Thank you for this post! So frustrated that my doctor isn’t bothered by my recent ferritin level of 21. I take supplements daily and still can’t get it much higher. Would love another post about treatment options.
Hi, thank you! Could treatment discussion including timing -- for example, if prescribed iron supplements and also already on HRT pills, is there any benefit to taking all the pills together or at different time of day?
I can't wait to read the follow up article! I've prescribed iron supplements for a number of years. Unfortunately, my favorite iron supplement is out of stock.
My doctor didn't want to test my ferritin level - based on my CBC results (normal hemoglobin and hematocrit (not low) and my MCV was normal (not low)) - and because the ferritin test "tends to have a high false positive rate" and she didn't want to muddy the waters with that. If you could include any information about false positive ferritin in your follow up, I would appreciate it. Thanks for ALL that you do!!!
Sought out & found a menopause specialist and asked for this testing after reading you. Started estradiol too. Wish it all was part of routine well woman care! If I’d known 15 years ago, might have prevented the osteoporosis.
Great post. Similarly, I had really persistent thrush in peri. After around 2 years of different treatments, none sorting it for more than a month or so, I was signposted to what used to be called the STD clinic. The doctor there tested my ferritin levels which were way down - she treated the iron deficiency & the thrush cleared up with a straightforward anti fungal & didn't come back. She told me she sees a surprising number of women who've been through all the standard thrush treatments where low iron is the missing link leading to persistent reinfection.
This is fascinating! I had a scope for a throat issue and they found thrush. I also had low iron at the time. I have never seen the two connected. Thank you. Mind blown.
This is critical information! I was one of those who didn’t know I was affected until I started treatment. My level was 6 and my doctor wasn’t worried, even though the lower threshold for my particular lab was 15… I didn’t know I bled heavily until I read about it, but that probably contributed.
I started on an expensive, heavy-dose iron (150mg) every second day, which went right through me and dropped my iron lower. A pharmacist suggested old-school, generic ferrous gluconate (30 mg) a couple times every second day and I’m up to a 25 after a few months. Just being consistent with it did the trick. My hair is coming back in and I don’t have the fatigue and feeling low or anxious all the time, which I thought I was going to just have to live with.
I wish more women knew how big a difference this can make.
I lost 6 pints of blood 2.5 years ago (long story) at age 51. I have a ton of inflammation markers and my ferritin is 14. I swim with a team and always feel flattened after workouts. This article is very helpful as I have my annual checkup tomorrow. Thank you!
This is an incredibly helpful article! I’d also like to see an article about treatment options.
My ferritin has always been on the low end of normal, hovering around 30 - even now, as I hit menopause. I also have chronic inflammation with rheumatoid arthritis. However, all iron supplements result in serious constipation, unfortunately
I'm guessing you've already tried Floradix liquid iron supplement? If not, that's one that seems to work pretty well for people who normally get constipation from iron. It's expensive, doesn't taste great, and needs to be refrigerated, though, so it's not always the most practical. I also know people who cook with an "iron fish" when they make sauces, stews, soups, etc.
Of course, Dr. G may have strong opinions on these ideas!
I tried it many years ago. It probably was the one product that I didn’t find constipating. I believe I stopped because it was expensive for the amount of iron it contained, and I read later that regular use could stain your teeth
Bulking supplements (fiber) just results in gas and bloat while still constipated when iron supplements used. Constipation is a huge deterrent to iron supplements for me.
My doctor finally paid attention when I told her about my intense ice cravings. Where I NEEDED to chew ice. I craved it. After a blood test, it came out that I had a severe iron deficiency.
Interesting! Glad her OB knew to test her. That's a lot of ice!
My husband was worried about my teeth, and that's the only reason I mentioned to my doctor! I can't remember how long it took my cravings to stop, but it was fast. It was such an odd, intense desire to chew ice and then it just disappeared.
Perfect timing for my annual physical. My hair is thinning so bad- meno? Ferritin? Id love to boost it & see what happens. My last chk up my ferritin was ~20, so doc said all normal- despite me saying im so tired. Goodness… so many supp over 50- vit d, k2, mg….🙄 😆
I’ve been battling low ferritin (8) and now low hemoglobin for several years because of my periods and supplements have been too difficult to take regularly. I finally had my first infusion after paying privately for a nurse practitioner. I’ve had every one of those symptoms for 3 years and have felt like a zombie.
I have one question: Could functional iron deficiency also develop in persons who didn't have bariatric surgery or don't suffer from chronic disease? If so, when would you recommend checking TSAT levels?
This article reminds me I need to request a ferritin test. January 2024 my gallbladder divorced me. My ferritin level post op was over 500. Four months later it was 459. My PCP said to discontinue any iron supplementation until it lowered. It's been a year so time to check and see where I'm at.
My 13 yo daughter is taking a supplement to bring her # up. I've learned that iron needs to be at a healthy level for ADHD meds to work optimally.
Do you by chance have a reference about iron and ADHD meds? I’ve been wondering about the relationship here and would love to read more on the subject, I’m a few months into iron supplementation, take ADHD meds, and have started estrogen gel, and . . . I don’t have one doctor who has expertise in all of these areas and I’m really feeling like I need a better handle on how these things all interact so I can ask better questions!
With hair loss, fatigue, and being turned away from blood donation due to my hemaglobin being just below the cutoff I did go get my ferritin checked, 34 μg/L. I don't have chronic inflammation or other health issues. I have two questions, if >100 μg/L ferritin is normal, it feels like 30-40 (or more) isn't exactly normal, how is that line drawn? And two, if iron is lost through bleeding and sweating, is it also lost through the production of other body fluids such as vaginal secretions from arousal or orgasm?
And thanks for this post. Such important information!
Thank you for this post! So frustrated that my doctor isn’t bothered by my recent ferritin level of 21. I take supplements daily and still can’t get it much higher. Would love another post about treatment options.
I am working on one!
Hi, thank you! Could treatment discussion including timing -- for example, if prescribed iron supplements and also already on HRT pills, is there any benefit to taking all the pills together or at different time of day?
I can't wait to read the follow up article! I've prescribed iron supplements for a number of years. Unfortunately, my favorite iron supplement is out of stock.
My doctor didn't want to test my ferritin level - based on my CBC results (normal hemoglobin and hematocrit (not low) and my MCV was normal (not low)) - and because the ferritin test "tends to have a high false positive rate" and she didn't want to muddy the waters with that. If you could include any information about false positive ferritin in your follow up, I would appreciate it. Thanks for ALL that you do!!!
I believe taking it with vitamin C at same time can increase
absorption
I do that for sure! Though not because my doctor told me to (frustrating).
Agreed. I don't think my doc is going to treat but I think I need to do so on my own.
Ferritin 56
Transferritin SAT 12
Late 50s & post menopausal.
Sought out & found a menopause specialist and asked for this testing after reading you. Started estradiol too. Wish it all was part of routine well woman care! If I’d known 15 years ago, might have prevented the osteoporosis.
Thank you for caring, even from afar.
Great post. Similarly, I had really persistent thrush in peri. After around 2 years of different treatments, none sorting it for more than a month or so, I was signposted to what used to be called the STD clinic. The doctor there tested my ferritin levels which were way down - she treated the iron deficiency & the thrush cleared up with a straightforward anti fungal & didn't come back. She told me she sees a surprising number of women who've been through all the standard thrush treatments where low iron is the missing link leading to persistent reinfection.
This is absolutely the case. I see this all the time.
This is fascinating! I had a scope for a throat issue and they found thrush. I also had low iron at the time. I have never seen the two connected. Thank you. Mind blown.
This is critical information! I was one of those who didn’t know I was affected until I started treatment. My level was 6 and my doctor wasn’t worried, even though the lower threshold for my particular lab was 15… I didn’t know I bled heavily until I read about it, but that probably contributed.
I started on an expensive, heavy-dose iron (150mg) every second day, which went right through me and dropped my iron lower. A pharmacist suggested old-school, generic ferrous gluconate (30 mg) a couple times every second day and I’m up to a 25 after a few months. Just being consistent with it did the trick. My hair is coming back in and I don’t have the fatigue and feeling low or anxious all the time, which I thought I was going to just have to live with.
I wish more women knew how big a difference this can make.
I lost 6 pints of blood 2.5 years ago (long story) at age 51. I have a ton of inflammation markers and my ferritin is 14. I swim with a team and always feel flattened after workouts. This article is very helpful as I have my annual checkup tomorrow. Thank you!
This is an incredibly helpful article! I’d also like to see an article about treatment options.
My ferritin has always been on the low end of normal, hovering around 30 - even now, as I hit menopause. I also have chronic inflammation with rheumatoid arthritis. However, all iron supplements result in serious constipation, unfortunately
A TSAT might be helpful.
I'm guessing you've already tried Floradix liquid iron supplement? If not, that's one that seems to work pretty well for people who normally get constipation from iron. It's expensive, doesn't taste great, and needs to be refrigerated, though, so it's not always the most practical. I also know people who cook with an "iron fish" when they make sauces, stews, soups, etc.
Of course, Dr. G may have strong opinions on these ideas!
I tried it many years ago. It probably was the one product that I didn’t find constipating. I believe I stopped because it was expensive for the amount of iron it contained, and I read later that regular use could stain your teeth
Talk to your doctor about the possibility of using Miralax (& generic) for constipation.
Typically people need a stimulant laxative, like senna
Bulking supplements (fiber) just results in gas and bloat while still constipated when iron supplements used. Constipation is a huge deterrent to iron supplements for me.
My doctor finally paid attention when I told her about my intense ice cravings. Where I NEEDED to chew ice. I craved it. After a blood test, it came out that I had a severe iron deficiency.
Yes, that is one of the more unusual symptoms!
That was the thing that got my mom's OB to test her during pregnancy with me. She would go through a pitcher of ice at her job, every day.
Interesting! Glad her OB knew to test her. That's a lot of ice!
My husband was worried about my teeth, and that's the only reason I mentioned to my doctor! I can't remember how long it took my cravings to stop, but it was fast. It was such an odd, intense desire to chew ice and then it just disappeared.
Thank you for this post! I’d also like to hear about treatment.
Perfect timing for my annual physical. My hair is thinning so bad- meno? Ferritin? Id love to boost it & see what happens. My last chk up my ferritin was ~20, so doc said all normal- despite me saying im so tired. Goodness… so many supp over 50- vit d, k2, mg….🙄 😆
Very helpful thank you!
I’m curious to know how many of these symptoms are also symptoms of too much iron rather than too little.
I’ve been battling low ferritin (8) and now low hemoglobin for several years because of my periods and supplements have been too difficult to take regularly. I finally had my first infusion after paying privately for a nurse practitioner. I’ve had every one of those symptoms for 3 years and have felt like a zombie.
Wondering if something like Hashimoto's counts as chronic inflammation?
Thank you for this post. I **love** the graphic.
I have one question: Could functional iron deficiency also develop in persons who didn't have bariatric surgery or don't suffer from chronic disease? If so, when would you recommend checking TSAT levels?
I think it’s worth checking a TSAT if someone has symptoms and their iron is < 75, just to make sure
This article reminds me I need to request a ferritin test. January 2024 my gallbladder divorced me. My ferritin level post op was over 500. Four months later it was 459. My PCP said to discontinue any iron supplementation until it lowered. It's been a year so time to check and see where I'm at.
My 13 yo daughter is taking a supplement to bring her # up. I've learned that iron needs to be at a healthy level for ADHD meds to work optimally.
Do you by chance have a reference about iron and ADHD meds? I’ve been wondering about the relationship here and would love to read more on the subject, I’m a few months into iron supplementation, take ADHD meds, and have started estrogen gel, and . . . I don’t have one doctor who has expertise in all of these areas and I’m really feeling like I need a better handle on how these things all interact so I can ask better questions!
With hair loss, fatigue, and being turned away from blood donation due to my hemaglobin being just below the cutoff I did go get my ferritin checked, 34 μg/L. I don't have chronic inflammation or other health issues. I have two questions, if >100 μg/L ferritin is normal, it feels like 30-40 (or more) isn't exactly normal, how is that line drawn? And two, if iron is lost through bleeding and sweating, is it also lost through the production of other body fluids such as vaginal secretions from arousal or orgasm?
And thanks for this post. Such important information!