Any body else have low blood iron levels without iron-deficiency anemia?

Speakeasy76
Speakeasy76 Posts: 961 Member
I had my iron checked (ferritin, iron, iron-binding capacity and % saturation) back in February by my rheumatologist. Of these, only my iron was below the normal range, but all the other numbers were in the low average (like 2-5 points above for some). When I met with the dr again in April, she recommended OTC ferrous sulfate supplementation. Gee--thanks for waiting almost 4 months to tell me, doc. I felt very rushed in the appt (also got a cortisone shot that day), and was not thinking too much about the supplement, so I didn't ask about recommendations or dosing (which I can ask). FYI, my hemoglobin is always normal, so it's not technically anemia.

I haven't started yet, mainly because I am worried about constipation as I'm already prone to that, anyway, despite a diet with plenty of fiber and water. I'm actually on an elimination diet currently partly because of that, so am not eating as wide variety of foods as I normally do (and currently no red meat). Does anyone take an OTC supplement that they've been happy with?

Replies

  • yirara
    yirara Posts: 9,943 Member
    Depending on your lab ranges there's a very good change that you are actually properly anemic. Here, a ferritin of 12 is considered still normal. Many people I know can't walk up stairs anymore below 20, and hospitals consider below 35 to be too low. Just a bit of inflammation somewhere will increase ferritin readings anyway. Normally, serum iron actually goes down when storage iron (ferritin) is depleted. Thus I would listen to your doctor and try it. Maybe start with just one tablet of high dose iron every second day or so, and then increase. Also take something with vitamin C with it. Absorption will be better, and food high in Vitamin C also has the tendency to loosen stool.
  • jeri30
    jeri30 Posts: 86 Member
    I suggest reading/researching the following:

    This one talks about iron rich foods:

    https://www.healthline.com/nutrition/healthy-iron-rich-foods#8.-Turkey

    This one talks about how to increase iron absorption from what you eat/take:

    https://www.healthline.com/nutrition/increase-iron-absorption#TOC_TITLE_HDR_6

    Like taking/eating vitamin c rich foods can help increase iron absorption but calcium intake may decrease it when taken at the same time.

    I also suggest reading about vitamin b, b12 and b9, deficiencies can also be a factor in anemia/low iron. Was this checked?

    https://www.nhsinform.scot/illnesses-and-conditions/nutritional/vitamin-b12-or-folate-deficiency-anaemia

    I couldn't take those iron supplements. They made my stomach hurt and my ibs worse. Turned out supplementing with the b vitamins raised my iron without the need for the iron supplement.

    Hope this helps.

  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    yirara wrote: »
    Depending on your lab ranges there's a very good change that you are actually properly anemic. Here, a ferritin of 12 is considered still normal. Many people I know can't walk up stairs anymore below 20, and hospitals consider below 35 to be too low. Just a bit of inflammation somewhere will increase ferritin readings anyway. Normally, serum iron actually goes down when storage iron (ferritin) is depleted. Thus I would listen to your doctor and try it. Maybe start with just one tablet of high dose iron every second day or so, and then increase. Also take something with vitamin C with it. Absorption will be better, and food high in Vitamin C also has the tendency to loosen stool.

    Interesting, my ferritin WAS 12, and the normal values are 8-252.

    I'm wondering if the fact that I donated blood about a month prior had anything to do with it, although I'm not a regular blood donor.
  • Beverly2Hansen
    Beverly2Hansen Posts: 378 Member
    I'm low normal and found extreme physical improvement from taking an iron supplement. I don't take it every day but every other day really helps and everyday during my menstration week. The nice thing is if you get extra backed up you can take it less often.
  • anna_lowe
    anna_lowe Posts: 39 Member
    do you happen to drink tea?
  • kshama2001
    kshama2001 Posts: 28,052 Member
    All of the forms of iron I've ever received from the VA were awful, and one sent me to Urgent Care with the worst pain in my life.

    However, I have no problems with iron bisglycinate. Ex:

    https://smile.amazon.com/Solgar-Gentle-Iron-Vegetable-Capsules/dp/B00013Z0QA/

    It's non-constipating anyway, plus I take it with powdered buffered vitamin C to bowel tolerance, so no problems there.
  • yirara
    yirara Posts: 9,943 Member
    yirara wrote: »
    Depending on your lab ranges there's a very good change that you are actually properly anemic. Here, a ferritin of 12 is considered still normal. Many people I know can't walk up stairs anymore below 20, and hospitals consider below 35 to be too low. Just a bit of inflammation somewhere will increase ferritin readings anyway. Normally, serum iron actually goes down when storage iron (ferritin) is depleted. Thus I would listen to your doctor and try it. Maybe start with just one tablet of high dose iron every second day or so, and then increase. Also take something with vitamin C with it. Absorption will be better, and food high in Vitamin C also has the tendency to loosen stool.

    Interesting, my ferritin WAS 12, and the normal values are 8-252.

    I'm wondering if the fact that I donated blood about a month prior had anything to do with it, although I'm not a regular blood donor.

    Yikes! People would probably be given iron infusions with a ferritin of 8 here! (while doctors are generally not fast to act) What kind of lab ranges of horrors does your area have!
  • yirara
    yirara Posts: 9,943 Member
    kshama2001 wrote: »
    All of the forms of iron I've ever received from the VA were awful, and one sent me to Urgent Care with the worst pain in my life.

    However, I have no problems with iron bisglycinate. Ex:

    https://smile.amazon.com/Solgar-Gentle-Iron-Vegetable-Capsules/dp/B00013Z0QA/

    It's non-constipating anyway, plus I take it with powdered buffered vitamin C to bowel tolerance, so no problems there.

    TO is very low in iron, and I'm not sure this would get her iron up. It might be good to start though.
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    anna_lowe wrote: »
    do you happen to drink tea?

    Not really, and because of the elimination diet I'm own I won't be able to add that in for another 3 weeks at least.
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    yirara wrote: »
    yirara wrote: »
    Depending on your lab ranges there's a very good change that you are actually properly anemic. Here, a ferritin of 12 is considered still normal. Many people I know can't walk up stairs anymore below 20, and hospitals consider below 35 to be too low. Just a bit of inflammation somewhere will increase ferritin readings anyway. Normally, serum iron actually goes down when storage iron (ferritin) is depleted. Thus I would listen to your doctor and try it. Maybe start with just one tablet of high dose iron every second day or so, and then increase. Also take something with vitamin C with it. Absorption will be better, and food high in Vitamin C also has the tendency to loosen stool.

    Interesting, my ferritin WAS 12, and the normal values are 8-252.

    I'm wondering if the fact that I donated blood about a month prior had anything to do with it, although I'm not a regular blood donor.

    Yikes! People would probably be given iron infusions with a ferritin of 8 here! (while doctors are generally not fast to act) What kind of lab ranges of horrors does your area have!

    Oh, wow! I live in northern Illinois (Chicago suburbs), but I've noticed even among different doctors/lab agencies the normal ranges for various tests can differ. What's even more frustrating is that apparently this doctor didn't even check the lab results until my appointment more than 3 months later. I got the results immediately, but didn't hear anything from the doctor. I'm going to be getting a supplement sooner rather than later and just try to manage the side effects.
  • yirara
    yirara Posts: 9,943 Member
    It's not a given you get side effects from iron. Many people don't, including me btw. When my iron is low again and I need to supplement again I usually don't on days where I go out because I drink less then. But that's all, really. Iron should probably be taken on an empty stomach, but maybe start with meals.
  • gothchiq
    gothchiq Posts: 4,590 Member
    I always have slightly low hematocrit regardless of normal vitamins, other minerals, electrolytes, blah blah. Second the rec for ferrous bisglycinate and I'd say to stay away from ferrous fumarate which is very, very intestinally clogging.
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    edited May 2021
    Just took my first dose of a slow-release Ferrous Sulfate. I took a half-dose and am taking it with grapefruit juice, since I currently can't eat oranges.

    If there is any kind of stomach/digestive side-effect with a medication/vitamin, it's pretty much a guarantee I'll get them, unfortunately.

    I'm also realizing how my fatigue and what I consider to be slow progress with my strength training may be related to the iron. I brush off a lot of symptoms as not sleeping well or enough, but lately I've noticed a sore tongue at times when I'm eating, which I just realized is a symptom of low iron.
  • kshama2001
    kshama2001 Posts: 28,052 Member
    yirara wrote: »
    Depending on your lab ranges there's a very good change that you are actually properly anemic. Here, a ferritin of 12 is considered still normal. Many people I know can't walk up stairs anymore below 20, and hospitals consider below 35 to be too low. Just a bit of inflammation somewhere will increase ferritin readings anyway. Normally, serum iron actually goes down when storage iron (ferritin) is depleted. Thus I would listen to your doctor and try it. Maybe start with just one tablet of high dose iron every second day or so, and then increase. Also take something with vitamin C with it. Absorption will be better, and food high in Vitamin C also has the tendency to loosen stool.

    Interesting, my ferritin WAS 12, and the normal values are 8-252.

    I'm wondering if the fact that I donated blood about a month prior had anything to do with it, although I'm not a regular blood donor.

    Hmm, in March my ferritin was 9.5 and my doctor ordered another round of infusions.

    I felt fine, as opposed to when it was 1.7 last June and my doctor sent me to the emergency room after getting that result. There I got a blood transfusion, which works faster, and I did indeed feel better after a few days. (Only to end up in Urgent Care due to the over-prescription of oral ferrous gluconate.)
  • kshama2001
    kshama2001 Posts: 28,052 Member
    yirara wrote: »
    kshama2001 wrote: »
    All of the forms of iron I've ever received from the VA were awful, and one sent me to Urgent Care with the worst pain in my life.

    However, I have no problems with iron bisglycinate. Ex:

    https://smile.amazon.com/Solgar-Gentle-Iron-Vegetable-Capsules/dp/B00013Z0QA/

    It's non-constipating anyway, plus I take it with powdered buffered vitamin C to bowel tolerance, so no problems there.

    TO is very low in iron, and I'm not sure this would get her iron up. It might be good to start though.

    Some forms of iron list the amount of elemental iron, and some list something else. My ferrous gluconate says 324 mg, but it provides 36 mg of elemental iron. The three brands of iron bisglycinate I use all appear to be listing the amount of elemental iron only.

    I take two 25 elemental iron during my period and one 36 on the other days. This is enough to keep my anemia under control, except when my (already horrendous) menstrual bleeding takes a turn for the worse, as it did last spring, when I had one 3 week long period and another one that had gone on for about 5 weeks until I stopped it with high doses of progesterone.
  • ninerbuff
    ninerbuff Posts: 48,985 Member
    Just had blood drawn yesterday and got the results.

    Ferritin mine 16 ng/mL normal range 22 - 365 ng/mL


    Iron 148 ug/dL 50 - 212 ug/dL

    Iron binding capacity, unsaturated 207 ug/dL 110 - 370 ug/dL
    This test was developed and its performance characteristics determined by TPMG
    Regional Laboratory. It has not been cleared or approved by the FDA. The
    laboratory is regulated under CLIA as qualified to perform high-complexity
    testing. This test is used for clinical purposes. It should not be regarded as
    investigational or for research.

    Total iron binding capacity 355 ug/dL 228 - 428 ug/dL

    Transferrin % saturation 42 % 14 - 57 %

    Apparently I have a bleed in my intestines somewhere. But I reflect no symptoms of anemia. I'm never fatigued and have lots of energy.



    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition

    9285851.png
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    ninerbuff wrote: »
    Just had blood drawn yesterday and got the results.

    Ferritin mine 16 ng/mL normal range 22 - 365 ng/mL


    Iron 148 ug/dL 50 - 212 ug/dL

    Iron binding capacity, unsaturated 207 ug/dL 110 - 370 ug/dL
    This test was developed and its performance characteristics determined by TPMG
    Regional Laboratory. It has not been cleared or approved by the FDA. The
    laboratory is regulated under CLIA as qualified to perform high-complexity
    testing. This test is used for clinical purposes. It should not be regarded as
    investigational or for research.

    Total iron binding capacity 355 ug/dL 228 - 428 ug/dL

    Transferrin % saturation 42 % 14 - 57 %

    Apparently I have a bleed in my intestines somewhere. But I reflect no symptoms of anemia. I'm never fatigued and have lots of energy.



    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition

    9285851.png

    I actually felt like I had a good amount of energy unless I didn't sleep well or enough UNTIL a few weeks ago. Today around 11:30 I felt like I could've taken a nap. Hope you figure out whatever is causing the issue and get it resolved.
  • gothchiq
    gothchiq Posts: 4,590 Member
    Intestinal bleeding... there are various possibilities. I wonder if a colonoscopy will be the next thing your doctor orders.
  • yirara
    yirara Posts: 9,943 Member
    edited May 2021
    Hmm.. an odd feeling on the tongue, pain or swelling sounds more like vitamin B12 deficiency. Did your doctor also test for that? And if he did, were you off all B12 for at least 4 months? That's including multivitamins and fortified cereals. Also, how's folate? B12 levels might be normal, but if folate is too low then it won't get utilized properly.
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    yirara wrote: »
    Hmm.. an odd feeling on the tongue, pain or swelling sounds more like vitamin B12 deficiency. Did your doctor also test for that? And if he did, were you off all B12 for at least 4 months? That's including multivitamins and fortified cereals. Also, how's folate? B12 levels might be normal, but if folate is too low then it won't get utilized properly.

    Ironically, my B12 was high, but I hadn't been off my mulit-vitamin for 4 months at that point (athough wasn't on it when tested and am not taking it now). My magnesium was a little high, too. Folate was well above the normal (18.3).

    I've pretty much determined both my newish PCP and this rheumatologist don't really look at the lab results until my appointment (which could be months later) and/or pretty much ignore any blood test results that might be out of the normal range if it's not something like cholesterol or thyroid (which are always fine anyway). I thought one of the reasons we get blood tests is to catch anything that may be off before we might be aware of any symptoms.
  • ninerbuff
    ninerbuff Posts: 48,985 Member
    edited May 2021
    gothchiq wrote: »
    Intestinal bleeding... there are various possibilities. I wonder if a colonoscopy will be the next thing your doctor orders.
    Had both colonoscopy and endoscopy with no bleeds. I did swallow a pill camera about 6 months ago, but nothing revealing. So I may have to do it again.


    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition

    9285851.png


  • Priasmama416
    Priasmama416 Posts: 103 Member
    I have been anemic all my life, so much that while pregnant, I had to have infusions. I take a centrum complete vitamin every morning, it has 100% of the daily iron value. I also eat iron rice foods to add to , but I eat the foods that also high in fiber( i.e. spinach, oats) the fiber helps combat constipation. Plus drink plenty of water.
  • Beverly2Hansen
    Beverly2Hansen Posts: 378 Member
    yirara wrote: »
    Hmm.. an odd feeling on the tongue, pain or swelling sounds more like vitamin B12 deficiency. Did your doctor also test for that? And if he did, were you off all B12 for at least 4 months? That's including multivitamins and fortified cereals. Also, how's folate? B12 levels might be normal, but if folate is too low then it won't get utilized properly.

    This is a great observation. I do not absorb vitamin B without L Methylfolate and was misdiagnosed numerous times prior to getting a saliva test that showed my B12 was low because on my own I don't absorb enough naturally. My symptoms mimic severe anemia but are in some ways worse. I had the feeling of suffocation upon waking and the back of my tongue and my throat felt odd. It is notable that I have much lower than average iron as well so they thought my symptoms were anemia related. So yeah this comment is super important for people like me.
  • yirara
    yirara Posts: 9,943 Member
    yirara wrote: »
    Hmm.. an odd feeling on the tongue, pain or swelling sounds more like vitamin B12 deficiency. Did your doctor also test for that? And if he did, were you off all B12 for at least 4 months? That's including multivitamins and fortified cereals. Also, how's folate? B12 levels might be normal, but if folate is too low then it won't get utilized properly.

    This is a great observation. I do not absorb vitamin B without L Methylfolate and was misdiagnosed numerous times prior to getting a saliva test that showed my B12 was low because on my own I don't absorb enough naturally. My symptoms mimic severe anemia but are in some ways worse. I had the feeling of suffocation upon waking and the back of my tongue and my throat felt odd. It is notable that I have much lower than average iron as well so they thought my symptoms were anemia related. So yeah this comment is super important for people like me.

    I hope you're feeling better now <3
    The annoying thing with B12 deficiency is that if only a tiny bit gets absorbed then serum levels go up big time. But it's not enough to heal the damage. Also, the serum test only tests for all B12, while the body needs two types of active B12 that needs to be converted. The blood test doesn't show how much of that is present. It's a *kitten* disease, with doctors often having a very poor knowledge about. But it's only women that are mostly affected. So not important (sorry, being a bit cynical due to living with this for a looong time and moving frequently).
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    I went to my regular dr. yesterday for something unrelated, and I had him test my blood iron level while I was there. Got the results today, and my blood iron level, % saturation and binding capacity were within the normal limits. My blood iron level went from 42 to 113, % saturation went from 17 to 42, but binding capacity went from 276 to 267--which I guess makes sense since I now have more iron. I've only been on the Ferrous Sulfate for about a week. I was surprised it worked that quickly. The last time it was tested was back in February (about a month after a blood donation), so it's possible it had already risen before then.