Low Ferritin and GP referral - but to what type of consultant?

[Tima69]

Hi

 I've have had  low ferritin levels  for the past three months (17).  After six weeks or so on Ferris fumarate  my levels have risen to what the GP claims to be "normal"  but  the test results are now obviously skewed by the medication. 

 I told her I wanted a referral since I did not want to be taking iron tablets for the rest of my life and obviously wanted to know why there was a deficiency in the first place  ( I have no obvious signs of bleeding and I went through the menopause several years ago).

 The GP seemed totally lost as to which speciality to refer me to and in the end she  said she would refer me to a "general doctor" at the hospital .  Who it is likely to be? Surely I should be seeing someone like a haematologist or endocrinologist ? 

[bluebug]

Actually a gastroenterologist to confirm you don't have stomach issues after talking to a haemotolgist.

The GP also doesn't need to refer you to the haemotolgist she needs to phone up and talk to them to find out common causes of ferritin problems.  Then refer you to the correct other specialist if needed.  In the case of men and women who have reached the menopause they should check for gut problems first. 

Also you may actually have had borderline levels for years even though you have long hit the menopause. It's only recently that lots of GPs have realised that they need to check this with haemoglobin levels. 

3 months isn't sufficient to rise your levels to an adequate amount and you shouldn't be on the dose for iron deficiency anaemia as you risk iron over load. You need to take a lower dose for a longer period e.g. one tablet for 6-12 months.  Also your blood test results aren't skewed by the medication though they can be raised  if you are ill for any reason. 

Finally get a print out of the number and range. - ask the receptionist. Ideally  you want to have a level near mid-range and 3 months worth of tablets won't do this.

[Tima69 in reply to bluebug]

Hi bluebug 

Thanks for your detailed reply. My GP seems lost and keeps asking if I have any blood in my stools (i haven't). She initially put me on 3 tablets per day of ferrous fumurate but that's now been reduced to one per day. I am calling them later to find out what the latest Ferritin level is. 

I have suffered breathlessness for three years now (and hair loss for two), and I assumed that if there was any sort of internal bleeding it would have manifested itself as something more serious by now....

GP initially was going to refer me to gastroenterologist but now seems to be unclear who to go to, hence the title of my post.

[Angel_of_the_North in reply to Tima69]

When my ferritin was really low I got a referral to gastroenterology, but they didn't find anything, so no idea why my ferritin is low all the time. I wondered about an iron-eating parasite (like some of the Lyme ones) but NHS doesn't recognize that possibility, so I'm stuck with low ferritin.

[determined56]

Hi bluebug has put it all in perspective very well.

I have had low ferritin for some months so now referred to a gastroenterologist and put on one ferrous sulphate tablet a day.

I have other tablets that clash with iron tablets so take one lot of tablets am and take my iron tablet at night.

I need to be checked in my gut & intestines for any signs of blood leakage.If it was severe I  would soon be aware of changes ie; blood in stools / vomitting blood .

I have had nausea and some vomiting prior to ferrous sulphate so also have anti sickness tablets.

Good luck to you 

Hugs to all

[Tima69 in reply to determined56]

Thanks for your reply, I'm now on one tablet a day (with high strength vitamin C) and not feeling too bad. I wonder if it might be an absorption problem?

[adrienne1972]

My ferritin had been really low for years. I thought I couldn't absorb it. I have now been taking 4 'nutri hair' tablets for a year and my reading last week was 82. I felt like I had won the lottery. My hair is longer than ever and all my natural hormone supplements seem to be kicking in to. I would say keep at it before you go down a frustrating route of trying to get a referral. To absorb more iron stop eating grain and take apple cider vinegar. A dr is not going to give you any revolution. 

[Tima69 in reply to adrienne1972]

Not expecting a revolution, but I'm told low Ferritin can be caused by blood loss and should be properly investigated to eliminate anything more serious surely?.....

[win_4ever in reply to Tima69]

Interested to read that you apparently have bleeding somewhere? My husband was diagnosed aneamic and had to have a colonoscopy to see if he had cancer of the bowels but it turned out to be diverticulosis. So that might be a thought for you to peruse. Hope it helps. Also hope you get your answer soon.

[Tima69 in reply to win_4ever]

No, i don't have any bleeding (that I know of), just one possible cause  that's all.

[NorfolkRose in reply to Tima69]

Can malabsorbion  also cause low iron?

[bluebug in reply to NorfolkRose]

Yep. Bit why are you not absorbing the iron? Most people taking supplements are fine. If your levels don't rise while taking supplements then you have an issue. 

[bluebug in reply to adrienne1972]

There is no need to do that. Determined56 gave good advice on taking iron. In short take it on its own with only vitamin C. The vitamin C can be in the form of orange juice or an easy absorbed vitamin C supplement.

Also I was advised to stop drinking tea and coffee completely  while taking iron supplements. That way I minimised the risk of having interference with tannins.

[adrienne1972 in reply to bluebug]

Basically just saying its a bit premature to start going down the route of not been able to absorb iron medically. 

[Tima69 in reply to bluebug]

Thanks, I am taking the tablet with high dose vitamin C

[Tima69 in reply to adrienne1972]

Thanks, might give those a try, especially if it helps with hair loss!

[Gillybean1 in reply to adrienne1972]

Hi Adrienne1972, Can i ask what brand is 'nutri hair' tablets please. Sounds promising. G

[adrienne1972]

Oh ok. Just saying what had worked for me.  Took ferragard C for years with no effect. 

[Tima69]

Update - just spoke to GP receptionist and my Ferritin is now up to 34 (was 17) after 5 weeks of ferrous fumarate. GP says "normal" but I have read optimal value is around 80 for women?

😞

[bluebug in reply to Tima69]

Normal is over 60 to mid-range. At 60 if you just had iron problems then your hair will stop falling out.

The range GPs use is where you won't be ill. 

As already said taking 210 is too much. You risk iron overload unless your haemoglobin is very low as well.

[thyr01d in reply to Tima69]

Hi Tima, that sounds very promising to me and I don't think you have any need to worry if your ferritin has risen that much in 5 weeks. I was on prescribed ferrous fumarate for 2 years and my level didn't rise that much, so I think it's just a matter of time for you. Someone mentioned absorption, my endo thinks my problem is absorption and expected T3 to resolve that, but it hasn't done.

[judburke]

As other posters have commented it can take a while for levels to improve and then a few weeks after for the symptoms to improve.

If your levels don't go up or stay up then your doctor is correct you need to investigate why. I had low ferritin despite taking iron tablets. Eventually I was tested for Coeliac and the damage to my gut meant I couldn't absorb vitamins and minerals. I had no other noticeable symptoms. 

[Tima69 in reply to judburke]

That's very interesting, thank you for your reply