Low Ferritin

[StarInTheSky2]

Hi All,

Feeling really low at the moment and would be nice to hear from people that have been through the same.

I have had iron deficiency for over 10 years now. Before I had children (3&4) I got through it probably because I was young etc but after I've had children I've felt horrific. Tablets have always been given to me by GP but my ferritin never goes up by 3-4 on a 3 month course of tablets.

In September 2023 I went private and got an iron infusion because my GP wasn't helping me despite my ferritin being 4 and previously never going higher than 6. After the infusion my ferritin went upto 90 but now has come back down to 32 and I feel like I'm dying and that's no exaggeration. I can't remember being this symptomatic before but I have zero energy, headaches, body aches, eye pain and also feel like my hearing is going as well as very loud tinnitus. If I could go private again then I would but I don't have that kind of money at the moment.

I just really don't know what to do and it's also really affecting my mental health now too. I'm sleeping in the day for an hour or two and then ready for bed at 7pm again. Vitamin d and b12 are good.

Any advice would be greatly appreciated.

From chatgpt

Low ferritin with a normal hemoglobin (Hb) level is often an indication of early iron deficiency, even before it progresses to anemia. Here's a breakdown:
What It Means:

1. Ferritin:
2. Ferritin is a protein that stores iron in the body, and its levels reflect your iron reserves.
3. Low ferritin means your body's iron stores are depleted.
4. Normal Hemoglobin:
5. Hemoglobin levels might still be normal because the body is compensating by utilizing its stored iron to maintain red blood cell production.
6. This is called latent iron deficiency or iron depletion without anemia.

Causes of Low Ferritin, Normal Hb:

1. Insufficient Iron Intake:
2. Diet low in iron-rich foods (e.g., red meat, beans, spinach).
3. Increased Iron Demand:
4. Growth spurts, pregnancy, or breastfeeding.
5. Iron Loss:
6. Menstrual bleeding, gastrointestinal bleeding (e.g., ulcers, hemorrhoids), or frequent blood donation.
7. Malabsorption:
8. Conditions like celiac disease, inflammatory bowel disease, or H. pylori infection.
9. Chronic Diseases:
10. Even without anemia, conditions like hypothyroidism or chronic inflammation can reduce ferritin.

Symptoms You May Notice:

• Fatigue or weakness.
• Hair thinning or loss.
• Restless legs syndrome.
• Reduced exercise tolerance.
• Irritability or difficulty concentrating.

What You Should Do:

1. Dietary Changes:
2. Increase intake of iron-rich foods:
3. Heme iron (better absorbed): Red meat, poultry, fish.
4. Non-heme iron: Beans, lentils, tofu, spinach (paired with vitamin C to improve absorption).
5. Avoid tea, coffee, and high-calcium foods around meals as they inhibit iron absorption.
6. Iron Supplements (if prescribed):
7. Commonly ferrous sulfate, ferrous gluconate, or ferrous fumarate.
8. Take with vitamin C to enhance absorption.
9. Side effects: Constipation, nausea, or dark stools.
10. Investigate Underlying Causes:
11. Check for menstrual irregularities, GI symptoms, or dietary patterns.
12. A doctor might suggest further tests like serum iron, TIBC, or ferritin saturation to confirm.

If untreated, low ferritin may eventually lead to anemia. It’s advisable to consult a healthcare professional for proper evaluation and management.

Have you been checked for fibroids? Your symptoms match mine exactly and eventually was diagnosed with a massive (melon sized) fibroid. Had it removed and periods are now a breeze and ferritin is normal.
The only thing that worked for me (my ferritin was persistently 4/5) was feroglobin liquid every day. It's much more gentle on the stomach.

Thanks @Theuniversalshere1 that's interesting! My HB was 102 g/L whatever that means!

Hope you get sorted soon OP. It really does make you feel miserable.

I have fibroids which cause heavy periods. I felt horific when my fertin was low.

I went on the pill and took 3 packets back to back.
Thia gave my body a chance to build up feritin again and my energy increased.

Is his something you would consider.

I haven't been checked for fibroids, could I have had them since being a teenager as I've have heavy periods since then? Do I need to be referred to a gynaecologist for further investigation?

I did try the pill too about 8 years ago but I kept bleeding with them. Being a woman sucks!

Have you tried taking the iron in liquid form as some people find that their bodies absorb that easier..
I've had low iron most of my adult life, which got very bad after having children and the tablets did nothing. But my doctor switched to prescribing liquid iron and it's worked much better. NHS GP not private. So you could try that?
And like PP said try different things regarding your periods. Stop the root cause.

I'm the same I usually go on iron at least once a year and even if I get it up a bit its never enough and it starts to drop the minute I stop the tablets even when I eat iron rich food. I also have heavy periods. Taking B vitamins along side iron can help especially folic acid, also there was some study which said that taking iron every other day improved absorption and reduced symptoms like constipation so you could try that. Also you might need to take iron on an ongoing basis like one week a month if your periods are heavy. My GP told me my blood looked like that of someone with Thalassemia which I don't have but I suspect I have some other issue as low iron stores and anaemia are rampant in my family.

Apparently you can also get iron patches I haven't tried them though, the IV is best but its hard to access via the NHS.

Hi I had a ferritin of 2 at one point and have managed to get back up to normal, albeit on the lower end, with decent ferritin and hb levels.

I also have PCOS and have been taking the mini pill for 5 years, so no periods at all, also took ferrous fumerate for nearly a year followed by normal over the counter iron tablets, vit d etc. and hammered the iron-rich foods (dried apricots in particular).

Not gonna lie, it took 2 years to get back to feeling better but if I were you I'd try to get the heavy periods under control/stopped, otherwise you'll always be getting more anaemic each month.

@sundaysunday2024 I thought they couldn't actually measure ferritin below 7 or 4 at the most?

They definitely can. Mine was 1.8 then 5.4 and now 11.9. Still feel exhausted though.

@orangina01 Ah ok I just recall a GP telling me they couldn't detect my ferritin at all as it was below 4 I think and the test didn't go down any further. Could be a different test though. 11.9 is still very iron defiant are you sure you aren't thinking of the haemoglobin test?

Another recommendation for ferrous fumarate medicine. Some clown has decided to flavour it with mint chocolate chip and so it tastes foul but I had much better results with that than the ferrous sulphate tablets.

I sympathise OP but unless you try and sort out the heavy periods it’s like running the bath with the plug out unfortunately.

My ferritin was 2 and HB 90 a few years ago due to heavy periods. I started using tranexamic acid to reduce my heavy periods which has made a huge difference. I can’t tolerate iron tablets but I use spatone with vitamin c to keep topped up x

Nope, sadly I've always been this way. On tablets for years.

Just checked my NHS app test results. Definitely says:

Serum ferritin level 11.9 ug/L - it's the highest mine has even been! 😬

Go back to GP and seek help for heavy periods. Eg tranexamic acid

I also think it’s worth getting checked for Coeliac disease. 1:100 people have it and most are undiagnosed (only 36% of Coeliacs are diagnosed). On average it takes 13 years to be diagnosed.
Low iron due to malabsorption is a very common symptom of Coeliac disease and in women it’s often just written off as being due to heavy periods.
My Coeliac daughter had very few digestive problems, her main symptoms were due to severe iron deficiency.

www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/what-are-coeliac-disease-symptoms/

Hi OP,
Definitely ask the GP for tranexamic acid to help slow your period blood loss. I've been using it and it's cut my period blood loss by like 50% and minimal clots.
Also ask for ferrous sulphate. It's much kinder on the stomach and it's absorbed much better. There is also sodium feredetate which my children take whose iron levels are constantly really low like yours which may help.

Hopefully you can get the help you need hun. I've been in your shoes and it's awful. I've used ferrous sulphate and it's not given me any issues. ferrous fumarate I couldn't tolerate at all so you may find your body is struggling to absorb it.

As others have said also get checked for coeliac disease as its well known for causing constant anaemia.

Great thread a lot of great advice. My ferritin is on 7 due to fibroids managed with the pill. Obviously the periods are lighter now but not light enough. Am on ferrous sulphate. I was getting palpitations hence had the blood test. Fatigue is my life but then I also have a very active toddler.

Same here OP. I'm 62 and post menopausal and have never had any kind of heavy bleeding. Ive had lifelong iron deficiency. The pills dont work and .y GP doesnt give a shit. I have to have iron infusions privately. It costs me £700 every time. I'm sick of it and the expense.

I have a long history of low ferritin and previously had an iron infusion. Also a folate deficiency.
I have been reading up about all of the info on the Vitamin B12 Wake Up support group and suggest you look up how it all fits together re B12 and iron deficiency as I've finally been coming to realise. There is so much on there that I have never had explained before at various times over the years.

Ah its annoying the way any help or investigation just stops, that ferritin level is really not good enough although who am I to say anything I'm more or less just as bad!

Just a heads up, I did take tranexamic acid due to heavy periods and low iron but it made my migraines much, much worse so I had to stop.

Thank you all so much for all the advice. I have an appointment with my GP on 4th Feb but I don't think I can wait that long so I'm going to try and get another appointment next week and hopefully it'll be someone nicer.

I'm going on holiday at the end of March, it was booked last year when I was feeling much better. If all fails here I can get treatment there but I'll be feeling horrible for the whole trip. I just feel so bad for the kids, they don't deserve this.