Pernicious Anaemia Society
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Continuous low ferritin levels

Was wondering if anyone had any idea why I cannot get my ferritin levels to stop falling? I have pernicious anaemia and Hashimotos thyroid. My ferritin dropped to 10 around 6 years ago and since then I have not managed to get it over 30. It just keeps dropping unless I take high dose iron everyday. I have a very healthy diet and eat raw spinach and other iron rich veggies daily. Continuously fatigued, help!

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If your iron is in the form of the sulfate then you'll probably benefit from taking it with Tesco effervescent vitamin C tablets. These contain ascorbic and citric acids, both of which help the iron atoms to go into solution - where they need to be to be absorbed.

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Thanks I always squeeze fresh lemon over my raw spinach leaves and drink a glass of fruit juice when I take iron supplements?

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it may be apocryphal but I remember reading in the past that spinach isn't really the best vegetable to be using for iron. There is something in it that can actually strip your iron and the whole pop-eye thing was actually down to a typo in the US nutritional tables in the 1920s that made it look as if it contained 100x more iron than it did.

Would suggest switching to brocolli and other vegetables and you definitely need to be taking it with vitamin c.

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Thank you, I also eat broccoli, watercress, avocados, kale and almost every other type of fruit and vegetables which all have iron in and always add fresh lemon and lime juice to my food and salad.

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I had issues with my iron as well. With PA there are very obvious absorption issues that may not stop at b12. My hematologist finally got irritated fighting with my levels. He put on 2 rounds of IV iron therapy. I felt better and my levels have stayed where they should be.

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Wow desperate measures but if it worked then that is great!!

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I don't know where you live, I understand the healthcare system is very different in the U.K. than it is in the US. But, if you have an opportunity to do the iv therapy to maintain your levels until the doctor finds the cause I'd suggest you go for it. It works much faster and there are no gastric side effects.

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If you are persistently low in iron and ferritin then you need to ask your Dr why and request to be tested for Coeliac. Low iron/ferritin is a classic but little known symptom. Take a look at the Coeliac Uk website it's very helpful. Not everyone has classic gut/abdominal issues - I didn't

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I tested ckear for coeliac despite the doc thinking it was causing deficiency and abdo issues. Now put down to IBS and heavy periods...

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Thanks, I will look into this!

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Hi, Judburke. My doctor just puts it down to heavy periods, despite telling him that I consider my periods to be normal? I saw an endocrinologist recently and he said that my ferritin levels which were 17 (bottom end of normal) at last test (8 months ago) are nothing to be concerned about. In fact, he said that because my iron levels were 11 that is the important thing. So I said the fact that my iron stores are constantly depleting is nothing to be concerned about and he said no. I left shaking my head!!

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I think your Iron value is low too! I think the UK range is 11.5 to 30. So your iron is on the floor too which is probably why Ferritin level is so bad.

If you have been taking iron and it still isn’t going up and you are feeling awful I would ask him to test you for Coeliac (or are you taking any tablets that can affect gut absorption such as PPIs for acid?). I would call Coeliac uk and ask their advise on how to get tested. There is a reason your iron is low and you need to find out what it is in my opinion. Do some reading about iron there is a lot of info on the Thyroid UK forum on here and lots of knowledgeable people to ask about test levels and optimal results. I think both iron and ferritin should be higher. I only feel ok when ferritin has been at least 70 to 90 for several weeks.

Good luck pushing for your answers :)

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I just noticed on an old posting of yours that you also have underactive thyroid. It’s probably worth asking what your thyroid blood tests results are too and posting them on the Thyroid Uk forum. If your Dr doesn’t know about optimal iron/ferritin levels it’s likely he doesn’t know much about optimal dosing for thyroid

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