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Low Ferritin


SeaConquest
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My ferritin levels came back low, but everything else seems ok. A few years ago, my iron saturation was low. Does anyone have any insight on low iron/anemia?

 

These are my levels:

 

Component Results

 

Component FERRITIN

Your Value 11 ng/mL

Standard Range 13 - 126 ng/mL

 

Component IRON

Your Value 98 mcg/dL

Standard Range 37 - 145 mcg/dL

 

Component TOTAL IRON BINDING CAPACITY

Your Value 399 mcg/dL

Standard Range 250 - 450 mcg/dL

 

Component IRON SAT

Your Value 25 %

Standard Range 20 - 50 %

 

Component HGB

Your Value 13.4 g/dL

Standard Range 12.0 - 16.0 g/dL

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With a ferritin score of 11, you must be dead on your feet. I know--I have been there. 

 

Your hemoglobin is on the low end as well. Some doctors would consider your hemoglobin acceptable, but I would not (and many doctors would also say that's too low to feel good). I feel horrible when my hemoglobin is that low. Coupled with the super-low ferritin, I am guessing you have very little energy these days.

 

You are anemic. You will need to aggressively supplement with iron. When my score was that low (both ferritin and hemoglobin), my doctor prescribed 125mg of iron per day. I took that much for eight months before my numbers finally crept into a range that was more normal. I find that I feel best when my ferritin is at least in the 50-80 range. After my numbers were more robust, I dropped to a maintenance dose of 50mg per day for about a year, and then down to 18mg per day. 

 

I have continued getting my iron tested yearly. I found that I could not maintain decent ferritin levels, so for many years I needed to take iron supplements for a couple months. My iron situation improved quite a bit with middle age.  :001_rolleyes:

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Thanks for your reply. It was super helpful. Honestly, I feel the same as I always do, so I must have adjusted to it. The panel was run as a part of pre-bariatric surgery labs. Do you think I will have to get my ferritin up to be healthy enough for surgery?

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Also, should buy an iron supplement asap, or wait for doc to rx something? Any recommendations?

I wouldn't supplement iron until your doctor reviews the numbers, there may be additional testing he wants to do related to your upcoming surgery and I wouldn't want to skew any numbers before hand.  There are some medications that should not be taken within a few hours of iron, so he will want to review any possible interactions before you start. 

 

The iron you get off the regular vitamin shelves is very low.  If he wants you to supplement, it will likely be one that you get in the pharmacy.  It doesn't have to be a prescription, but due to the high strength, it is kept behind the counter.  When you take it, make sure to combine it with vitamin C  (Oj or vitamin supplements is fine).

 

Iron helps with restless leg, so even if you aren't sleepy tired you may still notice a difference in energy/fatigue levels once you start supplementing. 

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The ferritin is what my doctor pays the most attention to--a measure of your iron stores. I don't know what your doctor will recommend in terms of surgery timing and supplementation, but I wanted to put in a recommendation for Ferrous Bis-glycinate forms of iron. I use Gentle Iron by Solgar. This iron has far better absorption compared to most other forms or iron. These means it builds up levels faster and has much less incidence of side effects of poor absorption common in other forms, such as constipation. 

 

Whatever iron you use, keep it away from egg, dairy, and soy in the diet. All interfere with iron absorption. Egg is actually the worst offender--both the yolk and white interfere in different ways.  I take my iron before bed so I have several hours post dinner meal before I take it. 

 

 

Edited by sbgrace
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Are your periods super heavy? That was the cause of my low ferritin and no supplement would fix it. I had to deal with the root cause.

I don't know. I was on bcp's for most of my life, so never had real periods until I went off them in my mid 30s to get pregnant. Being off the pill, periods just seem awful to me, but I never thought of mine as being outside the norm. They're usually 5 days, with day 2 being the worst. It's not like I'm changing a tampon every hour or two, or bleeding for 2 weeks.

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I had ferritin that was 4 a few years ago. I personally had to experiment to find iron I got on with the prescribed option is so harsh. I also found that I did better when I eventually started taking B12 too. Before that it felt like I wasn't making much permanent improvement.

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I also tend towards anemia.  It's such a hassle to get iron levels up!!!  

 

My doc would like to do an infusion, but reading about those scares me, lol, so I'm buying some heme iron supplements to see if that makes a difference.  This is the one I'm getting.  I have NO IDEA if the claims about it are true, and it's ridiculously expensive, but it's worth a try for me.  Also, if you're into a more natural treatment paradigm, dried liver capsules might be a good thing to add.  I can't quite bring myself to order them.   :lol:

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I also have low ferriton levels.  It causes Restless Leg Syndrom to be awful.  I feel fortunate that taking oral supplements helps.  The doctor said if they don't I would need to start going in to get regular iron shots.    I'm glad it hasn't come to that.  However, high doses of iron cause terrible constipation.  I don't know if the shots/infusions would be different.  I take my iron with magnesium which helps with constipation (and RLS too). 

Edited by PrincessMommy
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Whatever iron you use, keep it away from egg, dairy, and soy in the diet. All interfere with iron absorption. Egg is actually the worst offender--both the yolk and white interfere in different ways.  I take my iron before bed so I have several hours post dinner meal before I take it. 

 

So... with my iron sat being low and the dr recommending boosting iron via OTC sources, WHY did she not mention staying away from these things when taking it??? (GRR)  :cursing:  :banghead:

 

Seems it could be a wee bit important since I take it in the morning and most mornings have eggs for breakfast.

 

I suspect it could be why I haven't noticed a difference - or if I have - it's been in the wrong direction.  (sigh)

 

I SWEAR I learn far more from the Hive than from any Dr.

 

Thanks for sharing!

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The PA in Bariatrics that ordered the labs is saying that I am not anemic because all of my other numbers were good. Should I insist on talking to a hemotologist?

Edited by SeaConquest
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I rarely post and don't know how to link. But, we have dealt with low iron levels here.

 

Floradix is a liquid iron supplement. My MIL used it during chemo when her iron levels dropped precipitously. She had lifelong issues with constipation and Floradix did not cause problems for her. She was also a vegetarian so was not willing to increase her levels through red meat consumption or similar. Her levels responded quickly to the Floradix.

 

You can purchase it as a local health food store and/or Amazon or Vitacost or the Vitamin Shoppe.

 

Hope this helps!

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The PA in Bariatrics that ordered the labs is saying that I am not anemic because all of my other numbers were good. Should I insist on talking to a hemotologist?

 

Definitely insist on talking to someone else. My dd had repeated blood tests ordered by one doctor, who said she was fine because they were all normal, but who never bothered to order Ferritin. When a new doctor did, it turned out her number was ridiculously low and she's now on supplements. You can have iron deficiency without anemia (i.e. low ferritin/iron stores but normal hemoglobin/other bloodwork) and it still can have a big impact on energy, etc. So I'd not take the PA's word for it that you're fine if I were you.

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So... with my iron sat being low and the dr recommending boosting iron via OTC sources, WHY did she not mention staying away from these things when taking it??? (GRR)  :cursing:  :banghead:

 

Seems it could be a wee bit important since I take it in the morning and most mornings have eggs for breakfast.

 

I suspect it could be why I haven't noticed a difference - or if I have - it's been in the wrong direction.  (sigh)

 

I SWEAR I learn far more from the Hive than from any Dr.

 

Thanks for sharing!

 

I had the same experience actually! I finally researched because I was making no progress. 

 

The PA in Bariatrics that ordered the labs is saying that I am not anemic because all of my other numbers were good. Should I insist on talking to a hemotologist?

 

The ferritin is important. I would think even more so when you're looking at bariatric surgery. I would want another opinion, and I would start supplementing aggressively to try to raise it as much as I could. 

Edited by sbgrace
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I have been out of town for a few days, so sorry for not popping back in to answer your questions.

 

Personally, I would do the following:

 

--Insist on talking to a doctor who will take your numbers seriously. They are really low. Your ferritin score is quantifiably, clinically low, and your hemoglobin would be considered borderline. The combination is concerning. Your PA is wrong. When I had almost those identical numbers, I could barely function. 

 

--You can supplement on your own. You don't need a doctor's permission. BUT I would definitely talk to your surgeon to make sure that medications or whatever they will do in the context of the surgery will not react in combination with the iron. My guess is that iron supplementation will actually HELP your body process the surgery trauma more effectively.

 

--Once your doctor is in the loop, start taking iron supplements. You have every reason to do so, and I don't see a compelling reason not to. I found that it was best for me to take them in the evening. Some like to take their iron with orange juice as the vitamin C aids absorption. If you choose a liquid supplement, consider using a syringe to shoot the liquid past your teeth into the back of the throat as iron stains teeth.

 

--Consider eating prunes or increasing your fruit intake to prevent the common side effect of constipation. 

 

--Your dosage should be fairly high with those numbers. As I said, I took 125mg per day for quite some time. 

 

--Get re-tested every six months. 

 

--Expect it to take 6-12 months at the least to get your numbers up higher. If you do not see improvement, consider what other reasons there might be for chronically low iron scores. Some people take as long as 2 years to inch their numbers up into a healthy range. You should see incremental improvement.

 

--Once your numbers are much better, get tested yearly. Iron can be hard on the liver, so when your numbers are healthy, it's worth a trial of not supplementing to see how you do. That said, if your body needs iron, then going without it has a lot of icky effects throughout the body. I spent a few years supplementing 4-5 months and then taking a break for 6-7 months. That back-and-forth kept my scores in a healthy range. Middle age made it much easier to maintain good iron levels. 

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I haven't heard back from the doctor yet, but I bought a product called Hema Plex. It had a lot more iron than thr others. Will see how I do. Thank you all for the advice. I really appreciate it.

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My ferritin has stayed at 4 for the last year despite trying to improve it.  I'm also anemic and borderline low on B12 and Vit D.  I've started B12 injections in hopes that it will help and I have felt better overall.  Doctor didn't even want to test my ferritin at first and asked me if I knew what ferritin was.  I run 15-25 miles a week and he told me if my ferritin was low, I would want to run 5 miles but wouldn't be able to run 1.  Mmmkay....

 

The range my tests indicated as normal was between 18 and high 300's, so OP your 11 may not be as close to normal as you were told :)  I don't know the impact of ferritin before surgery but I'm praying your doctor can get a plan together for you.

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I have blood work done every 4 months (for other health reasons) and my dr checks either my ferritin or a full iron panel most times. I take iron supplements regularly. My dr is happy if my ferritin is above 50. However, I have read that optimally women should have their ferritin close to 100.

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OP, my ferritin has been anywhere from 6 to 16 this past year, and my doctor says 50 and above is 'optimal'.  I'm taking daily iron, avoiding taking it with calcium or coffee, going to acupuncture, and eating beef and red foods.  It's not going up.  I wonder if some people just tend to hover at low ferritin and still function well.  I am in a super overstretched time of life right now, especially with spring sports.  I'm running from early morning till bedtime, so I can't make sense of my 'low ferritin' either.  ( I am also anemic from the other blood counts.. low iron and rbc)

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What was your solution for the root cause?

I had a hysterectomy. I had a potato-sized fibroid embedded in my uterine wall that every month my body would try to "deliver." The amount of blood that I would lose, not to mention the pain, was unreal. Best decision I ever made. No ill effects whatsoever and my iron is normal for the first time in my adult life. I feel amazing.

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I had a hysterectomy. I had a potato-sized fibroid embedded in my uterine wall that every month my body would try to "deliver." The amount of blood that I would lose, not to mention the pain, was unreal. Best decision I ever made. No ill effects whatsoever and my iron is normal for the first time in my adult life. I feel amazing.

Thank you. I have had heavy periods for 16 years, and family history of fibroids (mom and sis have had oblations to treat) but I've also had a history of docs who just won't listen. I tell you, the times I felt my best are pregnant and post-partim until about 12 months (I usually get periods back at 6 months) - no severe blood loss during this time!. I have had docs Rx iron for me for low ferritin, but no one take my complaints about period flow/pain seriously. Edited by Targhee
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Thank you. I have had heavy periods for 16 years, and family history of fibroids (mom and sis have had oblations to treat) but I've also had a history of docs who just won't listen. I tell you, the times I felt my best are pregnant and post-partim until about 12 months (I usually get periods back at 6 months) - no severe blood loss during this time!. I have had docs Rx iron for me for low ferritin, but no one take my complaints about period flow/pain seriously.

 

I would strongly suggest you see a gynecologist who will listen to you. I was the same (only felt good when not menstruating). An ablation wouldn't have worked for me because the fibroid was submucosal. They discovered it via transvaginal ultrasound. 

 

My issues were causing me to have to alter my life. I could not go out for two days a month because I felt like I was in labor. The rest of the month, my iron was so low, I was just dragging myself through life. Hysterectomy is not the answer for everyone but I am so glad I went for it! I have experienced no negative effects whatsoever. 

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  • 7 months later...

Thought I would update after 6+ months of supplementation.

 

Iron: Was 98 now 74 mcg.

Total Iron Binding Capacity: Was 399 now 357 mcg

Iron Saturation: Was 25 now 21

Ferritin: Was 11 now 40

Hemoglobin: Was 13.4 now 14.3

 

The ferritin improved, but not much else. Not sure how to interpret these results. My surgery will likely be scheduled for January.

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Thought I would update after 6+ months of supplementation.

 

Iron: Was 98 now 74 mcg.

Total Iron Binding Capacity: Was 399 now 357 mcg

Iron Saturation: Was 25 now 21

Ferritin: Was 11 now 40

Hemoglobin: Was 13.4 now 14.3

 

The ferritin improved, but not much else. Not sure how to interpret these results. My surgery will likely be scheduled for January.

 

 

Thanks for the update!  

 

I also have an update, I decided to get the iron infusion.  Like you, I felt just fine at 11 ferritin level.  I felt about the same after the IV, but strangely, I've managed to finally start an exercise routine and keep to it... so I guess my energy level IS higher than it was!  

 

Good luck with your surgery.  

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Interesting. How much were you supplementing? 

 

I was down to a ferritin of 17 at one point and I felt terrible but my thyroid and hormones we're all whacked out too. I did 100+ mg of ferrous glycinate a day and moved up to 70+ in just a couple of months. 

 

Have they checked you for Celiac or thyroid disease? Both would cause problems with absorption? 

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Interesting. How much were you supplementing?

 

I was down to a ferritin of 17 at one point and I felt terrible but my thyroid and hormones we're all whacked out too. I did 100+ mg of ferrous glycinate a day and moved up to 70+ in just a couple of months.

 

Have they checked you for Celiac or thyroid disease? Both would cause problems with absorption?

I was taking 85 mg per day. Sometimes more.

 

My thyroid is normal. Never been checked for celiac, but I've never had issues eating gluten.

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I was taking 85 mg per day. Sometimes more.

 

My thyroid is normal. Never been checked for celiac, but I've never had issues eating gluten.

 

Not everyone has outward signs, the low ferritin is a symptom in itself. How are your other vitamin levels? Considering how much you are supplementing and you are still so low I'd be really concerned, I raised mine to normal within 3 months at 100+. 

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