Me again! 
I've just had my vit levels tested via thriva and I'm a bit concerned about my iron levels plummeting!
Should I be worried about it!?
I am vegetarian, although I've been eating fish lately and I probably don't eat enough iron rich foods but I didn't anticipate it dropping this much in 12 weeks!
My periods are pretty light so I don't anticipate iron loss being related to that.
I'm just going to try and bump this. 😏
Some questions...
1) Were both tests done fasting?
2) Were they done at a similar time of day?
3) Had you been taking iron supplements in any form before the tests? If yes how long before testing did you stop?
4) Were the tests done by the same company? And were they both the same kind of test? In other words, were they both finger-prick or both from a sample taken from the vein?
5) Did your diet change over Christmas and New Year? There are only three macronutrients - Protein, Fat, and Carbohydrates. If the ratio or the amounts of each of these changed then it may have affected your iron intake or absorption - but I'm just guessing with this. Do you eat gluten? If your diet deteriorated e.g. with more sugar, gluten sneaking in, more carbs, then you might have increased inflammation in the body somewhere.
All the above factors might affect your iron results.
You might find this link of interest, just for reference :
irondisorders.org/wp-conten...
Thank you for responding.
In answer to your questions:
1) Were both tests done fasting? No. First was, second wasn't. Would that account for such a large difference?
2) Were they done at a similar time of day?
No! First at 7:30ish, second at 15:00.
3) Had you been taking iron supplements in any form before the tests? If yes how long before testing did you stop? No iron supplements. Had an iron transfusion in June and haven't taken any supplements since.
4) Were the tests done by the same company? And were they both the same kind of test? Yes. Both by thriva so both finger prick tests.
5) Did your diet change over Christmas and New Year? I did start eating gluten again in September although I never did manage strictly gluten free. I thought I had but realised about a year in that there was gluten in the frozen chips I'd been eating a couple of times a week.
1) Were both tests done fasting? No. First was, second wasn't. Would that account for such a large difference?
Actually, I would have expected the non-fasting test to have had higher results rather than lower.
2) Were they done at a similar time of day?
No! First at 7:30ish, second at 15:00.
This link : labtestsonline.org.uk/tests...
says this about test preparation for iron tests :
...
Test Preparation Needed?
Your doctor may request that you fast for 12 hours prior to some iron blood tests. In this case, only water is permitted. You should not take any iron tablets for 24 hours before the test. Iron is absorbed rapidly from food or tablets, and can make your blood iron levels falsely high.
...
I would always suggest that iron and ferritin testing should be done first thing in the morning, while fasted for 12 hours (water can be drunk freely), having given up iron supplements for several days (I stop for 5 - 7 days).
3) Had you been taking iron supplements in any form before the tests? If yes how long before testing did you stop? No iron supplements. Had an iron transfusion in June and haven't taken any supplements since.
This may be the answer to your problem. Anyone whose iron and ferritin are so bad they need an iron infusion will almost certainly need to take maintenance doses of iron supplements to maintain their levels once they have dropped to a level as close to optimal as possible. Iron infusion will often raise levels very high so it is a good idea to monitor them every 4 - 6 weeks, let them drop a bit before starting iron supplements for maintenance.
I had very low iron and ferritin and raised it with tablets. (I wish I'd had an infusion.) I don't absorb iron well and it took nearly two years to get my ferritin to mid-range. My serum iron was still low even after all that time but it had improved a little bit and was at least in range. After a while I experimented and raised my serum iron to optimal with tablets. This raised my ferritin and my transferrin saturation over the range. I stopped taking iron supplements (my experiment was over at that point) and four months later my ferritin had dropped from 170 to 80 in just four months. (My serum iron and my transferrin saturation had also dropped after the four months with no iron but not nearly so much.) This may be what is happening with you.
5) Did your diet change over Christmas and New Year? I did start eating gluten again in September although I never did manage strictly gluten free. I thought I had but realised about a year in that there was gluten in the frozen chips I'd been eating a couple of times a week.
I found my iron/ferritin absorption improved noticeably when I gave up gluten completely.
Edit : I forgot to say... I started taking a maintenance dose of iron tablets as soon I got my ferritin to mid-range (apart from when I did my experiment).
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If you have taken iron supplements and have struggled with tolerating them then be aware that there are many supplements to choose from. The higher the dose of iron in an iron supplement the fewer people tolerate it. For more info on iron supplements see this reply I wrote to another member :
healthunlocked.com/thyroidu...
Thank you so much for this.
It crossed my mind that I would need a maintenance dose of iron but I wanted to see how I went with the iron transfusion and how long it would last!
I have started taking liquid florodix but have only managed a day or two before it became clear it's not a long term solution!
I guess my worry is that there is a reason for the iron loss and should I investigate it. To have gone from top of the range to the very bottom in transferritin saturation is concerning.
I think I will retest my iron so it's fasting and first thing and go from there. I also have a coeliac test on order just to rule it out again - Dr's tested for coeliacs in August 2020 and the result was 0.6 (0.1 - 3.9) so the result was very clearly not coeliacs.
I gave up gluten after that (although not 100% because I didn't realise there is gluten in frozen chips😭) but I've been a bit bloated lately so thought I'd check again before removing gluten again. I didn't notice any worsening of my thyroid symptoms on adding it back in though.
Anyway - will re-test and get some more comparable results.
I guess my worry is that there is a reason for the iron loss and should I investigate it.
Yes, you should investigate this, but it can be very difficult if doctors don't want to help you or if they consider any result in range to be perfectly okay. Also remember that if the conditions that made someone low in iron to begin with are not changed then supplementing may raise iron temporarily, but it will almost certainly continue to be lost once supplementation is stopped. If the bottom of the range for ferritin is 13 and someone has a result of 8 doctors will often only supply iron supplements until ferritin is about 30 or for three months, whichever comes first, then they think the patient is "cured". But 2 or 3 months later the patient may have a ferritin level of 8 again.
And doctors rarely test a full iron panel. Inflammation can keep ferritin higher than is really justified by actual iron levels. But you might not know your serum iron is actually low unless you find out your iron, transferrin saturation, total iron binding capacity etc.
Some of the commoner causes of iron and blood loss and some other info that I can think of :
1) For a lot of women the cause of their iron/blood loss is very heavy and long-lasting periods. For reasons I have never understood being short of iron may make periods even longer and heavier than before. By improving iron the periods may become more tolerable and less blood and iron may be lost.
2) Coeliac disease / ulcerative colitis / SIBO - these conditions may reduce iron absorption and may increase the risk of blood loss from the bowel.
3) Stomach / duodenal / peptic ulcers - these can cause enormous amounts of blood loss and the body digests it. Being digested changes the appearance of blood in the poo. In all cases of bleeding from the gut or the bowel blood will get digested. The higher up the digestive system the blood comes from the darker it will be. So it can be anything from black coffee grounds, to black but tarry looking, to very dark maroon to dark red, or bright red blood if it comes from piles.
4) There have been suggestions that people can improve iron absorption by taking iron on alternate days. I think it is definitely worth trying although I'm not hugely convinced by the theory myself. I want more data. See this thread :
healthunlocked.com/thyroidu...
5) Some people could have genetic problems that reduce their iron levels. For example, on my mother's side of the family many of the females and even a couple of the males end up almost permanently anaemic or low in iron. I can think of seven relatives who have problems. I suspect this is a genetic issue, but I'll never know for sure.
6) Liver problems can reduce absorption of iron e.g. fatty liver.
7) Doctors assume that women past the age of menopause can't be anaemic. This is obviously complete nonsense. It might be more rare to be anaemic or low in iron past the menopause but it certainly isn't as unlikely as doctors suggest.
8) Polyps in the bowel can also bleed. They don't necessarily bleed all the time, it can be intermittent.
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