Ferritin too low? Iron supplements? Anemia

[NoMeaning25]

Mod. note(mmt) 2020, March 30-  merged Iron Supplement Recommendation, anemia to Ferritin too low topic

Ferritin is a universal intracellular protein that stores iron and releases it in a controlled fashion. The protein is produced by almost all living organisms, including archaea, bacteria, algae, higher plants, and animals. In humans, it acts as a buffer against iron deficiency and iron overload. Wikipedia 

 

 

Sorry i posted this somewhere else and just copying and pasting for some advise. My doctor said its normal but im beginning to doubt anything she is saying (Always misdiagnosing me)

 

 i have severe fatigue, always feel run-down, losing hair, nails brittle etc etc The results:

IRON 26.2 (Ref 10-30)
TRANSFERRIN 2.9 (Ref 2-3.6)
TRANSFERRIN SATURATION 36% (Ref 15-50)

This is concerning me:

FERRITIN 23 (Ref 11-306.80)

I know the reference rage for the ferritin is 11-306.8 but 23 is really low and i read online its very low for anyone and it means i might have anemia.

Edited March 30, 2020 by manymoretodays
merged topics, added brief definition of relationship of ferrtin to iron(Wikipedia)

[rapunzel2]

you may not have anemia (if hemoglobin is ok), but iron plays a big role in energy processes. james greenblatt suggests in his book http://www.amazon.com/Breakthrough-Depression-Solution-Personalized-Physical-ebook/dp/B009M9ODQW/ref=sr_1_1?ie=UTF8&qid=1390212163&sr=8-1&keywords=depression+solution to get ferritin levels at least to 100. 

 

iron deficiency is one of the most prevalent deficiencies in the world.

 

getting your ferritin levels up may be a long process, usually it's quite hard to get them to increase. 

[compsports]

I may need to take an iron supplement due to concerns about anemia.   Any recommendations from people on this site who have used them?  Tried doing a search to no avail.

 

Thanks!

 

CS

[compsports]

No one has used iron supplements?   

 

 

[Psycritic]

I use an iron supplement from Innate Response but it really upsets my stomach, most probably due to gastritis.

[UnfoldingSky]

I know this isn't much help, but, I had borderline low iron, and they gave me some kind of pill, which I was worried about taking as it had many ingredients I was not sure about.  Instead I used a liquid iron supplement, I'm forgetting the name of it just now, I probably could dig it up though with some effort.  It was in a white, orange and blue box..that much I recall.  However it didn't contain that much iron.  But with the possibility of withdrawal-related supplement sensitivity I didn't want to start at a high dose anyway. Even with it just being a small amount it seemed a bit hard on my stomach.

 

I will likely be getting my levels tested again soon though so if I have to take something again I'll let you know if it works out. For now I am trying to keep it up with iron-rich foods, spinach, beets, etc...Though I realize if you have a problem that is more serious than mine that this sort of thing likely won't cut it.

[compsports]

Just to clarify, I am having a procedure under general anesthesia a week from Monday and due to concern about anemia, will talk to my doctor about taking an iron supplement tomorrow.   I was told to stop the multivitamin with iron due to the vitamin E which is supposed to be a blood thinner even at a low dose.   As a result, I am trying to eat more foods with iron but I suspect I will still need an iron supplement.

 

Psycritic, I am sorry that happened to you.   That is exactly what I fear and is the reason I would prefer to continue the multivitamin with the iron as I don't like taking any supplement in isolation.   

 

Unfolding Sky, thanks I will see what I can find.   Again, I hope the doc is reasonable and lets me stay on the multivitamin with the iron.   But I have to be prepared in case he says no.

[sunnygirl12]

I've been using Floradix liquid iron and vitamin formula. I'm a little concerned though that it might darken my teeth, I read some reviews of that happening on this product.

My gynecologist happened to test my ferritin on my last visit and it was only 23. I still need to set up an appointment with my G.P. Probably from absorbtion issues from Remeron.

[compsports]

Thanks Sunnygirl, it looks like a great product.  Unfortunately, it has herbs which are banned 7 days preoperatively.   Sorry, I should have mentioned that.

 

Hopefully, I will get this issue settled this morning.

 

Amazing how psych meds cause so many difficulties.  I hope you get your absorption issues resolved.

[UnfoldingSky]

comp, I hope your procedure goes well!  I'd heard that about vit. E too though didn't think they'd be sticky about something like a multivitamin.   

[AmyK]

I take iron supplement since november, when I discovered I had only 6 in ferritin.

I live in Sweden but it's called Duroferon.(Fe2+)

100 mg tablett. I take200 mg each day. No side effects.

It's only iron.

[Psycritic]

Compsports, my gastritis was much worsened when I took NSAID at very high dose. Could be that it gave me a small ulcer.

[compsports]

US, thanks for your well wishes.   Called doctor who said it was ok to take multivitamin with iron.   Hopefully, between eating the liver and taking this, things will be ok.

 

When I had a septoplasty in 2015, I was told taking the multi was fine as they were concerned with extreme amounts of vitamin E.  It is frustrating when there is no consistent policy but such is life in the health care world.

 

Amy K, thanks for the name of the iron supplement.   Since I can take the multi with the iron, I will go with that for now.   But will keep it on hand in case I need it in the future.

 

Psycritic, that could very well be about the gastritis.

 

Sorry folks for my panicky initial posts.   When I was told initially the multi was banned 7 days before surgery, I should have called my doctor right away asking to take it.   If god forbid there is a next time, I will know better.

[Blondiee1915]

@NoMeaning25, did you bring your ferritin levels up?  I have the same issue and was wondering how you are now.  From my research it appears low ferritin but optimal iron can be caused by MTFHR gene mutations.  Finding the correct B12 vitamin and avoiding folic acid can help.  

[Rachellynn]

So......anyone here ever had to take an Iron pill during their cycle? My iron is low...just want to revisit and see what the experiences have been❤️

[NoMeaning25]

Sorry no. I cant tolerate any supplementation and im sensitive to many food groups.

[Eastcoastgirl]

Mine dropped from 60 to 30 lately in a very short period of time. Although it's not considered "too low" my doctor thinks it's probably too low for me. I've been beyond tired so i'm getting a few iron injections this week. My naturopath says if your iron is in the higher range (100s-300s i'm assuming) it can actually be a bad thing and cause inflammation in the body.

[Blondiee1915]

30 for ferritin? What’s the range?

 

I was in the same boat.  My total iron, percentage saturation were high but ferritin was low.  My naturopath told me no iron as it is dangerous.  However,  my functional MD told me I was anemic and take iron 2 and 3 times a day.  He said for anemia they look at ferritin.  

 

I also found out you need B12 to help with iron absorbption and I was deficient in B12.  B12 I believe ties to methylation.  I was told to try a methylated B12 then I tried adeno B12 instead twice a day for a few months.  I continued taking iron even though I was worried about becoming iron toxic.  

 

I went for blood work and my total iron and percentage saturation dropped while ferritin went up a bit.  I was shocked bc I was taking iron.  But the fact that my ferritin went up a bit high 30s makes me feel like I am on the right track.  

 

I take iron extended release by Douglas lab twice a day with vitamin C to help absorption.  I also take adenocombalamin by seeking health in lozagen form twice a day and I take a complete methylated B complex as well.

 

I do think it helps my energy and I don’t feel as “dead” as I felt before.  I am also on natural desiccated thyroid which helps fatigue as well and adrenal cortex complex (I have low cortisol) 

[bheb]

32 minutes ago, Blondiee1915 said:

 My naturopath told me no iron as it is dangerous.  However,  my functional MD told me I was anemic and take iron 2 and 3 times a day.  He said for anemia they look at ferritin.  

 

Oh, interesting. Did either of those practitioners suggest "active" iron -- that's what some hormone specialist nurse practitioner gave me. Don't really know about the difference.

 

I had a ferritin of about 11. I started supplementing around the time the drug issues cropped up. I sometimes take my iron pills, but not consistently...unfortunately I lean on anemia as a crutch to help me sleep through akathisia

[Blondiee1915]

I don’t remember him mentioning active iron.  He just recommended Douglas laboratories extended release formula.  He did say that it will take time for me to increase iron - few months, a very slow process.  

 

What is your doctor recommending for this? Be careful not to make matters worse.  11 is pretty low. You must be exhausted 

[bheb]

I see. Yes I get quite drowsy. If I notice it getting too extreme (body starts buzzing--separate from akathisia) then I take iron. My doctor recommended 150mg. I did that everyday early on and was able to get my ferritin up to around 20 I think. Haven't been back to that doctor in a while. I've got my original regular Ferrex 150mg and then I've got some "active" iron that is about 20mg. 

[hennie86]

I have low ferritin levels  and have symptoms that is possible are caused by iron deficiency (such as brain fog, RLS,fatigue). I havent had those symptoms before withdrawal issues though but I have been in wd from several meds for years.

 

I have a bit concerns about iron supplement and supplements overall during wd because I have had severe sensitivities to supplements. On the other hand I have got benefit from some supplements that I tolerate but there have been supplements I have reacted badly. I have been thinking that during wd less is more and havent been wanting to take risks for a long time with new supplements and just take my nutrients from food. I think I will take the risk with iron.because I really hope it wouls help with my symptoms

 

I have started using iron. I start from low dose of liquid iron supplement and test it. Hopefully there will be no problems.

[Enid]

Hennie86, I am currently using transdermal iron. I don’t notice any side effects. However, I’m almost out and it is very expensive to get it compounded for me. 

For over the counter iron supplements, my naturopath recommended Bob’s Iron. It has several vitamin B’s in it to help with the iron absorption. I’m not sure if I should take vitamin B at the moment, since it can be stimulating and I already have high anxiety. I will see if I can find liquid iron, like you mention, at my pharmacy (I’m in Canada). 

My ferretin has been around 5 for the last year and a half. I have been feeling exhausted and have brain fog and feel terribly overwhelmed. Effexor has been very upsetting to my gut. I have recently been diagnosed with SIBO and it hinders my iron absorption.

[wanttosurvive]

I have recently started taking iron supplement. I was afraid of both side effects of iron and sensitivity in regard to WD. Fortunately, it has not caused any sensitivity.

As another member said "It is just iron!" But it is acceptable anyone in WD is afraid about sensitivity to anything...

 

I am taking Solgar gentle iron 17 mg. 

This product is said to have fewer side effects when compared to other iron supplementations. I agree with that. I have not experienced constipation or stomach discomfort, nausea, etc, although I have gastritis and WD-induced severe stomach issues.

[Nsr99]

Hi everyone

 

I searched for help in this site regarding iron deficiency anemia IDA but could not find it.

 

Need some help on iron deficiency anemia (IDA)

 

I am now 4 years into WD. Doing better, but not there yet. My WD is not as severe as it used to be, much improvements. All along I have tried to avoid taking supplements, as they exacerbate my WD.

I have been complaining of fatigue, and just recently, my blood analysis shows low iron which explains my fatigue, FERRITIN (5), and it should be 30 and more. My Hemoglobin is also low HGB is 11, and it should be more than 13. so the doctor told me that this is known as iron deficiency anemia (IDA) and prescribed to me iron tables; its name is: Ferrose F (100mg Ferric Hydroxide Polymaltose Complex / 350 mcg Follic Acid), and started taking them 2 weeks ago. I increased the dose to two tables per day a week later, per another doctor's advice.

 

I started feeling not good, my mood now is not that good, as it used to be, and this has slightly affected my sleep as well. I started feeling a little bit cold, a symptom that I had at the initial stages of my WD!

 

My question is if I persist and continue taking iron supplements, will my mood be better? What if I take the iron injection instead of waiting for months for the tables to do its work will it help? if I increase FERRITIN through injection, faster than tables, will things be OK and fatigue will go away? Will the injection also agitate my WD?

 

Your advice is highly appreciated.

[Eastcoastgirl]

52 minutes ago, Nsr99 said:

Hi everyone

 

I searched for help in this site regarding iron deficiency anemia IDA but could not find it.

 

Need some help on iron deficiency anemia (IDA)

 

I am now 4 years into WD. Doing better, but not there yet. My WD is not as severe as it used to be, much improvements. All along I have tried to avoid taking supplements, as they exacerbate my WD.

I have been complaining of fatigue, and just recently, my blood analysis shows low iron which explains my fatigue, FERRITIN (5), and it should be 30 and more. My Hemoglobin is also low HGB is 11, and it should be more than 13. so the doctor told me that this is known as iron deficiency anemia (IDA) and prescribed to me iron tables; its name is: Ferrose F (100mg Ferric Hydroxide Polymaltose Complex / 350 mcg Follic Acid), and started taking them 2 weeks ago. I increased the dose to two tables per day a week later, per another doctor's advice.

 

I started feeling not good, my mood now is not that good, as it used to be, and this has slightly affected my sleep as well. I started feeling a little bit cold, a symptom that I had at the initial stages of my WD!

 

My question is if I persist and continue taking iron supplements, will my mood be better? What if I take the iron injection instead of waiting for months for the tables to do its work will it help? if I increase FERRITIN through injection, faster than tables, will things be OK and fatigue will go away? Will the injection also agitate my WD?

 

Your advice is highly appreciated.

It's unlikely that your mood will improve from taking it everyday if it's setting off withdrawal symptoms. Injections were great for me in the sense that my IDA never came back but it took weekly injections for a whole year. There is also IV iron which I think can bring it up fairly quickly but I haven't gone that route so i'm not 100% sure.

[Nsr99]

Eastcoastgirl

 

Thank you very much for your input.

 

The other option for me is to go iron IV, rather than injection, as someone has told me that injections are not good, they may pose quick complications. But for IV, they can stop it immediately if things go bad.

Because of Coronavirus, I am kind of locked up, and hesitant to go to the clinic to talk to a doctor regarding iron IV. But wanted to hear from people who have gone this route. Thanks pal!

 

 

Edited November 13, 2021 by Karma
Name update

[rilexapro]

Ever since I started having the plethora of health problems I've had since last year, my blood work has always suggested iron-deficiency anemia, even after my hematologist told me to take 2 65mg iron supplements a day. Can a medication like Lexapro trigger that in someone's body, or is it unrelated? How common is it? Can it go away or be solved? Would weight loss help?

Has anybody else ever experienced blood work problems like this? I've read that Lexapro can cause anemia in very rare cases, but I just find it very strange it would still cause anemia in me a year after I stopped taking it completely.

[Altostrata]

What has your research into your iron deficiency found, @rilexapro? Could it have other causes? What are they?

[rilexapro]

14 hours ago, Altostrata said:

What has your research into your iron deficiency found, @rilexapro? Could it have other causes? What are they?

 

My hematologist, who I trust the most out of all my doctors, says that I probably don't have anemia, but there is something going on, possibly an infection or inflammation, that is causing the blood levels to be slightly abnormal. He said I should see an endocrinologist, and if my primary care doctor won't refer me to one (I am probably going to switch PCPs as the one I have now stonewalls a lot of referrals), he will.

[arbor]

I thought I'd share this study:

 

 2020 Jun:135:106050.

 doi: 10.1016/j.ypmed.2020.106050. Epub 2020 Mar 8.

Depression, antidepressants and low hemoglobin level in the Paris Prospective Study III: A cross-sectional analysis

Abract

Anemia is known to be associated with depression both in community and clinical populations. However, it is still unknown if this association depends or not on antidepressant intake. We investigated the respective association of depression and antidepressant intake with low hemoglobin level in a large community-based cohort. In 8640 volunteers aged 50 to 75 recruited between June 2008 and June 2012 in Paris (France), we assessed hemoglobin levels (g/dl), depressive symptoms and antidepressant intake. We examined the association of both depression and antidepressant intake with hemoglobin level, adjusting for numerous socio-demographic and health variables. We also assessed the association with specific antidepressant classes. Depression and antidepressant intake were independently associated with lower hemoglobin level (β = -0.074; p = .05 and β = -0.100; p = .02 respectively in the fully-adjusted model). Regarding antidepressant classes, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) intake were associated with lower hemoglobin level (β = -0.11; p = .01). To conclude, both depression and antidepressant intake were associated with lower hemoglobin level. In particular, as SSRI or SNRIs intake was also related to lower hemoglobin level, these classes should be used with caution in depressed individuals at risk for anemia.     Copyright © 2020. Published by Elsevier Inc.

[arbor]

Here's another study that might be helpful for dealing with low ferritin, ID, or low hemoglobin:

 

 doi: 10.3324/haematol.2019.220830. Epub 2019 Aug 14.

Iron absorption from supplements is greater with alternate day than with consecutive day dosing in iron-deficient anemic women

Abstract

In iron-depleted women without anemia, oral iron supplements induce an increase in serum hepcidin (SHep) that persists for 24 hours, decreasing iron absorption from supplements given later on the same or next day. Consequently, iron absorption from supplements is highest if iron is given on alternate days. Whether this dosing schedule is also beneficial in women with iron-deficiency anemia (IDA) given high-dose iron supplements is uncertain. The primary objective of this study was to assess whether, in women with IDA, alternate-day administration of 100 and 200 mg iron increases iron absorption compared to consecutive-day iron administration. Secondary objectives were to correlate iron absorption with SHep and iron status parameters. We performed a cross-over iron absorption study in women with IDA (n=19; median hemoglobin 11.5 mg/dL; mean serum ferritin 10 mg/L) who received either 100 or 200 mg iron as ferrous sulfate given at 8 AM on days 2, 3 and 5 labeled with stable iron isotopes 57Fe, 58Fe and 54Fe; after a 16-day incorporation period, the other labeled dose was given at 8 AM on days 23, 24 and 26 (days 2, 3 and 5 of the second period). Iron absorption on days 2 and 3 (consecutive) and day 5 (alternate) was assessed by measuring erythrocyte isotope incorporation. For both doses, SHep was higher on day 3 than on day 2 (P<0.001) or day 5 (P<0.01) with no significant difference between days 2 and 5. Similarly, for both doses, fractional iron absorption (FIA) on days 2 and 5 was 40-50% higher than on day 3 (P<0.001), while absorption on day 2 did not differ significantly from day 5. There was no significant difference in the incidence of gastrointestinal side effects comparing the two iron doses (P=0.105). Alternate day dosing of oral iron supplements in anemic women may be preferable because it sharply increases FIA. If needed, to provide the same total amount of iron with alternate day dosing, twice the daily target dose should be given on alternate days, as total iron absorption from a single dose of 200 mg given on alternate days was approximately twice that from 100 mg given on consecutive days (P<0.001). In IDA, even if hepatic hepcidin expression is strongly suppressed by iron deficiency and erythropoietic drive, the intake of oral iron supplements leads to an acute hepcidin increase for 24 hours. The study was funded by ETH Zürich, Switzerland. Copyright© 2020 Ferrata Storti Foundation.

[arbor]

I'm on a roll with iron deficiency studies that I hope may be useful to others:

 

Low plasma iron status and akathisia

Journal of Neurology, Neurosurgery, and Psychiatry 1990;53:671-674

 

Abstract: Thirty patients were examined to test the hypothesis that a depletion of iron levels is associated with symptoms of akathisia. Fifteen akathisic patients were pair-matched with 15 non-akathisic patients. Plasma ferritin levels were significantly decreased in the akathisic patients, and there was a significant inverse correlation between plasma iron levels and akathisia rating. In addition, akathisia ratings were found to be correlated with a scale measuring symptoms of tardive dyskinesia.

[Onmyway]

Thanks @arbor, I wouldn't have known the alternate day dosing one for iron. Well implement immediately. I'm always either low on iron or borderline. 

[gentlehermione]

Thank you @arbor

 

Interesting reading.

 

I just received an injection for low ferritin last week and have been wondering whether my previous AD use (20 yrs.) has caused a malabsorption issue although I'm 6 yrs post zero...

 

[WeLiveInHope]

On 11/17/2023 at 8:37 PM, arbor said:

I thought I'd share this study:

 

 2020 Jun:135:106050.

 doi: 10.1016/j.ypmed.2020.106050. Epub 2020 Mar 8.

Depression, antidepressants and low hemoglobin level in the Paris Prospective Study III: A cross-sectional analysis

Abract

Anemia is known to be associated with depression both in community and clinical populations. However, it is still unknown if this association depends or not on antidepressant intake. We investigated the respective association of depression and antidepressant intake with low hemoglobin level in a large community-based cohort. In 8640 volunteers aged 50 to 75 recruited between June 2008 and June 2012 in Paris (France), we assessed hemoglobin levels (g/dl), depressive symptoms and antidepressant intake. We examined the association of both depression and antidepressant intake with hemoglobin level, adjusting for numerous socio-demographic and health variables. We also assessed the association with specific antidepressant classes. Depression and antidepressant intake were independently associated with lower hemoglobin level (β = -0.074; p = .05 and β = -0.100; p = .02 respectively in the fully-adjusted model). Regarding antidepressant classes, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) intake were associated with lower hemoglobin level (β = -0.11; p = .01). To conclude, both depression and antidepressant intake were associated with lower hemoglobin level. In particular, as SSRI or SNRIs intake was also related to lower hemoglobin level, these classes should be used with caution in depressed individuals at risk for anemia.     Copyright © 2020. Published by Elsevier Inc.

I wonder if they ruled out thyroid disorder before embarking on this study. Since my diagnosis of hypothyroidism I am beginning to see such studies in a whole new light of further scepticism. 
 

Anaemia is also common in hypothyroidism, and people are often treated with all kinds of pain and psychotropic drugs before their thyroid disease is finally diagnosed. Madness!