Low iron in pregnancy; Spatone recommended - what was tested?

[Bearo]

My daughter (euthyroid, six months pregnant, vegetarian) has just been for a check up with the midwife and has been told “your iron is low. It’s 109 and we worry if it goes below 105 so you’d better get some Spatone”. I don’t know much about iron but from this site I have learned that a full iron panel consists of four elements. It looks like my daughter has had one element tested. Is that sufficient?

Is Spatone the NHS go to remedy? Would it be recommended here on the basis of one test reading of 109?

[humanbean]

The guidelines for iron/ferritin/haemoglobin levels are quite different in pregnant women than they are for non-pregnant women. The expectations appear to be that all these things will be, and should be, lower in healthy pregnant women than in those who are not pregnant.

Spatone has 5mg iron in it per sachet. Personally I think it is expensive.

tesco.com/groceries/en-GB/s...

There are other supplements with low levels of iron in that you might want to investigate - they might be cheaper than Spatone :

For example :

Floradix - 7.5mg iron per 10ml dose (Note the Floradix website refers to a 20ml dose so pregnant women should take half of this.)

Holland & Barrett own brand liquid iron - 7mg iron per dose

Always check the iron content of a full dose of any product on the packaging to make sure the dose isn't too high.

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I think the references to 105 and 109 are referring to haemoglobin level rather than serum iron or ferritin.

Haemoglobin is measured as part of a Full Blood Count, not as part of an iron panel.

The parts of a standard iron panel are (usually) :

Ferritin

Serum Iron

Total Iron Binding Capacity (TIBC) or Transferrin

Transferrin Saturation Percentage

C-Reactive Protein (CRP) This is useful when interpreting iron and ferritin because inflammation level (which CRP measures) can raise ferritin and lower serum iron, making ferritin look good if iron isn't measured too.

But, to be honest, I'm not sure that an iron panel will be worth doing if the medical profession always goes by haemoglobin level to check iron levels.

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I looked up iron in pregnancy and found a couple of reputable links :

gpnotebook.com/simplepage.c...

gpnotebook.com/simplepage.c...

There are also guidelines from NICE on the subject of iron deficiency anaemia and it mentions pregnant women a lot - it doesn't have a separate section for them, the info for pregnant women is scattered throughout the text and you should look for the words "pregnant" and "pregnancy".

cks.nice.org.uk/topics/anae...

It is a big topic, but if you look up each page in the guideline and look for the words "pregnant" and "pregnancy" it should be helpful.

Good luck.

Edited to add :

It isn't only low iron/ferritin that can cause anaemia (low haemoglobin).

Low vitamin B12 and low folate can cause anaemia too.

cks.nice.org.uk/topics/anae...

I've never read the above link, so can't comment on its contents.