Pernicious Anaemia Society
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Low Ferritin normal Haemoglobin

I've previously posted my FBC and Vit B12 results etc. (FBC normal, serum B12 is 254, but Active B12 120 currently waiting on MMA and homocysteine and a holter monitor result).

I got my ferritin tested this week and it has come back as 'low, see Dr. as planned' It is 13 (range 13-150).

I asked the Dr for this test the other day (he was a bit reluctant) and if there is any other tests for iron, he said no just the Ferritin but I've looked online and seems there is 'Serum iron', Transferrin, TIBC and saturation percent) - are these done on the NHS and would it be worth me trying to get them done?

Is low Ferritin a sign of something else I should be looking out for? (My TSH was 3.2, Dr says within range although people here have pointed out this can be hypothyroid but dr won't do other thyroid tests. Now with low Ferritin is there a connection? Can I now try and insist on these tests? i read a connection with Coeliac, should they check that?

Thanks in advance for your help and advice :)

4 Replies

Should say my recent Haemoglobin estimate is 131 g/L (range 115.00-165.00 g/L)


Well, you have an ill-informed GP. Try to see someone else in the practice next time, ideally a female. Let's start with the iron. A serum ferritin of 13 is on the floor, and you will be suffering from fatigue as a result and possibly other symptoms - slightly irregular heart beats, anxiety, possibly hair loss - maybe other signs.

The ferritin range was decided by measuring a whole load of people's levels. However, some of these were ill. Some weren't eating enough iron. So the range is not evidence based.

Here is an extract from a World Health Org document on this: . "Some manufacturers define a normal range as the ferritin concentra¬tion found in unselected, apparently normal subjects. However, a proportion of the normal population have almost no storage iron without being anaemic, particularly young women, and a smaller proportion will be anaemic. The “normal range” in young females will thus include ferritin concentrations found in iron deficiency."

The ranges for anemia for women are not evidence based either. You should apply the ranges for men to your haemoglobin results - is it now out of range?

Read this: BMJ. 2001 Jun 2; 322(7298): 1355–1357.

PMCID: PMC1120434

on Why should women have lower ferritin and haemoglobin ranges than men?

Start taking an absorbable iron tablet, ferrous bisglycinate or Ferrochel or any of those your pharmacist recommends - not ferrous sulphate, which often leads to constipation. Take at least 40mg daily at first and see how you feel - you can step that up given how low you are, but just make sure your stomach doesn't object.

Next: your TSH is too high as you know it should be under 2. Low iron is common in hypo. The thyroid needs it, and it may be raising your iron levels will help. Have they measured your Free T4? It sounds as though you are hypothyroid, but what signs and symptoms do you have? Is your cholesterol raised? If they refuse further thyroid testing, consider getting a private test including thyroid autoantibodies, the links are on the Thyroid UK website.


Thanks very much for such a detailed reply. Yes, I do have those symptoms and more...months of palpitations/racing heart, freezing cold or burning feet and legs, numbness on and off in feet/hands, random twitches, feeling eyes are difficult to focus, tired (walking up small slopes - usually I hike in the mountains with no problems), feeling of unbalance at times, foggy/lack of concentration, a couple of near fainting episodes.) Today I have numbness half the day in the top half of one foot and the past couple of days a pins and needles sensation in my chin! I've been sleeping in ski socks, tracksuit bottoms and a goodie all summer. Very fetching!

Thank you for the BMJ article link and the heads up on the men's range. Last month my fainting episodes were on the day I got my period, no coincidence I am sure. Plus, I am a 6ft tall woman so hardly a tiny female - a male range would probably fit my stature better.

Is there any benefit in getting them to do other iron tests (serum iron, TIBC etc) before supplementing or am I better picking my battles more carefully and trying to get him to test my other thyroid levels? (He has refused before since TSH is in range. (Otherwise I will have to go and pay for them I guess).

Also, should I be asking for my FBC to be done again since it is now 2 months since that was done and the figures we are working off could have changed? Or are the changes so slow moving that it wouldn't show much different?

I don't know if this is a silly question but I haven't been able to find the answer. ..would thyroid cause low iron or vice versa? Which is the chicken, which is the egg or does it not work that way?

I've never had my cholesterol tested, how would that be associated with ferritin/thyroid?

Sorry for so many questions, I want to arm myself as best as I can as I am fed up of being fobbed off. It's taken months just to get this far with the Drs!

Thank you very much, I really appreciate it.


Have you had b12 tested also?


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