Low Ferritin

[Pheebs93]

Hello everyone,Any advice please?

I have had my blood tests results back, they say the following..

Serum ferritin 6ug/L [23.0- 300.0] below low reference limit.

Serum Folate Level 4.1ug/L [3.1-20.5]

Serum B12 Level 300ng/L [187.0-883.0]

Haemoglobin A1C 39mmol [<48.0]

I feel so unwell, extremely fatigued, hair loss, aching and weak body. Anxiety and depression. Dizziness and feeling off balance, aswell as heart palpitations. Recently noticed I have a sore tongue and my skin, gums and eyes being very pale.

I have been taking ferrous fumarate 120mg since September and I am not feeling any improvement. Accessing the GP is hardwork, but I do have a phone call today coming from them.

I know my ferritin is low, I'm not sure about the other readings.

Can anyone advise?

Also any suggestions on what I need to do now, as I feel so unwell.

Many thanks

Pheebs

[Technoid]

Your serum B12 is inconclusive, not low enough to indicate deficiency but cannot be ruled out either. However your ferritin and folate are both in pretty bad shape as you know. A full iron panel might help.

This comment may interest:

healthunlocked.com/pasoc/po...

The outcome of that research was that dosages of 40-80mg of iron on alternate days worked better to raise iron levels than higher doses taken daily. Counterintuitive , but it has to do with something called Hepcidin which increases due to the large doses and ends up blocking iron absorption. Iron Bisglycinate forms are also usually better tolerated.

Further B12 tests, if you can get them, would be Active B12, MMA and Homocysteine, with MMA being the most specific, although there is no gold standard test for B12 deficiency.

[Pheebs93 in reply to Technoid]

Thank you for your reply technoid.I have a GP appointment today, unfortunately it is a telephone appointment which is disappointing as I wanted them to see me but I will mention the b12 as they didn't mention anything about that, they also didn't mention my folate either, so I assumed those were okay as they only mentioned the ferritin being low, so thank you for your advice on that!

I will check out the link.

Many thanks!

[Technoid in reply to Pheebs93]

To clarify there's nothing in your serum B12 that points to a deficiency but serum B12 is not a reliable test to rule out deficiency. Your folate is not below range but it's borderline to the bottom of the range. A ferritin as low as yours could of itself cause most of the symptoms you describe.I only mention B12 because this is the pernicious anemia forum where you can ask about issues with B12 It's not clear that you have any issues with B12 at present, at least until the ferritin can be sorted.

[Pheebs93 in reply to Technoid]

Hey technoid,Thank you for your reply.

I have been to the doctors today, he was reluctant to do any further testing and didn't believe my current symptoms (dizziness, lightheaded, fatigue, weakness, low mood) were related to my ferritin defiency.

I managed to get him to agree to do a full iron panel and a Holo Tc test. Hopefully will get the appointment in the next few days.

He said all of my results look fine other than ferritin.

[Technoid in reply to Pheebs93]

"didn't believe my current symptoms (dizziness, lightheaded, fatigue, weakness, low mood) were related to my ferritin defiency. "

Did he give a reason as to why he thought that? Your symptoms could have other causes or explanations but they are a reasonably good match for possible iron deficiency so I'm curious as how he's already ruling it out so confidently especially before the iron panel is done and given that your ferritin is very low indeed.

[Pheebs93 in reply to Technoid]

No absolutely no reason at all, well he did say because my haemoglobin is normal, he doesn't believe iron defiency alone would cause these symptoms as severely?He said we could be looking at something else entirely.

I'm still very convinced iron defiency is what's contributing to it despite what he thought, so I managed to get him to agree to do a iron panel and Holo TC, although he was reluctant.

Thank you for your guidance technoid.

[Technoid in reply to Pheebs93]

See this is what drives me crazy about doctors. They think they know a subject and wont spend 10 seconds googling it. Well I just did and I found this:

"Iron deficiency may be severe despite a normal hemoglobin and full blood count."

ncbi.nlm.nih.gov/pmc/articl...

I'm not a doctor. I'm not medically trained. So I don't understand how 10 seconds of basic research seems to show me that a doctor is making a claim that doesn't seem to check out with fairly easy to find published research.

[Pheebs93 in reply to Technoid]

Yes that's what I have read and heard by talking to others.It's so disappointing technoid when they don't take you seriously, I feel truly awful and just want proper treatment.

I called our out of hours service today, luckily the clinician I spoke to over the phone was more knowledgeable and she has requested GP to send me for an iron infusion.

I've not had one before, I'm not sure what to expect however I hope it will help!

Many thanks!

Pheebs

[Gen89]

Has your Gp considered why you are low in iron? It could be low dietary intake, heavy periods or a bowel bleeding problem. I have had very low ferritin for years despite taking iron supplements. I don’t seem to absorb it very well. I take omeprazole which can affect iron absorption as well as b12 absorption although I have reduced that to once a week and it doesn’t seemed to have helped! Taking the iron supplement with vitamin c eg orange juice is supposed to help absorption. A full iron panel might be a good idea as sometimes you can have a normal iron level but low ferritin although as you have low haemoglobin that probably isn’t very likely. My Gp recommended every other day iron supplements.

[Pheebs93 in reply to Gen89]

Thank you Gen, I had another appointment with the GP today, he has agreed to do a full iron panel and a Holo TC test. He was quite reluctant in doing so but managed to get him to agree.He hasn't really looked deeper into why this has happened.

Hopefully the bloods will give more clues.

[Gen89 in reply to Pheebs93]

I hope all goes well

[Gambit62 Administrator]

Just to be clear - whilst ferritin is generally a good indicator of iron status it doesn't tell the whole story and there have been a few instances of medics treating a suspected iron deficiency on the basis of ferritin alone without the back up of a full iron panel, leading to overdosing the patient with iron. If your GP hasn't done a full iron panel then I would ask them to do one - though I realise this is advice after your appointment.

[Pheebs93 in reply to Gambit62]

Thank you Gambit62, I had another appointment with the GP today, and I've managed to get him to agree to do a full iron panel and a Holo TC although he was reluctant in doing so.

[Nackapan]

I have been told znd read low ferritin can also mimic thyroid problems .As its an indicator of falling iron when looked as a whole .

My Gp prescribed iron .

I felt sone symptoms go when ferritin raised.

One of my daughters had doppler scans on her legs .

Hairloss.

Resolved when iron supplements raised ferritin . Hb normal.

Another daughters level dropped to 9 . She had relief in some symptoms when ferritin was raised. !

[Ghound]

Hi Pheebs, Good advice from everyone here. My ferritin level was only 6 at one point before my B12 deficiency was diagnosed and I was very ill with similar symptoms to your own.

I was prescribed ferrous fumarate, but it took several months to get my iron levels up to normal, and I didn't really recover until my B12 deficiency had been adequately treated.

In my case that involved B12 injections every other day for six months.

You definitely need further lab tests.

Best wishes and hope you feel better soon x