I have a GP appt this afternoon... Anaemia related.

[HopelesslyHopeful87]

I have a longstanding issue of being anaemic and suffer from multiple symptoms but also may crossover into other things.

I'm trying to be one of those women that go into appointments knowing what I want and what to ask for because I'm fed up of my symptoms being overlooked and passed off as 'anxiety'. I do have a history of anxiety and also have a clinical diagnosis of OCD so I feel like everytime I present with palpitations etc they just fob me off.

I'm looking for some advice on what blood tests need to be ordered to fully investigate so I can advocate for myself clearly and without getting upset with my frustration.

I had iron infusions during my pregnancy in 2021 as I am very intolerant to oral iron supplements and they make me very ill. I then had a PPH when baby was born and everything they replaced in my iron stores went on the floor and I was never followed up or given any further replacement. Baby is now 18 months old.

I presented to the nurse for my depo jab this morning and due to heavy bleeding and me looking very pale, she suggested booking appt to discuss further so I have one booked this afternoon.

My symptoms are:

-Always cold. Literally always. Heating can be on 28 all day and I won't feel it.
-Palpitations.
-Breathlessness.
-Hair loss. This has been particularly severe over the past 6 months and I would say my hair is 30% thinner than it was previously.
-Paleness. I look dead without makeup and everyone comments on this.
-Inside my eyelids are almost white not red.

I had an episode of chest pain extending into my arms about 4 months ago associated with really struggling to take a full breath. I presented to UTC for a check up and ECG was normal and they said it was probably anxiety.

Can this be a sx of anaemia?

Should I be asking for thyroid checks as well? Any advice is greatly appreciated I just want to be able to advocate for myself instead of feeling undermined all the time.

Of course it's anaemia. I would tell the GP the symptoms and insist on an urgent iron infusion. Tell them you can barely keep your eyes open and you need to be back to your best now, you have a young child depending on you.

They may want to do a blood test first, but either way the symptoms are clear. They should have done it after you had the baby and its absolutely rubbish that they didn't do that with your history!

Sorry should add I had all those symptoms for many years and only when I had the iron infusion did I realise how bloody ill I'd been and what pressure my body had been under! Good luck OP, you must insist.

Thanks for your reply.

When I was pregnant and had the infusions I'd never felt so good after a couple of weeks.

I have 4 kids and a job I just can't function like this anymore. I am overweight, albeit not excessively (84kg with a height of 173cm) but getting out of breath climbing the stairs is not fun anymore.

Ask for your B12 to be checked too.

I had low iron for years and never felt ‘good’ even taking 3 tablets a day. Eventually a GP said they would check my B12 levels, they were low so I had injections and have felt much much better ever since!

Yes, OP, all classic symptoms of low iron. I’m now “normal” on my iron after years of anaemia and the difference is staggering. I’d had no idea how poorly I was. Do push for a resolution, it’s worth it.

Dr said it definitely sounds like anaemia and really listened actually so I'm pleased with the outcome.
He is testing B12, ferritin, foliate, lft, tsh, clotting factors, u&e, esr, fbc, gfr, haemolysis, hba1c. So a full blood mot, booked for Monday

@HopelesslyHopeful87 fantastic, glad you got a good doc and hopefully you’re on the path to feeling well again! 💜

All my results are normal, no action required 🤷🏻‍♀️

@HopelesslyHopeful87 how odd! May I ask how old you are? Could it be perimeopause?

Hmm have you been given the actual numbers and range? You could be the low end of ‘normal’ and very symptomatic.

What is your iron count?

Yes, you need the numbers.

Did they check B12 and Vitamin D? They can present the same symptoms if low.

Taken the screen shots from my NHS app. It looks like my folate is the low end of normal.

I'm 35 and on the depo so doubtful that I'm peri. I had a baby 18 months ago.

Your ferritin isn't desperately low, but ideal is much higher, I've seen 70 touted as the minimum level to reach to solve hair loss. I'd definitely start taking some iron tablets - won't be a quick fix like an infusion but might get you feeling better within a few weeks. And might as well supplement folate too as it's on the lower side

@HopelesslyHopeful87 on my app it says normal range for ferritin is 28-200, and I’ve read online it’s 40-200 with 100 being ideal. So that could be classed as low. Odd that your range is different 🤷🏻‍♀️ Wonder if the range is age-dependent, I’m older than you.

I'd ask for Vitamin D and B12. I've been virtually non existent in both (at different times) and felt horrendous. Hair fell out with Vitamin D deficiency, I had pretty much all the symptoms of an under active thyroid but it was a vitamin D deficiency.

I've also had all 3 ways of being anaemic and felt worse with the Vitamin D deficiency.

You can get symptoms from low ferritin below 30, mine is 15 and I can't get an infusion because on my results the range is 13-something so it looks like it's ok... in the meantime I just have to wait for it to drop even further before they'll do anything

OP low vit D can make you feel dreadful, ask them to check that

I can't take oral iron at all. It makes me so poorly which is why I had to have infusions when I was pregnant. It's listed on my medical records as an adverse reaction.

To supplement folate do I just need folic acid? Just the standard stuff you buy OTC when pregnant?

@HopelesslyHopeful87 I get a lower dose easily absorbed iron from a herbalist - it’s called viridian and it gives me none of the awful symptoms that the ferrous sulphate does. I think it’s a food based source. It’s not nearly such a high dose - think 15mg rather than 200 - but I’ve found it does the job just as well, I must have hardly been absorbing the doc ones at all. Might be worth asking if you might be safe to take those.

There are so many doses of these available, I have no idea what strengths to get.

I am looking at Vitamin D, B12, folic acid.

Any advice on what IU to get would be much appreciated.

I will look into that gentler iron suggestion thank you.

I have tried the marketed 'gentler' Feroglobin iron before which was 17mg and couldn't even tolerate that. Even taken at every other day instead of every day.

My obs/gyn consultant calculated the length of time it would take for my levels to increase and it would have been nearly a year before that low dose would have an effect as my ferritin was at about 6 I think when I was pregnant,which is why I had infusions before I have birth. He knew I was at risk of PPH so he needed it raising before I had baby. So I must have retained some of the infusion after my PPH for it to be whatever it is now.

B12 and folic acid are both water soluble, which means you just pee out what isn't absorbed, so no real danger of overdosing. Folic acid is normally available in 400mcg or 5mg, when I've been low I got the higher strength ones. B12 can come in a range of strengths too, again I went for high strength - figured better to waste some than take ones that were too weak to raise my levels. I would suggest looking for sublingual tablets or drops though. These are absorbed into the bloodstream under the tongue as some people don't absorb that well from the stomach.

For vitamin D, technically you can take too much, though would have to be a very large dose over a long time. If you've not had a blood test for that one I'd say a normal daily dose is between 1-4000iu. (I've taken 10000iu daily for months at a time and still been within perfectly safe levels)

Thank you so much ❤️