anaemic and Annoyed

[TTCbabynumber22025]

I’m 30w pregnant with baby number 2, and my GP recently told me I was anaemic, my ferritin level is 5.

I had a gastric sleeve op a year before I got pregnant with my first baby, and I have some absorption issues with things like vitamins etc, I have to have annual blood tests for life and B12 quarterly and make sure I take a double dose of vitamins every day.

In my first pregnancy, my iron levels were low and I eventually had to have an iron infusion. I struggled to keep the iron tablets down, they made me extremely constipated even with laxatives, I was sick throughout the pregnancy anyway and would throw up 4/5 of the tablets I took.

Outside of pregnancy all my levels are generally in the normal range, albeit on the lower end usually.

So I’m pregnant again and guess what, exact same issues with my iron levels but they’re even lower this time. I’ve mentioned everything to my midwife at every appointment and they took bloods at the beginning of the pregnancy but they only took them again a couple of weeks ago. Anything I say to her, I just get told it’s normal for pregnancy and to just keep trying with the iron tablets.

This week I’ve been feeling really lethargic, I got winded singing my daughter to sleep while sat down. I’m having heart palpitations and feel dizzy when I do so much as walk upstairs and I’m just getting out of breath all the time. I caught myself in the mirror today and I looked awful.

I’m not sure what to do, I’ve tried over the counter iron tablets rather than the high dosage but I struggle with either and I can tolerate Spatone but the iron levels in that are so low compared to the tablets. Has anyone been in a similar situation or have any advice at all please?

I’ve had low iron for many years and like you it has been especially bad when pregnant. I would try again with the ferrous fumarate or sulfate tablets if I were you - the 210mg ones at least. What worked for me was taking the tablets before bed, every other day or every few days, rather than daily. It meant I got lots of the benefits but fewer side effects. Is there a reason you won’t try them again other than stomach issues (which do adjust with time)?

I do keep trying them, and I try them different ways like empty stomach with orange juice, after food, before bed, first thing on a morning but I just 4 out of 5 times throw them up again and there doesn’t seem to be a pattern as to the ones I don’t for me to repeat.

the decision re iron infusions in obstetrics is usually based on haemoglobin rather than ferritin - so perhaps that's what's informing their decision. If your Hb is lower than it should be for your gestation and you can't take any of the oral preparations then that might trigger an iron infusion, but otherwise, you're probably stuck with taking oral. Lots of people find they get better results taking much less iron than the standard prescription (eg. one table every other day or even every few days) and some people get on better with different salts to the usual first line FeSO4 so it may be worth asking about different preparations.

This happened to me. My midwife told me to go to maternity triage to discuss my symptoms and they gave me an iron transfusion when I went in.

hope you get what you need!