Sticky Blood-Hughes Syndrome Support
8,341 members8,516 posts

Low normal iron can cause fatigue

For those of us fighting critical fatigue, I am learning that those numbers on our blood tests that are just on the edge of being within the normal range can actually indicate underlying issues. Take iron for example.

My recent blood test showed my ferritin level (iron) was 14.4 (range 11.0 - 306.8). My doctor said it was just fine because it was within what the lab considered normal.

Come to find out that scientists have long known that women who suffer from fatigue and who have ferritin levels of less than 50 Ug/l in one study and less than 20 Ug/l in another study could have significantly more energy just by taking supplements. My energy has already improved some by taking 5000 i.u. of Vitamin D3 every day (I was deficient in Vitamin D on a blood test). The question for me is "Can taking a daily iron supplement improve my energy even more?" That's the self test I am going to do at the moment by adding an iron supplement to my daily routine.

Here is a link to a study from 2003.

Here is another one from 2012.

Yet, why hasn't any doctor recommended this to me? Don't they have access to the research too?

I am now learning through my research that my previous blood test results indicated a possible issue with anemia, yet it's been ignored for years because my values were just out of normal range or just within normal range. And it wasn't just my ferritin levels that were just barely within the normal range indicating possible anemia.

Combining a higher Platelet blood test with a low Mean Platelet Value can indicate anemia, infection, inflammation, autoimmune, or cancer. So there it is again -- possible anemia. Yet, my doctors never suggested trying an iron supplement. Why - because the labs always had me on the very edge of being normal or just in the abnormal range. In addition, my doctors aren't familiar with these studies. They go by what the lab ranges are and don't question anything that is close to normal. Ughhhh.

I realize many with Lupus and Hughes have low platelets. While it can be more unusual, scientists have learned that one can have these autoimmune issues and have high platelets. My platelet values in the last two years have ranged from just over the high range to just below the high range (384 - 402). (Some labs put normal at 150 - 450, while other labs put normal at 150-400). In addition, my recent Mean Platelet Volume (MPV) blood test came in at 7.1 (depending upon the lab, normal can be defined as below 7.4 or below 7.0). Of course my lab was one that uses below 7.0 as being out of normal, so my doctor completely ignored my 7.1 MPV.

So what does this mean, I am on the edge of being high on platelets and low on MPV. In dozens of scientific studies, this can indicate anemia. Couple that with my low ferritin and why hasn't any doctor ever suggested that I try an iron supplement? My self-test in taking iron supplements begins today.

Patients suffering from genetic disorders such as lupus or hemolytic disorders such as anemia also are most likely to have a lower MPV reading than normal. Autoimmune disorders which include lupus and rheumatoid arthritis and leukemia are among the major reasons that may result in a person having abnormally low values of MPV. So it may be that my MPV is low because of this -- but for me with severe debilitating fatigue it is worth trying the iron supplements.

Why is this important? When there are days when one has to lay down all day because of fatigue and other (most days) where one must take a lay down during the day and barely functions the rest of the day -- that is when if the doctors give up on us -- we still have to keep looking.

I had a doctor last week suggest that I should just accept fatigue as part of my life and stop visiting with doctors and doing blood tests. She suggested that if anything, I should visit reducing my stress. I know how to reduce my stress -- I need to get rid of the fatigue. That doctor went onto say that even in 100 years, she wasn't sure that doctors would know the cause of my fatigue nor have a way to improve it. Boy she is the type of person to who tells her patients to give up and go for disability. Disability is fine as needed -- but just give up. Not me.

The answers are out there. If you are ignored or dismissed by doctors -- stand steadfast -- there are answers. Today I feel empowered, despite being dismissed by a recent doctor. The scientific studies back up my position. Today I have something to try. Hooray! There is hope!

8 Replies

You raise a very good issue as you know myself and colleagues on here are advocates of checking the levels of iron, b and D, any of these being out can make you feel quite unwell and add to the burden of the disease(s) we all have. Thanks for the post.



I have had this problem lately also. My red blood cell index were under the normal range (in Finlad MCV, MCH and MCHC) many months. I got Restless Legs syndrome. Hemoglobin was in normal range, but lower than I used to have. After one month of having iron supplement my ferritin was only 9 (13-150). At that time I was so fatigued that I had to go to doctor and ask for sick leave from work. Doctor told me that fatigue was not because of iron deficiency. Because of normal hemoglobin. Still he doubled iron supplement. I agree with you Tranquility1! I found also a study that confirmes low ferritin causes fatigue. Slowly RLS syndrome has improved and I feel much better and have got more energy.


Hi Leenalina,

Thank you for you info! I am glad you are feeling better also. Best wishes to you from



Thank you Kerstin!


Hi tranquility, I'm so glad for your post as my thought process is the same as you. I also have low iron levels which are just in the normal range. Of course as I'm in "normal" range the docs don't even blink an eye! Clearly if you are exhausted then it is not normal for you and treatment should commence. I have read that low iron levels can mimic APS as well? Will adequate iron levels improve APS? ..... Lots of questions with more research needed. Thanks for sharing & I wish you the best.

Carmen from perth australia :-)


Huge swathes of doctors are seemingly scared or unable to use clinical judgements. So we succumb to tick box doctoring. They only respond if the computer tells them a particular result is out of a predetermined range.

Where the normal ranges appear incorrect it has probably been set that way by accountants working out the potential costs of treatment.

If doctoring was ever a skilled profession it seems that the government is doing its best to remove any noticeable skill level.

Doctors are often scared off by the GMC of using their own judgements.


Thanks everyone! It's nice to know I am not alone. :-)

Studies show that for those of us with low iron, taking the iron with orange juice increases the absorption. For example, in this study they found that taking iron with tea reduced the absorption to less than half, while taking the iron with orange juice increased the absorption two and a half times.

Darn -- just looked up coffee's impact on iron. "A cup of coffee reduced iron absorption from a hamburger meal by 39%..... No decrease in iron absorption occurred when coffee was consumed 1 h before a meal, but the same degree of inhibition as with simultaneous ingestion was seen when coffee was taken 1 h later."

Tea was worse than coffee at negatively impacting absorption. I just took my iron with orange juice this morning. I was thinking I would wait an hour and then have my coffee. That last study ruined that. From now on, coffee an hour before orange juice + iron for me. :-)


I just found your posts when researching low ferritin levels on my daughter, who has been suffering from extreme fatigue and has had numerous expensive labs done by multiple docs. However, no one tested her ferritin until a new doc (neurologist) did yesterday and she is low-and I am praying this is the answer we've been looking for. Did the iron supplementation help you significantly-and is it still helping? How long before it really kicked in? Desperate for answers.....thank you.


You may also like...