low iron

[Maryah85]

hi has anyone had low iron like this?? I’m not getting much from the doctor. They’ve not responded to my results. And this forum is usually very helpful

[Musicl]

I have just received my blood test results today, and my ferritin level is 26 ng/ml. The range is 10 - 322, but my GP says it is within the range, so it is OK, but I personally think it is too low, and I told her that I would have liked it to be somewhere in the middle of the range or higher, but she disagreed.

[Tina_Maria]

Your iron is far too low and you should go back to your doctor and have a full iron panel done.

Although your ferritin is just within range (although still low if you look at the scale), this could be due to an inflammation, as this can elevate your ferritin.

Are you out of breath easily and have headaches? Are you tired all the time and easily exhausted after walking just a few steps? These are all clear symptoms of low iron. If your normal GP is not responsive, it might be worth seeing another doctor, who will be willing to investigate further. This needs to be addressed and you will need supplementation to correct this.

[humanbean in reply to Tina_Maria]

The results given in the introductory post are from an iron panel.

[Tina_Maria in reply to humanbean]

Ah sorry, must have been a bit slow this morning. Still, would have been good to see a CRP, but the ferritin is low either way. Thanks.

[Maryah85 in reply to Tina_Maria]

my crp was high

[Tina_Maria in reply to Maryah85]

Well if your CRP was high yet your ferritin still at the bottom of the range, this clearly indicates a severe anaemia. As humanbean has suggested, you should try to get an iron infusion or if that's not possible, try to supplement yourself, she has given you some good options and advice.

[humanbean]

Your results :

Iron --- 4.2 (14 - 30) Under range

Ferritin --- 31 (13 - 150) 13% through the range

TIBC --- 59 (45 - 80) 40% through the range

Transferrin Saturation --- 7% (20 - 45%) Under range

Latest result for ferritin :

Ferritin --- 26 ng/ml (10 - 322) 5% through the range so worse than the one above.

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Sources for optimal levels :

rt3-adrenals.org/Iron_test_...

thyroidpharmacist.com/artic...

Optimal results to aim for :

Serum iron - yours is under range

• 55 to 70% of the range i.e. 22.8 - 25.2 with the range you've quoted

• higher end for men

To raise your serum iron you need iron supplements.

TIBC (total iron binding capacity) or Transferrin

• Low in range indicates lack of capacity for additional iron

• High in range indicates body's need for supplemental iron

Based on the info about TIBC I always assume optimal is mid-range i.e. 62.5 with the range you've quoted.

Theoretically, TIBC (Total Iron Binding Capacity) should be high when iron and/or ferritin are low, but having low TIBC can happen even with rock bottom iron. My own TIBC was below range when my iron was very low.

Saturation - yours is under range

• optimal is 35 to 45%

• higher end for men

To raise your saturation you need more iron

Ferritin - source is the thyroidpharmacist link given above

Normal ferritin levels for women are between 20 and 200 ng/mL. According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.

To raise your ferritin you need iron supplements.

Please note 1 ng/mL = 1 microgram/L

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Ferritin is a measure of your iron stores. Serum iron is a measure of the free iron in your blood stream.

I'm not impressed with your doctor ignoring the poor levels of iron, TIBC, and saturation just because your ferritin is within range, but doctors often only pay attention to ferritin.

You haven't given a result for haemoglobin (which is part of a Full Blood Count). If haemoglobin is below range doctors should diagnose anaemia and treat it. But, anaemia can occur with low iron and/or low ferritin and/or low folate and/or low vitamin B12. In my own test results the ranges for haemoglobin have dropped in recent years. So, the cut off for bottom of range used to be 120. Now it is usually 115 for women. It saves money by delaying treatment for anaemia. And doctors often think that a very close result e.g. 113 or 114 is "close enough"" and still don't treat.

Patients can be deficient in any of the above (iron, ferritin, B12, folate) for a long time before haemoglobin drops below range. This can also be used by doctors as a reason for not treating deficiencies. But if deficiencies are treated properly it can prevent anaemia from occurring at all. Doctors are so determined to avoid spending money in the UK that making patients suffer is just part of the job.

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

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

Note : CKS = Clinical Knowledge Summary

There are other causes of anaemia than low nutrients, but low nutrients are very common in thyroid disease. Search for guidance from NICE on other types of anaemia with this link :

nice.org.uk/search?q=anaemia

With your results you would definitely benefit from an iron infusion. Since your doctor has refused to treat you because your ferritin is in range I doubt you would get a referral to a haematologist who would decide whether to give you an iron infusion. If you had the money you could pay to get an iron infusion privately. There are several iron clinics dotted around the UK. I don't know where you live but this is one website for an iron clinic in London. Prices may be a bit lower further away from London.

theironclinic.com/

If getting an iron infusion is not possible then the only option is supplements. I'll discuss these in another reply.

[Tina_Maria in reply to humanbean]

It is actually astonishing that with an important mineral such as iron, they do nothing even when it is below the reference range, yet if your TSH is slightly below the reference range, they nearly throw a fit!🤦‍♀️

[humanbean]

The supplements prescribed by doctors in the UK (known as iron salts) can be bought without prescription from pharmacies. They aren't very expensive.

Ferrous sulfate 200mg

For dosing see this link :

bnf.nice.org.uk/drugs/ferro...

Ferrous fumarate 210mg

For dosing see this link :

bnf.nice.org.uk/drugs/ferro...

Ferrous gluconate 300mg

For dosing see this link :

bnf.nice.org.uk/drugs/ferro...

I would strongly advise against ferrous sulfate - it is popular with doctors since it is the cheapest iron supplement they prescribe, but it is very poorly tolerated. I felt as if I had swallowed a strong acid when I took it (briefly).

I took ferrous fumarate 210mg for several years, and I could only tolerate it with food. It did work for me, but only very slowly.

I've never tried ferrous gluconate.

If I needed to supplement now I would try the Three Arrows supplement described next.

.

Very popular on this forum because it works well for many people and causes few, if any, side effects - Three Arrows - read these links :

healthunlocked.com/thyroidu...

threearrowsnutra.com/en-uk/...

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Iron supplements of any kind should be used cautiously and while supplementing testing an iron panel should be done fairly frequently. I would suggest doing a couple of iron panels four - six weeks apart early in the treating phase so that you get an idea how well you are absorbing the iron. It helps with adjusting your dose and deciding on your testing frequency.

Avoid ending up with iron results which are high. High iron is difficult for the body to get rid of and it can take a long time. Some people end up needing to have therapeutic phlebotomy to get rid of high iron because it is dangerous in excess, and can get deposited in places you don't want to have it.

[Maryah85 in reply to humanbean]

Thankyou so much for your response