Who has had low ferritin and what did you do about it?

[frosty18]

First find out the cause of your low ferritin. Mine was at a 4. I was referred to a hematologist who insisted I get a colonoscopy, endoscopy, and a full gyno workup. I had already done all these by the time I saw him, and was confident it was from heavy periods. He still wanted me to get a capsule endoscopy to see if the other tests missed anything. I was scheduled for a hysterectomy, so I put off the capsule endoscopy. I got several iron infusions, but my ferritin was back at 4 after 6 months. I finally got a hysterectomy and more iron infusions after the surgery. A year later, my levels are normal. However, had they gone down again I would have definitely done the capsule endoscopy. Make an appointment with a GI and and a hematologist. Good luck and hope this gets resolved soon!

 

[A-Train]

I've also had my ferritin as low as 4. Had to do iron infusions just about every year since. I agree with other posts though, if you are a male you definitely need to have that checked out. Best of luck to you!

 

[Rolltide61]

Yes they check your bowel movements first (fun to scoop at home 😜)

Yeah I wouldn't do that. I'd just head over to the lab techs house while drinking my second cup of morning coffee.

 

[RaveBaddie]

Yeah I wouldn't do that. I'd just head over to the lab techs house while drinking my second cup of morning coffee.

Yeah yeah yeah I meant 'check your stool'.
English is not my first language 😉

 

[ambot88]

My feratin was 4 - I had an iron transfusion and felt MUCH better afterwards. right after the transfusion it was like 20 and now it's 11 but they won't transfuse me again until it hits 5 which is pissing me off. Idk why I don't have iron in me, it's weird. None of the iron pills I've tried have helped.

 

[PineCone99]

Mine was 11. I fixed it by getting a Mirena which stopped the (heavy) periods entirely. Problem solved.

 

[cldfront]

I just want to repeat and emphasise the message, as nearly all these posts are about supplemental iron, that unless you are a menstruating female , iron deficiency needs to be investigated. Or at minimum have a doctor make the assessment of whether it is needed or not.

The reason this is important is that many gastrointestinal cancers present as anemia or low iron levels, due to low grade bleeding from colon or stomach cancer. This is definitely not the most likely cause, but must at least be considered and investigated if the person is in the right age/sex group for this to be a reasonable possibility. Treating this presentation of a gut cancer with iron is how you get to end stage disease before it gets diagnosed. Things like peptic ulcers or coeliac disease also need to be diagnosed.

Most doctors ordering the test are going to follow a low ferritin up with what they think is required, and this will be very different depending on age and sex. There are a very large number of reasons iron stores can be low, but treating it only happens after you know why it is low. And then you can debate what iron replacement options are best.

I know this wasn't your intention, but I feel compelled to say that somehow I feel like women are getting the short end of the medical stick here. Is it not possible for menstruating females to get colon or stomach cancer? We're just going to only look into it for men, eh?

Anyway, I'm mostly supremely annoyed with paying over $800/mo for so. many. years. for medical insurance that gets me one appointment a year with a PA who doesn't care why my iron and ferritin are incredibly low and I have to buy my peptides on the grey market. It sometimes spills over.

 

[lessthanhalf]

You are of course correct. But in terms of the probabilities, a 15-45 yo female with low iron, the most common cause is going to be menses related, they just need more iron because of this, , so it gets depleted much more often, and obviously this is not the case in men, so a more serious cause is substantially more likely in men or non menstruating females. But this type of probabalistic logic will cause women with early GI cancers to be missed for longer. But you cannot do every test in every patient, that has its own set of consequences like false positives, so tests are more justified when the probability of finding a treatable cause is high enough to justify the costs and possible risks. I am not sure ideal answers exist for this type of problem. And yes the US does tend to have pretty ordinary primary care and preventive medicine, unless you are wealthy.

 

[tul9033]

I just want to repeat and emphasise the message, as nearly all these posts are about supplemental iron, that unless you are a menstruating female , iron deficiency needs to be investigated. Or at minimum have a doctor make the assessment of whether it is needed or not.

The reason this is important is that many gastrointestinal cancers present as anemia or low iron levels, due to low grade bleeding from colon or stomach cancer. This is definitely not the most likely cause, but must at least be considered and investigated if the person is in the right age/sex group for this to be a reasonable possibility. Treating this presentation of a gut cancer with iron is how you get to end stage disease before it gets diagnosed. Things like peptic ulcers or coeliac disease also need to be diagnosed.

Most doctors ordering the test are going to follow a low ferritin up with what they think is required, and this will be very different depending on age and sex. There are a very large number of reasons iron stores can be low, but treating it only happens after you know why it is low. And then you can debate what iron replacement options are best.

Was going to comment the same thing. Anemia can be something very serious which is best evaluated by your Dr.
Whole or red blood donations are also a common contributor.
With all that being said, when I got low iron from blood donations, I found Naturesplus hema-plex iron supplement to be the best to boost my iron levels verified with blood testing.

​

 

[Cannonball72]

"Your Ferritin is 20.3 ng/mL, which is below the optimal range and indicates low iron stores. Low ferritin can cause fatigue, reduced exercise capacity, and make weight-loss and muscle-building harder despite normal hemoglobin. Given your goals and TRT/peptide use, consider adjusting iron intake (dietary heme sources or an iron supplement) and rechecking ferritin after a few months of treatment"

Have you donated blood recently?

I am on TRT, have been donating regularly for years. Timing of blood work was 1 week after my last notation.

It pretty much explains the delta between iron and ferritin for me.

Also tells me I need to dial back on the donations as I don’t have any TRT related issues that actually require the donation.

FWIW, I uploaded all my bloodwork, pharma schedule (dosage and frequency), workout history, blood donation history, weigh-in history into Claude. Asked it to “assess”.

Any anomalies in my data were pretty easily explained, things I need to focus on, things that were a result of exercise/timing and etc.

Was a fantastic way to prep for discussion with the Dr. who will likely only see the blood data 5 mins before he/she sees me, won’t bother asking all the details for the complete picture was able to Laos

 

[HidingInPlainView]

I have low ferritin as well and some sort of iron binding issue, and have had this problems since before taking TRT, before taking a GLP, and before my peptide journey. I have already been down the rabbit hole, upper/lower GI scope, oral iron, fecal hemoglobin tests, unine tests, genetic tests, modification of diet, supplements, changed cookware, labwork, imaging, all of it. 3 years later and thousands in lifestyle and diagnostic testing the new answer is I get an iron infusion once a year. Honestly it's not a big deal, my TRT I/M injections sometimes hurt more than the IV for iron infusion. Typically takes 45minutes and costs me about $50 total. Completely worth it.

 

[FlowerFairy]

You are of course correct. But in terms of the probabilities, a 15-45 yo female with low iron, the most common cause is going to be menses related, they just need more iron because of this, , so it gets depleted much more often, and obviously this is not the case in men, so a more serious cause is substantially more likely in men or non menstruating females. But this type of probabalistic logic will cause women with early GI cancers to be missed for longer. But you cannot do every test in every patient, that has its own set of consequences like false positives, so tests are more justified when the probability of finding a treatable cause is high enough to justify the costs and possible risks. I am not sure ideal answers exist for this type of problem. And yes the US does tend to have pretty ordinary primary care and preventive medicine, unless you are wealthy.

I’m 63. I’ve never had heavy menses, but I’ve not had menses for 20 years.