Low iron, tearful and exhausted - anyone else?

[beeble347]

I'm just about 12 weeks with my second, still breastfeeding 19mo (down to once per 24h, one feed at night in the early hours only now).

I keep getting tearful I'm so tired and don't know if it's normal. I have messaged the GP surgery today to pass on to the midwife just in case. Taking ferrous fumarate for just over a month now as my ferritin was 16ug/L in August - actually up from 7ug/L in May this year, before this pregnancy.

I also have treated hypothyroidism and coeliac disease diagnosed in May. Work part time as a teacher and do all drop offs pick ups etc, working days are just constant rush though I've been making sure I stop and take 5 mins to eat lunch even if working with one hand at the same time. First few days back at work this academic year I couldn't eat until about 5pm, just too busy.

Pescatarian since I was very young as well (my choice) but I've been really wanting to eat chicken recently and considering adding it back into my diet, which feels so restricted right now with everything going on.

Just wondering if this is normal pregnancy or an iron issue? Obv can't rest as much as I did with my first!

Sounds like a low iron issue. Yours is dangerously low and will affect your baby's health as well as yours. Breastfeeding depletes your body of all nutrients (no judgement there as I bf all the way through pregnancy and afterwards).

Health iron levels are ferritin of 100+ and transferrin saturation of at least 20%. The NHS normal range (starting at ferritin of 30) doesn't mean "healthy", it just means "not low enough for us to want to spend money treating".

The chances are that you could get your levels up faster by following the best advice on supplementing. I would recommend the Iron Protocol FB group. Their guides tell you everything you need to know about how to supplement to improve your levels as fast as possible. You ought to be able to increase ferritin by 10-15 points a month.

In the longer term, I'd also get your toddler's levels checked as iron deficient mothers give birth to iron deficient babies.

For some reason I can't link the group but it's called The Iron Protocol for Iron Deficiency With Or Without Anemia and it's the world's largest patient advocacy group for iron deficiency. They have a very helpful guide in the files that tells you everything you need to know about getting your levels up ASAP. They recommend that everyone who has been iron deficient aims to get ferritin to at least 125 for at least 6 months.

Being pregnant can deplete your iron stores.

Are you in the UK? With low ferritin (iron) your GP would usually prescribe ferrous fumarate or sulphate tablets to get your iron up. Low iron at the point of delivery can make you more likely to require a blood transfusion after giving birth so it does pose a risk to women.

I am 26 weeks pregnant with my second baby. I have a 23 month old too, so similar to you. Before baby 1, my iron levels were over 30. After delivery they dropped to 8, and my Hb levels fell to 10.0. I managed to get my iron and Hb up with tablets before falling pregnant again.

Now they are low again, iron has gone from 23 to 10. My midwife is going to see if she can refer me for an iron transfusion as the deficiency is now quite long standing and the tablets only help temporarily.

Rubbish isn't it, I feel awful too x

Thank you so much am researching it now!

Thank you, yeah it just feels awful. I'm on ferrous fumarate, for just over a month now. I started taking non prescribed iron tablets after my blood test results earlier in the year (think it was actually Feb not May!) but stopped when I found out I was pregnant until I got the okay from the midwife and GP. I just worry it's not enough but I've requested a new blood test.

DH said we'll start "ironmaxxing" my diet so really trying to eat for iron even though it's tough with first trimester food aversions. I'm really wanting chicken atm and haven't eaten it in almost 3 decades but I've heard it's not even particularly high in iron? Trying to eat some salmon this evening despite the nausea.

I'm sorry you're going through it as well, it's really tough 😞

@beeble347 iron maxxing sounds good. My problem is like you with food aversions and overall in both my pregnancies it seems I totally lose my appetite. I was a strict vegetarian almost all of my life but started eating meat a few years ago, however in both pregnancies totally go off meat it seems!!

You are right chicken isn't good for iron. The best animal sources are usually offal like liver, then beef next. If you get a good fortified breakfast cereal like special k and eat a 50g portion every morning, plus about 3 eggs in a day you are not far off your RDA of iron as a woman. If you add your iron supplement on top of something like that you are probably doing the best you can as a vegetarian/pescatarian. Adding vitamin c is good for absorption.

I think the general assumption is that all meat contains useful amounts of iron and it doesn't. Eating a combo of things seems to be the way forward, to get the haem and non haem variety.

For me, whenever I take the supplements my severe nausea is triggered and I get the most awful pain and heartburn. It makes day to day life even harder looking after a toddler and trying to work. I also take omeprazole for the heartburn in pregnancy and I think it hinders absorption. I just hope that with my most recent blood test results and a confirmed history of anaemia they will take pity on me and offer a transfusion!!

I would really go for the chicken if it’s what you’re feeling OP. I was veggie before my first, turned pescatarian while pregnant with her, and a few months into breastfeeding was craving chicken awfully. Like I knew it was something I needed to listen to cos I’d been veggie/pesc for so long without craving any meat whatsoever. I think it was my body telling me if you wanna keep breastfeeding you’re gonna have to give us something more! Even if chicken itself isn’t great for iron, there could be other reasons you’re craving it like protein. Or it could be a gateway meat to get you back into eating higher-iron meats as was what happened with me 🤷‍♀️

Could you also get your thyroid levels looked at again and have a b12 test?