The link between low iron levels and fatigue, and why this diagnosis is often missed

Today’s edition of the British Medical Journal contains an article which summarises guidance from the UK’s National Institute of Health and Clinical Excellence (NICE) on the management of chronic fatigue syndrome [1]. Let me start by saying I have special interest in this area, as quite a number of my patients present with ‘fatigue’ (often, long-lasting) for which no specific cause can be found.

My experience is that it is often able for individuals to regain much if not all of their lost energy using, usually, a range of approaches which may address more than one apparent cause. While the recommendations from NICE are better than nothing, my sense is that we prove to be of much use for a significant number of sufferers.

One of the reasons for this is that the recommendations do not embrace some issues that I find are common in CFS including compromised adrenal gland function. And even where a testing is advised, there are reasons why conventional interpretation of results may ‘miss’ something that is relevant clinically.

By way of example, I’m going to focus on NICE’s recommendation to measure ‘ferritin’ levels. Ferritin actually gives a pretty good measure of iron levels in the body. Low iron can cause anaemia (which can cause fatigue), but even if it doesn’t, on it’s own deficiency of this nutrient can cause fatigue. What is more, low iron (ferritin) is common in CFS sufferers, and restoring iron levels often leads to a significant improvement in energy and wellbeing.

NICE’s recommendations are that ferritin levels should be taken in children and young people only. Personally, I don’t agree with this, because in practice I see iron deficiency very commonly in vegetarians (of all ages) and women.

Next, I do think with iron levels it’s important to distinguish what is ‘normal’ from what is ‘optimal’. This week, I’ve been doing some work in Canada which has entailed, among other things, advising people on the results of their ‘medicals’. Ferritin levels are measured in women as a matter of course over here, and the normal range is quoted as 10 – 291 micrograms per litre of blood (mcg/L). Just seeing how wide this ‘normal’ range is set should set alarm bells a’ringing. Are we really saying that two individuals, one with 29 times the iron level of the other, are both ‘normal’.

You see, what is ‘normal’ is something determined by statistical techniques, not common sense, and is utterly arbitrary. Basically, the normal range for ferritin is set too wide. We know this partly from our experience in clinical practice, and partly because there is even some evidence that shows that individuals with iron levels well within the ‘normal’ range can still suffer as a result.

I suppose one of the reasons that I’m writing about this is that almost all the women I have seen this week has ferritin levels that I regard as far from optimal. And none of them had had this mentioned to them or had any advice given regarding this. The most memorable of these was a women who complained she lacked ‘stamina’. She turned in a ferritin of 4 (yes, four). And despite this being even lower than the ‘normal’ range, this seemed to have been ignored by her doctor. Personally, I think iron does not get enough attention, and yet I find it’s often critically important to those who are suffering from chronic fatigue or simply feel ‘below’ par.

The article pasted In below includes more information of the value of optimal iron levels with regard to brain function, and also offers some advice about iron supplementation.

References:

1. Baker R, et al. Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance. BMJ 2007;335:446-448

Metal fatigue – iron deficiency found to slow brain function in women – posted on 12 March 2007

While medical practice generally turns a blind eye to the value of nutrition in health, it has at least embraced the importance of certain specific nutrients including iron. Iron is important for the manufacture of haemoglobin ” the protein in the red blood cells responsible for carrying oxygen around the body and delivering it to the tissues. Iron deficiency can lead to anaemia, which can lead to symptoms which include fatigue and low mood.

What is less well recognised about iron is that it participates in the reactions that generate energy within the body. It is possible for individuals to become iron deficient without becoming anaemic. However, iron deficiency in the absence of anaemia can still cause individuals to suffer symptoms such as fatigue and low mood. This is particularly common in women of child-bearing age, particularly as a result of loss of iron via menstrual blood each month.

The relationship between iron status, anaemia and mental function was recently studied in a group of 149 women aged 18-35 years. At the beginning of the study, women were classified as being either iron-sufficient, iron deficient and anaemic, or iron deficient in the absence of anaemia. All women were put through their paces with 8 tests of mental function.

At the beginning of the study, the iron-sufficient women performed better and completed the mental tasks more quickly than the iron deficient anaemic women. Cognitive performance and task completion results among the iron deficient non-anaemic women fell between the iron sufficient women and iron deficient anaemic women.

Women who were iron deficient were then treated with iron supplements for a period of 8 weeks. At the end of the study, a significant improvement in serum ferritin was associated with a 5-7 fold improvement in mental function. The authors of this study concluded, Iron status is a significant factor in cognitive performance in women of reproductive age. They went on to add that the severity of iron deficiency affects accuracy of cognitive function over a broad range of tasks.

In medicine, we commonly check for anaemia. However, we much less commonly check for iron status. I do think it is important for individuals to be alert to the fact that iron deficiency in the absence of anaemia have adverse effects on health and wellbeing.

In my experience, the best test for iron levels in the body is what is known as the ‘serum ferritin’. It is my experience is that ferritin levels of less than about 50 are generally associated with symptoms such as fatigue, low mental energy and low mood. As I said, women of child-rearing age are at risk of this. This is particularly true for vegetarians and vegans in my experience.

Those not wishing to stoke up on liver and red meat may wish to contemplate supplementation. Many iron supplements are not well absorbed, however. One that I find useful in practice is Floradix – a liquid form of iron that is available from most health food stores.

References:

1. Murray-Kolb LE, et al. Iron treatment normalizes cognitive functioning in young women Am J Clin Nutr, 2007;85(3): 778-787

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107 Responses to The link between low iron levels and fatigue, and why this diagnosis is often missed

  1. Carol Homer 31 August 2007 at 4:36 pm #

    What a funny thing is serendipity. I gave blood for the first time in my 52 years about 2/3 months ago and for two weeks afterwards I dragged myself around feeling absolutely dreadful. When I went returned to the Blood Donor group this week I was advised it was probably to do with my iron levels and perhaps I should re-consider giving if it left me so completely exhausted. I have collected a number of little health blips, but with this reaction I could recollect I had done something different – I had given blood! I shall try the liquid supplement you recommend and monitor the results.

    Thanks once again.

    Carol Homer

  2. George Steele MD 31 August 2007 at 4:49 pm #

    Dr Briffa,
    Excess iron is a problem for most men and post-menopausal women. I encourage men and non-menstruating women to donate blood if possible. I interpret a healthy ferritin (less heart and liver disease) to be about 50, which is the goal in individuals with hemachromatosis (or even less). Menstruating women may need additional iron but most of us do not. Would you agree?
    Thanks, George

  3. Matty Maccaro 31 August 2007 at 10:22 pm #

    For years I had a low hematocrit, yet no doctor ever paid it any attention. Eventually, I was diagnosed with Chronic Fatigue Syndrome, still never a word about lacking iron. Last year I had double by-pass heart surgery, after three months I simply could not believe how devastating my exhaustion was. While mentioning this to the heart surgeons’ nurse, I was told “oh honey, all our heart patients are anaemic.” Clearly the exhaustion and depression patients suffer during the supposed recovery period were of little concern, she told me it would take 6 months to get my iron up. That is when I discovered Floradix on my own. Within a few short weeks my energy began to return without the least trace of constipation. It was well worth the expense. Thank you Dr. Briffa for mentioning it, sometimes such a simple thing makes an amazing difference. If only other physicians would stop listening to drug company hucksters and listen to what their patients are telling them.

  4. Tiggy 3 September 2007 at 10:13 pm #

    I tried Floradix and it gave me bad diarrhoea. I tried taking a lesser amount than it suggested but that meant it went out of date before I’d had much.

    How can you know if you need an iron supplement and can you suggest a non liquid one that’s effective?

    Tiggy.

  5. Ava 10 September 2007 at 10:52 am #

    I am a female vegetarian and often feel very tired for no discernable reason (particularly when menstrating) so this article was fascinating. Could you offer advice on how to ensure someone gets enough iron without taking supplements? I already eat quite a lot of green vegetables and nuts so if i upped my intake of spinach and the like would that have the same effect as supplements, and, if so, what sort of amounts would I need to eat?

  6. donna 20 February 2008 at 9:18 pm #

    hi, great to read your article. i,ve just been diagnosed with a ferritin level of 3. last year it was 4. as a nurse i understand the significance of this , however feel that to little attention is paid to iron levels / stores. very interesting article.

  7. PAULA COWELL 10 March 2008 at 10:49 am #

    I have been feeling very tired and low for some time, I have been having tingling in my face and leg and have just had an MRI scan which I am awaiting results from. My fatigue is really getting me down now. I have just had a blood test and the level was 13 which is low I believe I just want to feel well. Please help.

    • Nic gill 22 April 2014 at 6:04 pm #

      Hi, maybe you should check your B12 levels. I think a lack of this can cause tingling. It is very important to keep your B12 levels in check.

  8. karen 12 March 2008 at 3:42 pm #

    I had tingling in my face and legs and tests showed I had low calcium levels, my ferritin is below 3, my iron levels are also low, below 8.
    I’m taking medication for this, but it’s slow going, although the calcium replacement worked within 24 hours and the tingling stopped.

  9. Dr John Briffa 12 March 2008 at 3:49 pm #

    So, Paula, sounds like you should have your calcium levels checked (I’m not aware of this tingling being a symptoms of low iron). More iron almost certainly would improve your energy levels (see above).

  10. Dr John Briffa 12 March 2008 at 3:51 pm #

    Karen
    Thanks for that, re calcium. If you’re finding it slow going getting your iron levels up, you may think about switching to a more absorbable form of iron (if you haven’t already).

  11. Theresa Joseph-Mcsween 3 April 2008 at 12:31 pm #

    Very good article

  12. Jennifer 9 April 2008 at 11:37 pm #

    I am 35 years old female, I am glad that I found this posting. In 2005, had an upper GI a year ago. Before the procedure I ha my blood/lab work done. On that follow up appointment they said my ferritin level was a 12. Becasue they were concern I agreed to a colonoscopy. That was fine. The GI dodctor said that I am low in iron due to heavy periods and I don’t eat enough iron. I am lucky that I don’t have high colesteral, I eat red meat, grains eat, green veggie etc… not to mention that I went on birthcontrol pills for my period.
    I still always feel super tired, my memory is sporatic, I lose track of my thoughts like some one who is exhausted and over tired. I crash and sleep sometimes for 12-13 hours and wake up tired.

    In the fall of 2007, I had to repeat the upper GI becasue my acid reflux medicine wasn’t working. They did more blood work. Didn’t hear anything again about it. I called followed up again . Recommended another a colonscopy after the holidays. I went to get the lab results – my ferritin was a 7 she was suggesting I had an absorption problem. She tested me for thryoid, and celiac disease which came back negitive.

    My primary doctor referred me to a hemetologist and said he thinkings I may have a liver iron storage problem that I may be showing symptoms now? I can’t find information. I am a bit nervous. All the anemia sites say you need to find the cause to treat with a cure. Any thought??

  13. Katie 22 April 2008 at 7:59 pm #

    I just recently had a CBC, Ferritin, B12 and Folate Levels checked. My ferritin level is at 29, which is within the normal range, but I feel especially bad (mainly with sore calf and arm muscles) right before I get my period. Could this be due to an iron situation. My other RBC are normal. Also, my B12 levels are 1460 (much higher than the normal range). I do regularly take the product Emergen-C which has 470% of the daily recommendation of B12.

    Any thoughts?

    Thanks,

    Katie

  14. Tanya 13 May 2008 at 5:39 am #

    Dear Dr Briffa,
    these articles make so much sense of my experiences of fatigue which gets extreme during my period. At mid-cycle, my ferritin level was 5, so goodness knows what it drops to when I menstruate. I only had a test for iron because I asked for it and even then my GP was only concerned with anaemia which she didn’t think I had and I don’t. She and another GP in my practice prefered to prescribe anti-depressants instead for my period problems which I refused. Luckily, I had to see 3rd GP for the test results and he understood what this level meant and I’ve just started taking iron supplements. However, I did not ask what the normal range of ferritin levels are and these articles have helped me so much. Thank you. Incidentally the other GP wrote to me to say that my iron levels are “slightly low” as if it was nothing to do with how I am feeling !! Obviously she hasn’t read this research.

  15. sobti 28 May 2008 at 4:32 am #

    hello dr bariffa,

    Thanks for your article.
    As a child, teenager and young adult i have been very active, though my hemoglbin has always been very low between 7-8:50. and my BP has been very very low. At age 23 i was diagnosed with hypothyroidism, thinking back some of my symptoms had started around 16-17. Presently ‘m taking 300 mcg of synthyroid. from late 80′s to early 90s, i was feeling so low, fatigued,the best i could describe how horrible i felt ” how a sugarcane must feel after going through the juicer!”
    In 1995 i came across a small book in which adr had said that if one has one auto -immune problem, the probability of multiple autoimmune problem increase. The book suggest B-12 deficiency, as i was feeling tingling sensation on my legs and , lost sensations in my left toe,plus was having terrible leg cramps.
    i mentioned this to my dr and finally after 7 yrs, she listened to me and ordered some test, called me later and said that u have severe B 12 deficiency and suggested B 12 shots , which i have been taking since Dec 1995 and i felt a lot better, even the sensation in my toe came back
    I felt better but not 100 percent….
    around 6 yr back i was having mild stomach pain, my doctor was so confident that i had bleeding ulcer, so he put me through, upper and lower scope and both came out very clean and nice.
    my husband , who is a pediatrician felt that the pain seemed more like gall stone and eventually, it was discovered that i had 3 stones.
    i avoided oily food and was ok
    Around a yr and half ago i again started having constant pain so was suggested operation, but as i mentioned my heamoglobin was around 7:50 , so i was told either i can have transfusion or take 12 treatment of iron infusion.
    while taking the 2nd infusion my BP went very high. i mentioned this to the nurse and she called the doctor but he brushed it of saying that the iron infusion had nothing to do with my high BP. and arythemia
    I came home and my husband looked it up in the medical books and it clearly said that though in 30% pts , it lower the BP , but in 12 % of pts it can make it go up, ut the hematologiost wouldn’t hear me out, finally i told him where to look and i guess i offended him. i went to a friend, who is a cardiologist, because of the arythemia, the surgeon wouldn’t do the surgery any way. the cardiologist suggest that i should have cardiccatherization to rule out blockage, which i did and there was no blockage. luckily i don’t have cholesterol problem.
    finally coming to my recent problem….. about 2:30 months ago, i started feeling extremely fatigued , out of breath, BP went up and was weezing. I had never felt so listless ever.
    went to see the cardiologist and he did EKG and said that your heart is working at 35% less out of 60 and if u were a little older , i would have admitted you right away.( my DOB is 13th jan “59).
    I was in Atrial fibrillation, though since then i am back in sinus rythem but do feel out of breath and very tired, but not so tired as i as feeling 2-3 months ago. He put me on warffin 10 mg, cardizam 250, benecar20 mg and toporol.

    within last one month i have had received 5 letters from the drug company saying that if u took iron in past yr u are at risk for iron overload and u are at risk for heart and liver failure and by the time these symtoms appear , its often too late etc, etc
    Initially i ignored these letters , then my husband came across one and said may be u should go for liver functions and ferritin level.
    please help… i had gone for ferritin level on the 8th of april and the lab messed up and forgot to do ferritin level, and when i asked my dr about it ” if the ferritin level was okay..he said yes it was fine, and today i found out that the lab had not even done level, so i wonder what he was looking at when he said that it was fine.
    who do u trust?
    i am very upset… i feel let down, can u please help?
    thanks in advance,
    c.sobti

  16. Denise 1 July 2008 at 2:50 pm #

    I live in the UK. I am 43 years old. I have been suffering with extreme fatigue, short term memory loss and lack of concentration. I just got my blood results and I was told that it was 5 – the norm being 3 – 20 (not sure what the measurements were). She told me I was fine but told me she thought I was depressed and has prescribed me pills for this. I really don’t feel depressed, just down at having no energy. I started taking 14mg iron supplement today as I really do feel that my iron is low. My periods are extremely heavy. Please could you advise on the best course of action. Thankyou

  17. rachel 7 July 2008 at 4:17 pm #

    hi all,
    i have been suffering low ferritin for over a year i am a 22 year old female who has also been diagnosed with CFS.
    i am constantly tired and sleep most of the day, the fatigue leaves me lifeless some days. my ferritin has averaged at about 4 but when i collected my result 2day from hemotology was concluded at a 7. i may need a iron infusion i am waiting on a phonecall from hospital?

  18. Claire 17 July 2008 at 3:19 pm #

    Hi, I’m looking for a case study for an article on iron-deficiency anaemia for a Boots publication. I need to find a 20-something female (not a mum) who has been to their GP and been told to take iron tablets. I would interview you over email and we’d need to run a picture of you. If you’re interested, please let me know asap! Thanks. claire.atherton@gmail.com

  19. Carol 30 July 2008 at 6:48 am #

    Oh….well I guess I’m in trouble. I got my blood test back yesterday with the test for Ferritin and I was quite shocked at the extent of my iron deficiency. So I went on the internet to do some searching.

    It states on my report that 20-291 ug/l is the range, while I tested 3. It’s true that I felt very tired and lethargic about three or four years ago, and that I took iron tablets, but since then I’ve felt much better and not at all as tired as before. After reading your article, perhaps I should go and buy those iron supplements now and not wait until the weekend.

    When I asked for other possible causes aside from blood loss for my severe iron deficiency, the doctor ignored me and insisted that I eat more red meat and that the cause was most definitely blood loss. I’m not a vegetarian, and I eat red meat at least twice a week, so I wanted more information, eg. would it be malabsorption or something else? But instead I was brushed off. Maybe the doctor was oversimplifying things?

  20. Dumrong Chiewsilp,M.D. 2 August 2008 at 5:14 pm #

    excellent information

  21. Dumrong Chiewsilp,M.D. 2 August 2008 at 5:52 pm #

    excellent information.One of my responsibility is taking care of the anemic blood donors,especially menstuating female blood donors.Many of them have serum ferritin lower than 15 ng/ml,that mean their iron store equivalent to zero.Trying to raise up theiriron store,not merely hemoglobin,I wonder what would be the optimum level of serum ferritin for them,for optimum health.Would serum ferritin level between 50-100 ng/ml be the optimum for optimum health.As we know,if not all,high serum ferritin is not benefit for optimum health,especially for cardiac health.

  22. Lola 27 August 2008 at 12:35 pm #

    Hi I have been exhausted for months, I work for a GP and also have a metal heart valve which means taking warfarin which seems to get blamed for most of my health worries, anyway he was on holiday and i saw the Locum, he tested not just my FBC but ferritin too, my Hb was 10 and my ferritin level is 3.4!no wonder I’m so exhausted, when I’m not working I’m sleeping, on iron therapy now but locum wants to look further at causes.
    My advice is – its sometimes better to have a fresh perspective as my GP and boss had obviously become a little complacent and not given my earlier results the attention they deserved (in his defecnce he does has 1000s of patients and is generally a great GP) and assumed that the problem revolves around my warfarin therapy for my metal heart valve.

  23. michelle 29 September 2008 at 10:17 am #

    I have been low in iron for years and iron tabs always made me sick. Stumbled upon a great product called Spatone. 100% natural iron supplement. Worked miracles for me. I used to suffer from heart palpatations, depression and extreme tiredness and heavy periods. Thanks to Spatone i no longer have palpatations and my periods have been reduced to half a day! Iron levels were 3 and as of today they are at 24. Takes a while to build levels back up but try this product and stick with it. I have experienced no side effects and swear by this stuff. Ferritin levels still low was 3 now 6. Slowly moving up, trying to find out why they don’t move much. Any thoughts?

  24. Kim Di Luca 29 September 2008 at 1:36 pm #

    Dear Dr. Briffa,
    Hi, I am a female, just turned 50. I have been going to my GP regularly since Jan 08 with stomach problems – constant loose motions 6 times a day and low ferritin of 10. I am always totally exhausted. I get up in the morning, get my husband off to work, eat a meat rich breakfast, then go to sleep for several hours. I have no stamina during my waking hours. I run (Or try to!) a small farm and it is now becoming impossible. For the record my periods are quite light. I feel that I am not absorbing iron from my diet.
    I am now paying to have a colonoscopy (it is criminal that I have to pay). Iron supplements make me constipated, as in I need colonic irrigation every week to empty my bowels. I am seeing my doctor again this afternoon. I don’t want alternative iron supplements, or iron injections. I desperately need a quicker fix. Am I within my rights after losing nearly all year to exhaustion, asking for a blood transfusion, and would this help. Any advice would be so appreciated.

  25. mandy jarvis 14 October 2008 at 4:15 am #

    just read your article what an eye opener.Last year feeling extremly tired midwives at work suggested having my blood taken to check my thyroid Went to see my gp who asked if i was feeling depressed at all or low i replyed i was feeling low and that was why i wanted my thyroid checked, she decided to do this and an FBC.checking my results at work i was shocked to see my HB was 8.4 depressed my foot more like knackered.Revisited my gp who gave me a prescription for iron supplements but wanted my ferritin level checked first this came back as 4.After a discussion with the gp she put it down to heavy periods even though i told her this was not a problem.Eventually my HB returned to 10.9.Then last week feeling tired again had my blood taken at work my HB has dropped to 10 again and have now had a letter wanting to discuss my mild anaemia.i have suffered with very sluggish bowel on and off for few years.any suggestions.

  26. sonya 16 October 2008 at 1:22 pm #

    I am a Crohn’s sufferer and so naturally my iron absorption is not great. Since having children I have always been slighty anaemic and have often suffered with exhaustion, I always put this down to bringing up a family and the Crohn’s disease. However my GP recently requested a full blood test and discovered that my Ferritin levels were 3.6!! My GP said he had never seen a count as low and that and that I must have been functioning on air! He prescribed Ferrous Sulphate tablets to be taken 3 times a day, but they do tend to upset my tum because of the Crohn’s disease ,So I am going to try a liquid supplement from the health shop. My levels are now at 16 which is an improvement, but no where near what they should be! I eat a fairly good diet and so I believe that it could be the medication I take, Mesren, for the Crohn’s disease that is partly responsible for my low Ferritin levels….any suggestions from anybody else who is a Crohns sufferer welcome!

  27. Nancy 24 October 2008 at 8:27 am #

    My daughter has been going to school but feeling very sick & not getting better recently. Just found out her Ferritin level is 1. Have been reading everyone else’s comments and wondering how she has functioned as long as she has. Dr prescribed oral iron 3x per day but this could take forever to get to normal, and her schooling is really going to suffer. Just wondering if any of these iron supplements mentioned such as Floradix or Spatone are available anywhere in Canada or USA?? She needs something quicker than something that will take months to help her. Any help greatly appreciated.

  28. S Freyne 3 November 2008 at 3:27 pm #

    Hi, I have been diagnosed with CFS/ME and had a Ferritin level of 8, I was retested 3 months later, have been taking Iron suppliment and it has only gone up to 33 which is in the normal level but with the high level of Ferrous fumerate that I’m taking I was expecting a huge increase in my Iron level. My docter wants me to stop my tablets for 6 weeks and have another blood test, I eat normally actually very healthily, fruit, veg, meat, fish, have even taken to drinking Guiness to get Iron (recommended by my docter). What reason could there be for my body not to absore Iron? Any thoughts would be greatly appreciated as I do not want to go backwards with my health

  29. Leanne 10 November 2008 at 9:55 pm #

    Nancy, Ask your doctor about iron infusions, it is much faster, but expensive if your insurance won’t pay for it. Also, you will probably need to see a specialist in order to get it.

    I was first diagnosed with anemia when I was 12 years old, before I even started menstrating. I have had trouble with fatigue, low mood, and bad memory most of my life. I wasn’t diagnosed with low ferritin until I was 37 and it was at 2. I still struggle because I hate taking pills. I’m so used to feeling bad I can’t imagine how it would feel to have a ferritin level of 50 (as suggested in one of the posts).

    I found a blog at http://www.mothering.com/discussions/showthread.php?t=336058 that talked about getting Floradix at health food stores and The Vitamin Shoppe. It also mentioned something called “Iron and Herbs,” among others, and chlorophyll (???) I will have to do more research about these claims.

    After checking the internet, I found out that you can ordern Floradix online through The Viamin Shoppe (vitaminshoppe.com).

    I am not endorsing this product or Vitamin Shoppe, only going by what I have read on posts. Apparently it tastes better if you drink it with orange juice.

    From experience I know that this is not something you can get rid of once and forget about, it is an ongoing routine that one must get in the habit of doing and to continually get blood work done. Try not to let insurance lapse otherwise it will be seen and a preexisting condition and your new insurance may not pay for the blood work (yes, again from experience).

    Good luck!

  30. Leanne 10 November 2008 at 10:38 pm #

    Forgot to mention…

    Vitamin C helps with the absorbtion of iron. My doc recommended taking my iron pills with orange juice. when I don’t have any I take a Vit C tablet.

    Check with your doctor but taking folic acid, B6, and B12 may be good too. (all of which are in regular multivitamin tabs).

  31. Clair 21 November 2008 at 1:44 pm #

    Just read your article and found it very informative. In May I was feeling extremely tired, after days of my partner nagging at me I went to doctors and was sent for blood tests. Obviously a week later was told I was anemic. After taking ferrous sulphate for a month I was told after another blood test I was fine. Imagine my surprise though when in October I started to feel the same again after another visit to the docs and another blood test found out my ferritin level was 12 so have just finished taking tablets for 4 weeks and had another blood test yesterday fingers crossed it comes back normal. It is a horrible feeling and when I had just finished my period last month I felt shocking.

  32. sam 21 November 2008 at 11:13 pm #

    I have been feeling tired with mood swings for years, literally! I have recently had a cold, which developed into the flu, and my friend recommended taking Floradix, and some other supplements. I reluctantly handed over my money (thinking it would be a total waste!). 5 days later and I swear I am a changed woman!! I have nearly finished working 48 hours in 4 days at work and have not felt tired once!

    I would be so tired normally I would find it hard to function every day without having regular naps in the afternoon, I would also be very tired and grumpy at work and have no energy to do anything else. I was ever increasingly relying on coffee to get me through the day. I CANT BELIEVE!!! how much better I feel since I have taken Floradix, I feel alive again!! It’s so bizarre. I realise now my problems must have been due to low iron levels. I recommend it to everyone and especially if you are so tired and grumpy all the time like I was! x

  33. Rikki 14 December 2008 at 2:35 am #

    Greetings – my ferritin has just been done and it’s 4 (four). I have chronic pain which causes chronic fatigue and I get 12-14 nerves blocks (continaining prednisone) 3 to 5 times yearly just to be able to live life. I take care of my 83 year old mum and 21 year old daughter (I’m the only driver). I’m also asthmatic with disc disease (the reason for the nerve blocks). I am also having an extreme problem losing or maintaining weight. I eat about 300 calories per day, my nurtritionist can’t help me because I’m not meeting nutritional needs. I know all this. However, if I eat any more, I gain weight and can’t get it off. I have been on prednisone for about 45 years (I’m a 49 year old female), either orally for asthma or in my nerve blocks. My thyroid levels are normal (tests done at the same time as ferritin levels.) Could there be some other process at work here. Please don’t tell me to simply eat more. I can’t, and won’t gain weight. I’m 5’7″ and 157.5 pounds, but for asthma and disc disease I’ve been told to weigh about 135 and to be honest , I feel best at that weight – if I could get there. Could there be an adrenal involvement here? I’m told there is a simple salivary test that could be done to test hyperthalmus levels of TSH, or because my thyroid levels are normal does that eliminate adrenal problems? I feel terrible, with crushing exhaustion. It’s taken me nearly four years to lose just 20 pounds (I was very ill, the only way I could lose it) and I want to be able to eat three meals a day like everyone else. I also exercise in the pool (for my disc disease) but it’s becoming so hard w/ the exhaustion. Does anyone have an answer?

  34. Rosemary 18 December 2008 at 12:20 am #

    Hello,

    I just got my ferritin levels checked and it was 10. I almost always feel tired, draggy, (low energy) a bit unhappy, and my memory is bad fairly often. I am also always cold. My hands, toes, nose. It gets so annoying. Even after I’d go for an invigorating, brisk walk I seem to get cold hands a few hours later. Is this to do with my iron being low? I am also wondering what level I should bring it up to to be functioning optimally, and how long would this take. As of today I am starting on one 300 mg pill /day for the next cpl of months. Is there such a thing as overdosing on iron and if so, how much is that?? Would anything bad happen? Thanks so much

  35. Andrea 20 December 2008 at 1:30 am #

    Hi,
    I have just had a blood test result back and told my HB is 120 (this has also been described to me as being 12 in the past). Its described as being normal but i have all the symptoms of aneamia – palpatations, fatigue but insomnia, cold hands/feet etc also mild depressions. i have heavy periods every 3.5 weeks. i was interested in the point made about ‘optimum’ iron levels but not sure how to interpret my results. I’m told this is ‘normal’, but they prescribe below 100 and i’m sure that prior to having my three children (all under 5) my HB was over 140 so my thoughts are that it must be low. but what would my optimum be? does it vary with age?
    I would like to know what other’s think about this!
    thanks in advance
    Andrea

  36. Janiedoll 30 December 2008 at 4:04 am #

    Hi this is a really interesting website!

    My periods have been getting heavier over the past 6 months and I got some meds to lessen blood and ease pain. I’m a 38 year old mother of a very energetic 7 year old so need energy to keep up with him! Unfortunately I’ve been feeling tired for what seems like forever and I’ve just learned to live with it. I’ve been catching all the bugs going and have been off work quite a few times in the past 8 months – not good! My doc sent me for blood tests and my ferritin came back at 3.3 – it should be about 50!

    I am now very scared and can’t imagine how I’ve kept going for so long without collapsing! My sis has chronic fatigue and I’ve seen how it floors her – I can’t afford to get to that stage while caring for my young son!

    I’m on 3x 100mg ferrous sulphate per day and hope that this will help, as well as the tabs to lessen the blood every cycle.

    I’m planning on making sure I have a healthy lifestyle in 2009 and this includes improving my diet which will hopefully help. I’m giving myself another week off work and to let the ferrous sulphate get in to my system then I’m going back to the doc to see if there’s anything else I should be doing!

  37. Amanda 9 January 2009 at 4:06 pm #

    hi, my ferritin level came back today of 7.1, my iron on christmas eve was 10.2. i am 19 weeks pregnant with 5th child. june 2007 i had a colectomy. Full removal of large bowel. I do struggle with high iron foods and more so high fibre as i get constipated again. But i am trying. I am always exhausted but i always put it down to 4 young children. Glad that there is a valid reason for always sleeping. But how can i go about getting my iron up without overdoing it. I struggle to take the likes of OJ because of pain and cramps i get. Any advice would be great. tahnk you

  38. Jenny 14 January 2009 at 7:32 pm #

    Hi there,

    I found this article rather interesting, so thought I’d share my experience.

    I am a 22 year old and over the past couple of years had got increasingly tired and felt generally really low and often quite depressed. I was finding myself falling asleep in the afternoons, which I never used to do. I have been to the doctors before saying I was tired etc, but anemia was never suggested as being the cause. I have always had heavy periods and about 5 months ago I started getting heart palpatations, which just confirmed in my mind that something wasn’t right.

    My new doctor straight away booked me in for a blood test which revealed that my ferritin levels were less than 1, so was extremely low and I got prescribed Ferrous Sulphate tablets straight away. I have been on 3 a day for about 3/4 months now and my Ferritin levels have got up to 15. I am still prescribed to take the tablets for another 3 months and then I should be able to stop.

    I have been advised into looking at Progesterone only contraceptives, which apparently, in most cases can lighten or even stop your periods. This will then hopefully prevent going through the same ordeal.

    Janiedoll – I have found that the Ferrous Sulphate tablets really do work, after 3 months of taking them I have noticed a big difference in my energy levels. I have also read up on eating a good healthy diet with lots of iron included so hopefully i can maintain my iron levels without medication. I have reduced my tea and coffee intake 2 hours before and after eating and taking the tablets as this inhibits iron absorption. There is loads of information onthe web, so I would definately suggest having a loook around.

  39. Anita 22 January 2009 at 4:12 pm #

    I was diagnosed with a ferritin level of 2. Five weeks later it is up to 8, with one moderate to heavy period during that time. I have a difficult time with regular iron supplements, so my doctor recommended a product called Proferrin, which is easier on the stomach than regular iron tablets. It’s a heme product (animal iron) which apparently absorbs well. You can buy it at pharmacies in Canada (it’s usually behind the counter) and is non-prescription.

  40. Sally Mertens 28 January 2009 at 3:13 am #

    Based on my experience dealing with low ferritin, I would highly recommend taking Repliva 82mg/day available only by prescription. Once a doctor (my GYN not my Cardiologist!) figured out that my chronic atrial fibrillation might be related to my low ferritin level (9), after only 6 weeks of taking Repliva, my ferritin was up to 29 and my A Fib had stopped. I haven’t had one A Fib attack since I started the Repliva. I concurrently stopped donating blood (which I was doing as frequently as possible) and began eating beef – at least 8 ounces per week – again (after 3 years as a vegetarian). My GYN would like to see my ferritin level at about 50 and told me it would take about 6 months for me to get my blood “stores” back to normal… As a footnote, every time I donated blood, I passed the Red Cross hemoglobin test. My GYN understood how that was possible but I didn’t understand the explanation well enough to share it with you here….. I feel extremely lucky and grateful and lucky that when I moved to a new town I got referred to a GYN who was well aware of the link between anemia in pregnancy and heart conditions. I’m well past child-bearing age and thus, as a precaution, my GYN also sent me for a colonoscopy to rule out internal bleeding as a factor in my low ferritin..

  41. tracey 4 February 2009 at 10:42 am #

    i recently visted my gp after fasting and asked him to do a blood test to check my cholestrol as i had experienced a few chest pains over the last few months and also the odd pain down my arm. the results showed my cholestrol level to be 5.4
    my doctor said he would review it again in 6 months time, however my hb level was 9.4 and ferritin 3, he prescibed ferrous fumarate 210mg, one to be taken twice a day, these caused me to be constipated almost immediately so i took movical which the doctor prescibed as well as laxatives, drunk orange juice and prune juice and still i couldn’t relieve the constipation. my gp advised me to stop taking the iron and after 5 long days i went to the loo. my gp is referring me to see a specialist. i also had an ecg test and was told everything was fine. my gp told me my blood cells were smaller than normal so at the moment i am feeling a little concerned.

  42. Audrey 20 February 2009 at 7:14 pm #

    Excellent article. I read it just now after coming bk from the GP. For about 2 years or more, I’ve had low energy levels, low mood, feeling cold and palpitations. More recently, I’ve had to sleep in the afternoons to cope, have become increasingly forgetful and depressed. I put it down to overwork and reaching middle-age. Thankfully, a friend’s recent experience prompted me to go to my GP to ask for a blood test. This morning I got the results – normal haemoglobin levels (11), but very low ferritin levels (4). I was so relieved to know that I hadn’t been imagining the symptoms al along. I had felt so guilty about going to see the GP before (twice) for what in hindsight were vague symptoms such as palpitations and feeling ‘under the weather’. Now I know what’s been wrong! I’ve been put on iron tablets and medication to lighten my chronically heavy periods which must have depleted my body of its iron stores. Hope this message helps someone else.

  43. Paula 26 February 2009 at 10:27 pm #

    Hi

    I am living in Scotland and for the past 16 months have been having regular blood test because I feel extremely tired all the time and generally “run Down” I have just turned 40 so do not expect to be feeling like I am 140 just yet. My 1st result I had an iron level of 24. I was told the levels were 26 – 350 and that “normal” people generally have levels in the middle. I started taking Feragrad tablets 1 a day because they were a high dosasge. 3 months later my levels were up but my haemaglobin was low so continued my iron tablets, next blood test my iron was 28 and my doctor said I could stop the iron tablets. 3 months later the next test my levels have dropped to 25 and now the doctor is saying I have low ferritin. I do not know the level of my ferritin. I am now being referred for further blood test to check my B12, Folic Acid levels also liver, kidney, thyroid, coeliac disease. I am really cross that it has taken 16 months for anything to finally be looked at properly. My main concern at the moment is I feel very breathless as well as my other symptoms. I have read others comments and I did not see anyone else mentioning breathlessness. I feel like I am not getting enough oxygeon when I breath through my nose. Is this a sign of low iron, ferritin ???

    Thanks

    • sarah 22 August 2014 at 2:50 pm #

      Yes, when you are low in iron you do feel breathless. Iron is used to transport oxygen in the body,

  44. Anita 3 March 2009 at 2:27 am #

    Paula, interesting that you should mention breathlessness. I, too, have experienced that from low hemoglobin (94). That particular symptom has subsided now that my hemoglobin is up to ‘normal’ levels. However, I continue to experience breathlessness, but this is now due to my low blood pressure. I often find it difficult to breathe deeply when my BP drops (sometimes a slight ache in my chest accompanies this). I understand that low blood pressure goes hand in hand with iron-deficiency anemia, and bp is sometimes extremely low. Could that be something to look at in your case?

  45. kristy 17 March 2009 at 1:48 am #

    Well I have a weird and interesting one. I am 32 and a year ago diagnosed with dysautomnomia and postural orthostatic tachycardia syndrome. I always have had low hgb with blood transfusions and suffer low iron. I am unable to absorb any type of iron because of something they call thalessemia. Its a genetic anemia that stems from a meditarranian backround.l have had hgb as low as 6 have been asymptomatic. Since being diagnosed with the tachycardia my symptoms have gotten worse and worse. The cardiologist drew blood but never checked my iron with my backround. I was sent to the hematologist because my hcb was back down to 8. Well this morning i got a call that my iron or ferratin was dow to 1! So tomorrow I go for a blood transfusion and start on 6 weeks of iv iron. But in the meantime I have suffered from so much breathlessness and rapid heart rate due to the defeciency of both. Dont let the doctors overlook these things cause they dont always check your ferratin in routine bloodwork. With my history they didnt even check mine till i was basically unable to move or stay awake. What can i do to prevent this from happening again?

  46. SVETLANA LUKYANOV 22 March 2009 at 11:11 am #

    I’ve had a lot of different symptoms over the last 2 years including tingling in face, hands, feet. Muscle spasms, dizziness, fatigue, muscle, joint pain etc…
    My doctor tested me for just about everything – MS, calcium, magnesium, B12, thyroid, diabetes…..Nothing! Said I probably have fibromyalgia. Finally just 2 mo, ago he tested my ferritin level. It was 6. No wonder I have been feeling so awful so often. I have been taking iron supplements. My midwife recommended Floradix (Iron + herbs) liquid. I’ll go back to the doc. soon to get my ferritin retested.

  47. sobby 24 March 2009 at 7:17 am #

    interesting site, I have always suffered from being tired from being a teenager, never interesting in going out and socialising. When giving blood mostly was refused due to low iron. Over the past 2 years I have been feeling so tired and ill, and the past 8 months have had flu like symptons for a day when I did something a little more strenuous like work an extra day. The next day i would be in bed feeling awful with pains everywhere and hot and cold. I felt very lazy as I would take myself to bed whenever I had a spare moment. Three weeks ago I went to the doctor and told him I was feeling ill but couldn’t say what the matter was only that I had flu symptoms continuous sore throat and my legs hurt, he did lots of blood tests and I got a letter saying to go back as I was aneamic. When I went back they said my blood level was 9 and my ferritin level was 2 and thats why I felt so bad. I had never heard of the ferritin level before even through I have been aneamic a number of times before. I am on 3 iron tablets a day and feel worse, whether its because I was so low or the iron is making me worse I don’t know. I have had to cancel my shifts at work over the past 3 weeks as I feel unwell luckily I only work doing bank shifts so not letting anyone done but losing my wages.
    The other surprise is that i was crunching about 20 glasses of icecubes a day and when I researched it it said to get my iron checked as it is a sign of aneamia. Since taking the iron tablets I have not wanted any icecubes.

  48. Joy J 2 April 2009 at 5:19 pm #

    My little boy (you don’t seem to mention boys!) has been constantly ill and tired for 18months now. He is always off school sick or arrives at school late. To cut a long story shrt, Alder Hey hospital has diagnosed him with CFS. I have just received his bloods and they saythat alothough his ferritin levels are on the low side (23.3) his haemoglobin levels are normal. I realise that many others have a much lower level but my concern is that my little boy may need a supplement. he is always cranky, does poorly in school because of poor memory and has great diffiiculty in concentrating. Do you think I should self treat hm with the proposed treatments or should I go back to my GP

  49. Bonnie 16 April 2009 at 6:08 pm #

    I have been recently diagnosed with low iron levels. My ferritin level is at 9. I have been exhausted, having palpitations, muscles pain and fatigue, memory and concentration issues. My ND got a copy of these results and put me on iron supplements. My regular MD says that my levels are fine. Is it possible that the ferritin levels are causing these issues? I’ve been tested for everything else under the sun and the only thing that they found was a 1.5 cm solid nodule on the right lobe of my thyroid – I’m having a scan at the end of the month.

    Signed,
    Fed up with being sick and tired.

  50. April 22 April 2009 at 1:10 pm #

    This site has been a great help. I have been ill for the past 15 years with several visits back and forth from doctors and hospital consultants. And experiencing a lack of help and understanding and i have even been scoffed at twice by condesending doctors/consutants. My symptoms started around the age of 15 yrs old and gradually got worse over the years. They started with a whole host of digestive problems- IBS, GORD, Food Intolerances etc until i got to the point where i was living on a very limited diet. I was also experincing anxiety/panic attacks (heart palpatations) muscle/joint pain, headaches, fatigue and to top it all off i would vomit for hours if i ate anything high in sugar. I was left to find my own treatment. I thought if i could resolve my digestive problems i could get a better quality of health/life. I went to see a Nutritionist who started treating me for Candida Albicans. This was in 2006 after having to leave work and stop my studies as i was in an absolute mess. By January 2008 my symptoms had got a lot worse. I was unable to eat without a lot of stomach/bowel pain, i had flu like symptoms, recurrent infections, infected spots coming up on my face i was in a lot of pain with my joints and muscles and i couldn’t even sit up on some days. I would have to crawl around the house or i would experience dizziness and black outs. My hair was dry and falling out and i was slurring my words.My periods had stopped and my gums were cracked and pale.I was constantly cold and was basically bed ridden. My Nutritionist told me it sounded like CFS or a problem with my thyroid/adrenals/bio chemistry. She asked me to go back to the docter to have my thyroid tested and the epstein-barr virus test. She warned me that the doctor may say that my thyroid was in the normal range but this may not be normal for me. My tests came back normal and after being told by the docter on my first visit to have the blood tests that it wouldn’t be CFS he had now decided it was CFS and told me to go and get a book on pacing after prescribing anti-depressants.

    My Mum had come across a book by a man called Martin Budd who had been treating people from all over the world with my symptoms. My Ferritin was low at 17. My adrenals were below the range at 17 and my thyroid at 15 even though in the NHS range was too low for my age. I am now taking Nutri Thyroid, Nutri Adrenal extra and nutri hemagenics (iron supplement especially designed to restore iron ferritin levels) I realise that it is a long process trying to rebuild my iron stores as they are at 23 after a year of treatment.

    After being failed by the NHS i am now having to fight for benefits that i have been reduced to after a life of ill health. So i came across your site whilst searching for medical evidence to support my case. Thank You!!!!

  51. sarah 10 May 2009 at 5:17 am #

    I have been very interested reading this site,as for 3-4 yrs now i have suffered from lethargy,some days could fall asleep when shut eyes and have a sinking feeling.Often feeling low in mood,at least every 6-8 wks when been particularly busy would end up in bed for a day with aching limbs ,hot and cold ,feeling generally unwell.My periods are very heavy ,increasingly so.
    Had full blood count done 2 weeks ago-Hb was 10.Ferritin was 5.
    Finally i know why,this may also explain episodes of palpitations,and always feeling cold.
    I have starten ferrous sulphate three times a day-has anyone heard of adding vit b12 and folic acid to help?
    Thanks.

  52. crissy 10 May 2009 at 11:06 am #

    last summer I was having heart palpitations, extreme fatique difficulty thinking. I felt like I was in my own little world. b/c heart disease runs in my family my DR. took me thru a series of EKG’S stress test , ect. everything looked good. however labs came back with my platelet count a little low my wbc low and ferritin @7. it’s been a yr of taking ferrous sulfate and my platelet count is still low wbc still low the hematologist said that I could just naturally be that way and my ferritin is at 54 but she wants me to continue on the iron pills for another yr. everyone seems to say within 3-4 months they’re where they need to be. so why is it taking 2 years to build my ferrritin back up? also when I mentioned the tiredness and palpitations to the dr. she said low ferritin would not cause this, so what was causing it then? luckily after a few months on the iron pills it almost all went away. coincidence?

  53. Connie 20 May 2009 at 7:26 am #

    I have never been anemic but was experiencing hair loss for a number of years. I’m a 58 year old female. My doctor checked my ferritin level and it was 28. She told me that anything under 70 can cause hair loss. I also have heart palpitations and fatigue.

    The information presented here is helpful. I might try the
    Floradix.

  54. Thyroid Boy 1 June 2009 at 1:35 pm #

    Having thyroid and adrenal issues, I found out that my ferritin levels dropped over period of time and now not quite sure what is the best way to increase the levels safely. My levels came back 39 which is just at the border levels so thinking of getting oral iron to raise it.

  55. Jackie Bushell 13 June 2009 at 10:51 am #

    Spatone is a natural iron supplement which many ‘alternative’ doctors recommend. I am taking it myself. It doesn’t have the constipation and black stools side effects of the ferrous sulphate tablets you’ll get from GPs if you are in the UK.

  56. Ruth Rounce 14 June 2009 at 7:30 pm #

    Hello – I wonder if you can help?
    I was diagnosed with Iron Deficient Anaemia in Jaunuary this year. My blood count was 7. I felt like the walking dead. Since then I have been taking Ferrous Sulphate (200mg) twice a day at first for three weeks when my count went up to 10, and then it stuck at 10 and went no further (should be 13.5). After a gastroscopy to check for celiac in February, and a colonoscopy in April a medium sized polyp was removed from my bowel and Ferrous Sulphate was increased to 3x daily.
    But although my blood count rose to 10.8 it then fell to 10.3 and is now at 10.5.
    This has all taken since January and I still feel lousy!!
    Twice in the last month I have been very sick in the night for no apparent reason.
    Is it ok for me to take Floradix AS WELL AS the iron pills? And have you heard of Doctor Colin Ainley a London gastro-enterologist who has invented a drug called MALTOFER which is supposed to have amazing results, but is not available on the NHS.
    Any ideas on all this? Help!! Many thanks, I’m getting desperate to get well again, and would like to get back to work. Ruth

  57. Rose Larkin 25 June 2009 at 5:46 am #

    Hi, I just got out of Intensive Care. My heart went into Atrial Fibillation and my heart rate for 7 days was upward of 185. This was caused due to my critically low ferritin level of 5 and high blood pressure. Mostly the low iron (ferritan ). I highly recommend any of you that have irregular heart beats and a low ferritin level to get to someone who knows what they are doing. I nearly lost my life and fortunately, Upon doing a TEE. A trachial echo, they found no blood clots, and they were able to shock my heart back into a normal rythm..However I am taking vitamin b-12 supplements to get my iron back up..

    Seriously.. do not wait.. Doctors do not seem to understand ANYTHING that has to do with iron. It is best to seek a specialist in that area…

  58. Ruth 26 June 2009 at 11:00 pm #

    Seriously, so many interesting stories on here, but does anyone qualified ever read them to answer them?

    Just as an appendum to my story I had serious nausea and vomiting attacks recently, and it was reckoned to be the long term (five months) use of so much ferrous sulphate. I’ve come off it totally (my choice) and no more nausea or vomiting or stomach pains.
    I feel much better but no energy and blood count still far too low, ferritin level also much too low at 9.

    Every doctor seems to have a different opinion on ferritin levels, the GP I saw when I was so sick said 9 was low but ok. This is not what Dr.Briffa says in his article.

  59. Heidi 24 July 2009 at 2:20 am #

    I am a 35YO female with CFS. I have had documented low ferritin for 10 years and all MDs have always ignored or just said, take a little iron (if you want to). It was 7 many years ago, got up to 10 in 2007 and it’s now down to 4. I’m saddened by the ignorance re: iron deficiency. I bought Floradix today and I’m trying to convince my MD about doing an IV iron infusion. We’ll see. I think the info provided in this blog is invaluable and I just might be fwd or printing it for my MD. Thanks for all your input.

  60. Sheela 26 July 2009 at 5:31 am #

    Hello Dr. Briffa:

    Many thanks for your valuable advise upon ferritin and related issues. I need your help too. I am 38 years old, unmarried and vegatarian. I had 3 blood tests done over the past 1.5 months. My ferritin levels were 5, 7 and 5. Haemoglobin was 11.2, 11.9 and 10.2 (must have dropped because I donated blood 3 weeks before the last blood test).

    My doctor has ordered H-Piroly (I think so) , serum something somthing….and stool test. He wanted to put me on supplements but I denied for it as I wanted to know the cause of the problem.

    I eat iron rich food with vitamin C to enhance non heme iron absorption as I love to donate blood, I do not have heavy menstruation and surprisingly enough I do not have any apparent symptoms like feeling tired, fatigue, or having concentration probelm, or seeing blurry-nothing of the sort. I try to walk on an average for about 2 hours a day 4-5 times a week. I work well and do not feel any apparent change in the body. I sleep early and wake up early too, having on an average of atleast 8 hours of sleep. I do have itchy anus mostly at night when I am slepping and at rare times duing the day too. I have a tag (I think so, round like) at the entrance of the anus on the inside and at times when I am scratching I see blood in my finger. I assume it must be from the tag (or don’t know what else could it be).

    Do you know what could be the possible reason for such low ferritin level? I want to avoid taking iron pills as it will prohibit me from donating blood if it is prescribed by the doctor and I LOVE to donate blood.

    Please share your knowledge with me and other patients too.

    Kind regards,
    Sheela.

  61. Dr John Briffa 26 July 2009 at 5:02 pm #

    Sheela

    Non-animal sources of iron (non-haem iron) is not very well absorbed, particularly by some people. The fact that you are vegetarian and, I assuming, menstruating each month, is more than enough to explain your low ferritin in my experience.

  62. Sheela 27 July 2009 at 12:16 am #

    Hello Dr:

    Thanks for your reply. I have my past reports from other years too where the ferritin levels were in one year 60 and and in another 28. These were way far from 5. Could the reason still be being vegetarian and menstruating?

    Is there any other way to enhance absorption apart from taking citrus rich food?

    Sheela.

  63. Anita 17 November 2009 at 7:24 pm #

    Supplementing iron therapy by drinking nettle tea twice a day, eating Chinese red dates every day, along with weekly acupuncture for anemia can help increase iron levels.

  64. 122artina 17 November 2009 at 11:10 pm #

    Funny you mentioned your patient had Ferritin 4. I have just been told my was 3 ! and heamoglobin 9. I have started iron and will have to go back to test in three months.
    I suffer from exhaustion, dizziness, lack of motivation or ability to concentrate, heart palpitations that would not let me sleep, would wake up often and couldn’t go back to sleep for hours. Just I was going downhill in every way possible. My menstrual cycle was such that I had bled heavily for two months until they put in mirena coil. I am slightly improving since it’s only been two weeks on iron supplement. Must take it with orange juice or it will cause me awful stomach ache and sickness. So let’s hope my fatigue will improve. All the best for the rest of you’s that have same problems.

  65. 122artina 17 November 2009 at 11:19 pm #

    Dont take Ferrous Sulphate if it makes you sick Ruth. I couldn’t take it either because of the stomach pains. I have better experience with Ferrous Gluconate, ask your doctor for it. It seems to work fine if I take it in the evening after dinner with a glass of orange juice.

  66. Debbie 30 December 2009 at 6:03 pm #

    For 5 years I complained of feeling horribly tired, sleeping alot, just not to standard for my age wich is now 34. I also had tingling in my fingers, hair loss, mood swings, trouble concentrating. so my doctors fed me increasing amounts of anti-depresants, when they didnt work they switched to different ant-depressant to no avail. At a point i was ready to acept I just wasnt energedic and never would be, I moved and had to get a new doctor. So I tried once more. They checked a ferritin level on me and found it to me a 6. After 2 months I am feeling better, and as far as depression…..it doesn’t always explain why a woman is tired and I am annoyed about all the time I lost to narrow minded doctors.

  67. Dawn 11 January 2010 at 11:19 pm #

    I have just been told that my ferretin level is a 6, the only reason they took the blood test was that I was have been burping a lot lately and they booked me in for an endoscopy. I have started taking 420mg a day of Ferrous Fumerate – have been taking it for around 10 days with no adverse effects – I am now eating an iron rich diet – can’t believe how much iron bran flakes has in it!

    I do not eat any kind of meat, my periods have got a little heavier in the last 12 months (I am just 49).

    I have been able to sustain 2 vigorous sessions at the gym, with a trainer, each week, plus miles and miles of walking for every week in the last year – – I have been able to do this apparently because my haemoglobin level is a very healthy 12, despite the low 6 for ferritin, so have plenty of oxygen floating around to do the fitness stuff.

    I find the posts above, interesting that mention the heart, I had an ablation for atrial fibrillation 2 years ago and all has been well until the last few months, where my AF has come back with a vengeance. I am soooooo hoping that my low ferritin level has played a part in this.

    They now want to do a colonoscopy as the endoscopy showed up nothing that untoward, apart from a small hernia and mild gastritis.

    Here’s hoping for a much better 2010!

  68. Natalie 5 February 2010 at 8:33 pm #

    Hi,
    I am a 31yr old woman who has always sturggled to put on weight and have had decreasing energy levels for the past 10 years. In 2007 I was admitted to Hospital with bloody diarrea that was stopped with steroid treatment. Whilet still on the steriods I had a colonoscopy which showed nothing strage, although the rigid sigmoidoscopy on the ward showed inflammation on which basis I was told it might be Crohns. I was later told it was just IBS.
    Now in 2010 I have had bloody stools for a month, I am very constipated and can barely concentrate on work. When I am extrememly tired I get light headed, nauseaus and have heart palpatations. I have recently been screened for Coeliacs but the test came up negative and I do not have an IgA deficiany, although my serum ferritin levels came back as 4.
    Any advice would be fantastic as I don’t know how much longer I can cope with feeling this tired.

    Thankyou.

  69. Susan 19 February 2010 at 3:09 am #

    This is amazing! All these testimonials make low feritin seem like it’s epidemic! Mine is a 7 and I have been experiencing what I call “crushing fatigue.” I’m supplementing with Floradix + Herbs liquid iron supplement and after just one week into it, I think I’m starting to feel a little more zip. I also have hypothyroidism and wonder if there is a relationship there? I can’t wait to feel like myself again! I thought I was depressed and just didn’t know it.

  70. Tina 20 February 2010 at 11:10 pm #

    To Dr. Briffa and all the people who have written comments.

    I have been having trouble with my memory for some time. I’ve also been extremely tired, even after more than 8 hours of sleep. In addition, I find at times that it takes me about 10 seconds to register what someone has said much to the consternation of the people I’m speaking to.

    My husband has found it hard to believe that anyone can be as forgetful and unconcentrated as I am and feels that I am just acting this way to annoy him. This situation has caused quite a strain on our relationship. I myself have also found it unbelievable and was beginning to question my own sanity.

    Several people told me it was due to taking care of 4 small children but having been very active before children, it didn’t make sense that I wouldn’t have more energy as they keep me exercising all day.

    I saw a doctor a year ago with these symptoms thinking that perhaps it was a late onset of post-partum depression. I was told that my iron level was “a little low” but could be easily corrected by eating more red meat. The conclusion: there was nothing physically wrong with me other than I just needed to eat more burgers and steak which was definitely not something I was going to have a problem with.

    A year later, I still have the same symptoms. After having a really bad ‘concentration’ day, I decided to try another doctor.

    I found a wonderful GP who believes in using natural remedies when they’ve proven to work better than their prescription counterparts. He ran several blood tests which showed that my iron level is 3. He said that this was definitely a reason to feel as I was. I cannot express how wonderful it was to be told that not only was I not crazy, but the problem I had was easily correctable and I should probably be back to my old self in a few months.

    In researching iron-deficiencies, I came across your blog and was comforted by the comments and stories of people who have been through similar circumstances. It was more helpful than any of the sites that offered just ‘the facts’.

    I still have questions ie. does milk/cheese hinder iron absorption? As I do not seem to fall into any of the categories of why my iron is low, this is the only reference that I noticed might apply to me. Also, how bad is 3?

    Things that I have learned that have helped me:
    1) iron-deficiency is extremely common
    2) concentrated store-bought iron supplements are not often absorbed well and can cause unpleasant side effects as I learned from personal experience.
    3) health stores may have supplements that are derived from more natural sources and include vitamins that help your body to absorb the iron so you don’t need to take as high of a dose.

    Thank you again everyone. I’m excited to get well and pray you do too.

  71. Margaret Wilde 26 February 2010 at 10:39 pm #

    To Rikki, if Rikki happens to visit this page after so long an interval of time:

    The excess weight that distresses you is sodium and water retention because of taking the prednisone. If you cut down significantly on your intake of salt/sodium/salty food, you will lose some of this fluid retention from your body by way of excreting extra urine, and you will find that you can eat more food. It is your salt intake that you need to reduce, not your food intake.

    I do hope that you will see this suggestion sometime and find it helpful. There is more detailed information on my website.

  72. tcm 18 March 2010 at 1:59 pm #

    This blog has been an absolute wealth of knowledge, thankyou. It in a way has been music to my ears. I thought I was really loosing my marbles.I’m 42 and when my 2nd child hit 1 1/2 my symptoms began, what a nightmare. Ive been battling something which I have now concluded is low ferritin for about 11 1/2 years. The symptoms have been intermittent and include off balance feeling, like I’m lost somewhere in space, fatigue,almost exhaustion,palpitaions,rapid heart beat,cold feet,no inspiration and I think that’s it. Over the years I’ve been to every “ologist”under the sun. I’ve treated each symptom individually, because GP’s always say that if your ferritin is in normal range you should be feeling normal.I feel this is so far from the truth it’s just not funny. Mine has been down to 10 and currerntly sits at 23 and I still feel like crap. The only time I managed to get it up to 90 was when I was on the pill and I also then felt alive. Due to my age I’m now going back on the Mini Pill for a while and dosing up on an iron liquid and will see what happens. It’s certainly a process and you need a lot of patience. Frustration plus and very depressing.I can relate to all of these comments and think ferritin is definetly underrated. I will keep you posted on how my current plan is going. Perservere everyone,you’re not going mad.I’m going to get myself some of those organic chicken livers can hardly wait!!

  73. Deborah 3 April 2010 at 11:09 pm #

    I have been unwell for the last year. Have had fainting episodes, headaches, chest pain, palpitations, numbness, extreme weakness and tiredness (among tons of other things) I have been to see my regular GP over and over again and have been told it is all down to stress/depression and have been prescibed all kinds of anti depressants, have had an angiogram, a brain scan, have had so many “investigations” and my GP has said that “he has come to the end of the road” with me and as everything was normal I should just “live with” my feelings as I was in danger of becoming a hyperchondriac! After every test came back negative and was treated so badly by my GP I was also coping with depression and started to think I was going mad. When it all began he ran a FBC and it came back midly anaemic. Was put on iron for two months and it seemed to have corrected itself but I continued to feel really ill.

    A month ago a new GP started at the surgery and I thought I would try once more and see if I could get some answers from someone completely new. I had been googling my symptoms and I was wondering whether it could be down to some kind of dysautonomia. She said she was not allowed to refer me for testing as it would be “going against” what my regular GP wanted! What she would do was run some more blood tests.

    Normally at my surgery, they make an appointment and contact you if anything turned up. I didn’t hear anything but after two weeks I thought I would just ring to make sure. The results person said my ferritin was slightly out of range. My ferritin was 6! The notes on the results were to await paitent contact which means its nothing unless the patient has any symptoms that need looking into!

    I thought this was ok then (another normal result) and I would contact her about being referred for dysautonomia. When I called her she said, yes I have just glanced at your blood results. You’re not anaemic but I’d like to start you on iron before we talk about referring you. I’m completely confused. I don’t really know what this means. All I know is I feel ill and I don’t really know whether they know what they are doing around there. I’ve been taking the iron for three days and although I don’t expect to feel better yet, I didn’t expect to feel worse. I feel weaker and keep getting a terrible stabbing pain in my left shoulder. I just don’t know what is going on. I don’t feel like I can go round there because of the way they make me feel. Can anyone advise me on whether I’m being treated correctly here and why I might be feeling worse. Thank you in advance of any help.

  74. Silvia 5 April 2010 at 1:14 am #

    Hi, I’m 32 year old woman. Last 2 week I suffer from vertigo especially when rotating. I’ve seen my doctor and I’ve got very peculiar blood test results. Here they are:
    Leukocytes 5.0 x10^9 /L
    Erythrocytes 4.34 x10^12 /L
    Hemoglobin 128 g/L
    Hematocrite .384 L/L
    MCV 88.5 fL
    MCH 29.5 pg
    MCHC 333 g/L
    RDW-KV 12.4%
    Trombocytes 191×10^9 /L
    MPV 8.5 fL

    Glucose 4.8 mmol/L
    Aspartate-aminotrasferase 18 U/L
    Alanine-aminotransferase 15 U/L
    Gama-glutamimiltransferase 16 U/L
    Cholesterol 5.12 mmol/L
    Triglycerides 1.33 mmol/L
    Iron 35.1 micromol/L
    UIBC 37.0 micromol/L
    TIBC 72.1 micromol/L

    Ferritine 15.91 ng/ml

    So, what concerns me is Low feritine and high Iron. Can you tell me what could it be?

    Thank you any help in advance!

  75. tracey laden 8 May 2010 at 11:26 am #

    hi any advice would be greatly appreciated, i am a 45 year old female with chronic fatigue, i sleep about 9 hours every night and can easily have 2 or 3 hours in the afternoon, i literally could fall asleep all day long, i look terrible and people are commenting on how ill i look. i have heavy periods and have recently had blood results with hb – 11 and ferritin – 6 . i have upped by iron intake in my diet greatly.
    i went to see my gp yesterday and he said my blood levels are normal, any advice would be greatly appreciated

  76. lisa 22 May 2010 at 12:28 am #

    hi was wondering if u could help i have a 14mth old boy with iron level 2 and hemoglobin of 6.8 i really really want to know if this is so low i should be worried and asking the doc more questions he is iron extra iron 2ml a day
    thanku so much i am so worried about him

  77. Kelsey 2 June 2010 at 6:30 pm #

    I hadn’t been feeling well for months, was short of breath, sleeping for very long periods of time (20 hours at a time). I actually thought I had mono since I was a teenager and in college. I told my neurologist who I see for migraines and he did some blood work. My iron level came back at 3. I feel fine now after taking iron almost every day for a few months. I really appreciate the fact that the neurologist picked up on this and listened to me. I know this is comonly missed by a lot of physicians.

  78. Kelsey 2 June 2010 at 6:41 pm #

    Lisa-The levels that your son has (iron-2, hemoglobin 6.8) are pretty low. I work in an emergency department and we would usually give a blood transfusion for a hemoglobin lower than 8. Children can be more resiliant and tend to bounce back faster but they also aren’t able to tell us when they are sick. I know you didn’t say if they had a reason for these abnormal values but it probably would be helpful to see a hematologist. They specialize in blood disorders and abnormalities and might be able to tell you more about why this is happening. Usually you would have to see a pediatric hematogist which would be at a children’s hospital or a large hospital that specializes in pediatrics. If you are doubting the doctor I would suggest you get a second opinion or see a specialist. It’s better to be safe than sorry

  79. Natasha 5 July 2010 at 1:04 am #

    Hi, i am female vegertarian and have been for 12 years now, i also eat little dairy and drink soya milk rather than cows milk. For the past few months i have been feeling constantly tired and rundown , i do work full time and have a child but i do make sure i get around 7 hrs sleep a night. I am also epileptic and my siezures have also got also worse over the past 2 years since my son was born. After 6 hours at work im constantly yawning and sometimes end up falling asleep in the office even though i may not have done alot that day. I had the implano (birth control chip) put in a few months back and now im constantly bleeding so does this have something to do with it or is it how i eat?

  80. Debbie 8 August 2010 at 9:01 pm #

    Hi, I am a 53 year old female and have a severe anemia for 18 years. levels ahve been as low as 4.1. I am now at 8.1 but my FE is 7 and my ferrit: 1.7. I have not been prescribed anything but if I don’t have something done how long will it take and if I wait will the levels go back up by themselves? I do go to a health club every morning but only because I am pushed in to it by my roommmate. I is a healthclub nut and works out daily and has a great physique!!! I find I get breatless and dizzy all the time. MY GP said i do have heart palpatations. Should I be working out??

  81. Tina Skellett 10 October 2010 at 2:42 pm #

    I am 54 yrs old, still having regular periods and on estimation losing about 800mls each time. My hb recently was 133 and ferritin 20. Should I take a supplement? Am feeling tired, down and achy.

  82. SusanRae 16 October 2010 at 12:44 am #

    For years I had elevated hematocrit, hemoglobin, and red blood count. I stopped taking a vitamin with iron. The levels dropped to norml but when I had my serum ferritin checked, it was 17. My naturopath wanted me to get the serum ferritin levels up to 75-100, and now I’m at 50. Guess what? Hematocrit, red blood count, and some other iron count are all now high and my regular doctor wants me to stop the iron. I guess I have to choose between low serum ferritin and normal hematocrit and red blood counts, OR normal serum ferritin and really high hematocrit and red blood counts. Has anyone else ever experienced this? Which is more important? I’ve read that high red blood cell counts and hematocrit can lead to “sticky” blood which can cause some serious problems.

    I’m tired all the time, forgetful, and just feel blah. I don’t want to do anything but sleep (I don’t think I’m depressed–been there, done that and this is different). I feel tired after a night’s sleep, even though I got a $4000 sleep dentisty appliance that lets me sleep without waking. I do have sleep apnea but it seems like it shouldn’t be a factor in the tiredness now that I’m able to breathe all night.

    Any ideas?

  83. rh 30 October 2010 at 12:18 am #

    I was told that on a CBC I had “low iron levels” so they ran iron tests, and found 7 ferritin (low is 8), 28 iron (low is 50), 445 transferrin (high is 360), and 4% saturation (low is 15%). I have a mitochondrial disease, which until it was diagnosed appeared like a CFS syndrome.

    I just started iron, but I’ve had trouble with literally passing out. I am concentrating on eating lots of vegetables to keep things running smoothly since I was warned about the iron causing constipation.

    It was a surprise that I had low iron levels, because although I’ve had anemia before, it was when I was a teenager, underweight (over now LOL), and had heavy periods. Now I rarely have periods due to continuous BC to help decrease fatigue from blood loss, and they tend to be light although I did have a two-day heavy episode (still not that bad).

    No red meat due to hemoccult test in the works, and I find it hard to concentrate. Regular doctor says it is likely a GI bleed, but my GI doctor has not gotten back to me (though due to see him beginning of December).

    The scary part is that I have stomach and colon cancer in my family, and I hate the idea of “get the iron levels up and we’ll worry about what’s bleeding next”. I work full-time and cannot take sick days, though my schedule is flexible sometimes so I can get 20 hours of sleep in if I need it once per week.

    It seems like there are a lot of people with anemia out there, and the only difference is that my Hgb has not depleted my iron stores yet (well 12.1 when 12.5 is the low doesn’t seem too bad). Though I had fatigue, we thought it was my chronic neuromuscular disease until regular labs showed a problem.

    I definitely have the hair loss issue, I have very little hair in the back now. It would be wonderful if not only my iron levels came up, but my hair started to grow back!

  84. DN 8 December 2010 at 2:57 am #

    I would like to know how long it should take for ferritin levels to rise.
    I have Crohn’s, I also have uterine fibroids that are being treated (ie. I’m on progesterone to stop any periods – they are really heavy, probably because of the fibroids) and these fibroids are soon to be (hopefully) removed.I am 34 yearsold. How long should it take to restore ferritin levels, because it seems mine are taking ages to replenish. Does anybody know? Sure, maybe it could be dueto the Crohn’s (malabsorption)but i don’t think so. In the space of 4 months ferritin levels have increased from 9 to 14. im not anaemic – any comments?? does anybody know?

  85. v.k.bhatt 25 March 2011 at 1:46 pm #

    Sir,

    Kindly suggest how to make balance between foods which at one side increase iron level in blood and simultaneously increase bad cholestrol like liver and eggs.

  86. Edith 30 April 2011 at 2:02 pm #

    Does anyone know where I can order the mouth test for thyroidism? Thanks

  87. Laura Fowler 18 August 2011 at 5:21 am #

    Hello, I have a Ferritin of 7!!!! I have been battling Hoshimotos Thyriditis for several years now. The things that have helped are : Gluten free diet, Chlorophyl!!!!, and magnesium at night. I also take vegetarian based Iron. My level has gone up to a 12 in a years time. Very slow, but, it is going up. CHHLOROPHYL is amazing at helping give me energy while I fight to get my level of Iron back up. Try it!!!!

  88. jj 27 September 2011 at 11:22 pm #

    hello

    had anemia 2 yrs ago treted with iron tablet over a course of 4 months felt better…4 months ago i started to get the symptons again had bloods done told not anemic proberley anxiou, felt anxious when i had anemia before and that went once i started treatment..anyway just finshed a heavy period feeling really fatigued breahless low energy have cold hands went to drs yesterday and had blood taken i really wished i had read this site before i went as i would ask about ferrin levals especially as they said my bloods were ok 4 months ago ive had a lot of time of work with dizzy spells etc im told i look really pale too. what i want to know is will they test the ferrin leval anyway? or do i have to ask for this test if the bloods come back ok again? many thanks jj

  89. Ann 10 December 2011 at 7:53 pm #

    Wow!!
    I have been reading about ferritin levels since I had m last blood test and my Ferritin level is 431. This is alarming as the high end of the acceptable range is 200. Can someone help?

  90. Kat 31 December 2011 at 10:37 pm #

    I recently had blood work done (on my own since I lack health insurance). It was a complete “wellness” workup where it included a CBC and other testing. From what I gather from my research I am anemic. I have ordered another test for ferritin because I have read that ferritin is what I can use to figure out if my anemia is caused by a lack of an iron rich diet or caused by chronic illness. I have been dealing with fatigue and lack of motivation for years. I was told in 1992, when diagnosed with Mono, that I was “borderline anemic” (Which I now find out is another way of saying you are anemic). So I wonder if I have been anemic for years without knowing it. I have one child and was never told that my iron was low but at the time of pregnancy I was taking prenatals and eating meat. I know my diet has been lacking in the iron rich foods so I am using common sense in determining my anemia but want to make sure before I start supplements. Can anyone help me to figure out (based on my initial testing) just how anemic I may be?
    Here are the parts of the test that deal with blood:
    Carbon Dioxide = 19 mmol/L (ref 20-32)
    Iron,Serum = 19 ug/dL (ref 35-155)
    WBC= 5.3 x10E3/uL (ref interval = 4.0-10.5)
    RBC =3.78 x10E6/uL (ref = 3.8-5.10)
    Hemoglobin= 9.0 g/dL (ref 11.5-15.0)
    Hematocrit = 28.7 % (34.0-44.0)
    MCV = 76 fL (ref 80-98)
    MCH = 23.8 pg (ref 27.0-34.0)
    MCHC = 31.4 g/dL (ref32.0-36.0)
    RDW = 16.3 % (ref 11.7-15.0)
    Platelets = 293 x10E3/uL (ref 140-415)
    Neutrophils = 56 % (ref 40-74)
    Lymphs = 32 % (ref 14-46)
    Monocytes = 8 % (ref 4-13)
    Eos = 3 % (ref 0-7)
    Basos = 1 % (ref 0-3)
    Immature cells
    Neurtophils (absolute) = 3.0 x10E3/uL (ref 1.8-7.8)
    Lymphs (Absoulte) = 1.7 x10E3/uL (ref 0.7-4.5)
    Monocytes(absolute) = 0.4 x10E3/uL (ref 04.-1.0)
    Eos (Absolute) = 0.2 x10E3/uL (ref0.0-0.4)
    Baso (Absolute) = 0.0 x10E3/uL (ref 0.0-0.2)
    Immature Granulocytes = 0
    Immature Grans (Abs) = 0.0

    Can anyone help me to better treat myself using this information? I cannot afford to have the doctor run more expensive tests especially if it is just for an iron deficiency caused by my poor food choices, excessive chocolate eating, pregnancy and an illness back in 92. Thanks in Advance for any help. To be honest I am hoping that my ferritin levels are low so that there is no doubt in my mind about the cause of the anemia. Anyone have similar test results?
    P.S. Is iron, serum different than the ferritin iron serum? Are they two separate tests? Thanks

  91. Anna 1 January 2012 at 3:03 am #

    I have been struggling with iron deficiency for close to two years and it has been one of the most frustrating experiences of my life. I have had to deal with doctors that dismiss my complaints of exhaustion, shortness of breath, slow muscle recovery and bad skin as “normal”, no matter how many times I said that this is NOT normal for me. I, essentially, had to treat myself. Fortunately, I had success switching iron supplements. However, I still have to continue a realtively high dose of elemental iron to maintain my serum ferretin values. I would like to know the cause of my iron deficiency and why it would appear suddenly with no apparent cause. I sometimes worry that because I wasn’t taken seriously, something serious was missed. I feel like the medical system has failed me in this respect.

  92. Bronwyn 7 January 2012 at 2:26 am #

    I had suffered for 10 years with , low energy, exhaustion, rapid and irregular heartbeat, hair loss etc….like so many other people have described here. Year after year, doctor after doctor, they all said, well you are not anemic. None of them bothered to tell me that that my ferritin was low. After reading pages and pages of stories like those above I finally just “lied” to my doctor and said I had been anemic in college, to get them to run a full iron panel. My circulating iron was indeed low, my ferritin was 35 (after self treating for 6 months with ridiculous quantities of beef liver and methyl b12). I finally started taking “Bifera” (a combination of heme-iron and a polysacharide iron designed to raise ferritin levels almost as fast as IV iron) and OMG I have my life back. I have not felt this good since my early 20′s. Floradix helped too but Bifera helped faster. It may take years to get my hair back but at least I have the energy to care for my children again and to be the wife my husband married. I seriously wonder how many people out there have been wrongly diagnosed with CFS when in fact they just desperately need iron.

  93. Sophy 23 February 2012 at 6:42 pm #

    Hello,
    This is quite an old artical, although completely fasinating for me. I was diagnosed with Chronic Fatigue Syndrome aged 12, so 6 years ago now. I am a veggie, and have been my whole life. I have had my ups and downs, being ill for so long so young, and recently moved to a new area. I went to my new GP with low moods, tiredness, falling asleep and a vague dizzyness and hazy feeling when I was tired. I was also feeling dizzy very often and just really down about everything. My new GP is wonderful, she got full bloodworks done on me and the results came back with the lowest iron levels she had seen in someone who was not anemic.

    After reading this artical I feel so hopeful and so happy that I won’t be ill for the rest of my life!

  94. olly 21 May 2012 at 1:10 am #

    hi.
    try hematinic formula by solgar.

  95. Jible 6 July 2012 at 8:49 pm #

    last summer I was having heart palpitations, extreme fatique difficulty thinking. I felt like I was in my own little world. b/c heart disease runs in my family my DR. took me thru a series of EKG’S stress test , ect. everything looked good. however labs came back with my platelet count a little low my wbc low and ferritin @7. it’s been a yr of taking ferrous sulfate and my platelet count is still low wbc still low the hematologist said that I could just naturally be that way and my ferritin is at 54 but she wants me to continue on the iron pills for another yr. everyone seems to say within 3-4 months they’re where they need to be. so why is it taking 2 years to build my ferrritin back up? also when I mentioned the tiredness and palpitations to the dr. she said low ferritin would not cause this, so what was causing it then? luckily after a few months on the iron pills it almost all went away. coincidence?

  96. LM 9 July 2012 at 1:08 am #

    Hi,
    I am 19 years old and when I went to donate blood recently they said my haemoglobin was to low and sent my blood away for testing. My feritin came back at 5, my haemoglobin, MCH and Hematocrit were also lower than the normal range however my platelet counts was extremely high. I showed these results to my GP who has now sent my blood away for more tests. I am currently doing a pre-med year and you get very little sleep as it is. I have heard chronic fatigue and low iron/ferritin can decrease cognitive performance. I am currently not in a position where I can be disadvantaged in such a way. I can only afford to have 6 hours sleep max however my body is telling me other wise. I have heard that it can take months to a year to restore levels however I need to be back on my feet now. Any suggestions??? Thanks.

  97. Giada van Wyk 31 July 2012 at 3:01 am #

    Daughter has fatigue, took floradex but not helping. Dr is there something else she can take? Her iron levels are low.

  98. Chris 30 August 2012 at 6:45 pm #

    For people who can’t raise their ferritin levels you may need to also supplement manganese with the iron as it appears to be involved with ferritin as well.

    It took 50mg/day of manganese to normalize my manganese blood level. Most doctors would consider that to be an excessive amount but in my case it was what was needed for whatever reason.

  99. Steph 15 December 2012 at 12:24 am #

    I’ve recently undergone treatment for low ferritin levels – mine were at 8. I had injections weekly for 5 weeks (as well as injections for a B12 deficiency and tablets for VitD deficiency). Blood tests came back as ferritin 96 last night, and I’m over the moon.

    My doctor told me to not even bother with iron supplements – my body simply doesn’t absorb it through food, so it wouldn’t absorb much through oral supplements and would just make me feel sick. Anyone who is struggling to get levels up by taking oral supplements – ask your doctor about iron infusions.

  100. Nur 15 January 2013 at 1:30 pm #

    Reading all these posts confirms what I have been going through. It is clear that for many women despite a near normal Hb level, ferritin levels below 60 can cause heart palpitations, fatigue, hair loss, memory loss. After all the gastro investigations, I was diagnosed with IBS which makes oral iron absorption impossible (and because of OBS, oral iron caused nausea, constipation, dirrohea, distension etc) , so I only feel better with intra-venous iron but almost impossible to persuade a GP to give me one. Any tips please on how to get the injections?

  101. Sy 26 February 2013 at 3:08 pm #

    I wish more doctors were aware of this; furthermore I wish doctors were made aware of the effects of putting such women on thyroid hormone replacement. My Ferritin level last tested at 6.2. This blood draw was taken while I was taking 150mg of Feramax daily + eating iron rich foods such as liver in an effort to raise my levels. Add Synthroid to the mix and I feel like me heart is going to beat out of my chest. Yesterday, when I told my doctor he said “you can’t be having palpitations because your TSH is not suppressed (1.9) and you’re just barely anemic”. He prescribed 20 mg of Celexa and said he will send me to see a psychiatrist if im still tired & depressed when I next see him in March.

  102. Nur 27 February 2013 at 6:30 pm #

    Dear Sy,

    I feel for you. I finally manged to persuade my GP to consider iron injections on the basis of getting the cardiologist I had seen (because my heart was beating wildly and my ankles swelling badly) to call my GP and speak to her about my particular sensitivity when ferritin levels became low. Below are some articles about the link between low ferritin and fatigue which you coul look into and cite. Good luck.

    http://www.ncbi.nlm.nih.gov/pubmed/11190004/

    http://www..cmaj.ca/content/early/2012/07,cmaj.ca

  103. Nur 27 February 2013 at 6:31 pm #

    Sorry here is another fuller citation of the article

    http://www.cmaj.ca/content/early/2012/07/09/cmaj.110950.full.pdf

  104. Robbin 16 April 2014 at 12:15 am #

    I have a history of low ferritin levels and it seems my body doesn’t absorb iron through the gi track. About every 18 mo I get a series of iron infusions which are very expensive and time consuming. I find that when my ferritin level drops, as now it is a 6, my muscles fatigue extremely easily. A short walk that would normally not bother me makes my leg muscles burn and is very painful. It is all the muscles u use to walk. Not just one specific group. Is this related? No one has answered my question. Is is lack of oxygen in the muscle since I have very little iron stored? What do you think?

  105. sarah 22 August 2014 at 3:36 pm #

    Thank you for this helpful article.

    I was doing a lot of exercise and then when I got my period I completely burned out.
    After having a lot of different tests from the doctor, the one that was low was iron.
    It was only 16. I was feeling so rough, just completely burned out. Having to sleep a lot even in the afternoon because I just could not stay awake. Also my muscles became so sore, especially my legs. After a few months my energy was gradually returning. I was feeling better and so I went swimming and started doing normal things again. That is when I burned out all over again! Had my levels retested and they were at 23.

    I looked into this more and what I have found out is interesting
    Exercise uses up iron. I had read that when you exercise your need for iron is increased, but had not thought it through that it follows that exercise reduces iron.
    So, if you are a women who menstruates and exercises your need for iron is greater.

    I have been suffering since this began in March (now end of august 5ths later).
    Why does it take so long to build up iron stores?
    My doctor said I cant have the injections because I am not anemic
    But I feel so bad, just ache all over, feel so weak, feel like I have run a marathon.

    I would like to know is, since this is such a common problem for a lot of women,
    Why hasn’t a better solution come to light?
    Some sites say it can take 6 to 12 months to build up iron stores.

    Why does it take so long to build up iron stores?

    Are there factors that make it take longer?

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