FlowerFairy
Explorer
Red meat is something I really enjoy. If only eating it were enough on its own!
Low ferritin: what worked for you?
- Thread starter jason370
- Start date
laansasa
Explorer
The results came in today. I already have a high-quality vitamin C that I use. I didn't realize calcium and iron shouldn't be taken together, so that's helpful. Really appreciate the tips!
FlowerFairy
Explorer
No problem at all—everything I know comes from my background in nursing, from having weight loss surgery, and from my time working with an endocrinologist. Whenever something might help make life a little easier for someone, I’m happy to pass it along!
laansasa
Explorer
Thank you so much! The endocrinologist and PCP I see are awful. The only one who is decent is my radiologist, though his hands are tied. If I request them, he'll order labs that the other doctors refuse to, but because labwork follow-ups aren't his responsibility, he can't handle those. Still, he makes an effort.
FlowerFairy
Explorer
Finding out that ferrous sulfate had been my regimen at 3 tablets 3x/day despite my body being unable to absorb it—for 10 YEARS—left me furious. Only after a hematologist visit did polysaccharide iron come to my attention. It crosses my mind all the time now, whenever I see older patients prescribed FeSO4 even though their stomach acid is too diminished for it to do any good. During my time in hospice, iron wasn't something we ever provided, so I would mention polysaccharide iron and leave the choice up to them.
CathyGoesFar
Explorer
When a man has low iron and there's no clear dietary reason behind it, that situation calls for a workup. In my case the cause is obvious: losing weight threw my cycle into chaos, so now I bleed for weeks on end at intervals.
I've cycled through several formulations, and at this point I take Ritual Iron Bisglycinate on an every-other-day schedule. I used to assume those "pretty" pills were just marketing, yet my labs say they outperform even other bisglycinate products. The price tag is noticeably higher
. Plenty of voices online insist heme iron is the only way to go, but for me the non-heme options are delivering the strongest results.
My routine: dose every other day, first thing after waking, with nothing in my stomach, then wait a minimum of 1 more hour before any food. So many things can get in the way of absorption that I'd rather sidestep the whole issue. Alongside meals I take vitamin C or eat something rich in vitamin C. Even if you've got potent absorption blockers in your system, vitamin C neutralizes the problem.
At this stage I'm thoroughly fed up with doctors who keep handing out the iron forms that are hardest on the gut and poorest at being absorbed, dosed in the least effective manner possible. Anemia and iron deficiency are extremely widespread. There's simply no excuse for such poor management.
I've cycled through several formulations, and at this point I take Ritual Iron Bisglycinate on an every-other-day schedule. I used to assume those "pretty" pills were just marketing, yet my labs say they outperform even other bisglycinate products. The price tag is noticeably higher
. Plenty of voices online insist heme iron is the only way to go, but for me the non-heme options are delivering the strongest results.My routine: dose every other day, first thing after waking, with nothing in my stomach, then wait a minimum of 1 more hour before any food. So many things can get in the way of absorption that I'd rather sidestep the whole issue. Alongside meals I take vitamin C or eat something rich in vitamin C. Even if you've got potent absorption blockers in your system, vitamin C neutralizes the problem.
At this stage I'm thoroughly fed up with doctors who keep handing out the iron forms that are hardest on the gut and poorest at being absorbed, dosed in the least effective manner possible. Anemia and iron deficiency are extremely widespread. There's simply no excuse for such poor management.
RaveBaddie
Explorer
My own doctor was equally clueless when it came to iron supplementation.CathyGoesFar said:
When a man has low iron and there's no clear dietary reason behind it, that situation calls for a workup. In my case the cause is obvious: losing weight threw my cycle into chaos, so now I bleed for weeks on end at intervals.
I've cycled through several formulations, and at this point I take Ritual Iron Bisglycinate on an every-other-day schedule. I used to assume those "pretty" pills were just marketing, yet my labs say they outperform even other bisglycinate products. The price tag is noticeably higher
My routine: dose every other day, first thing after waking, with nothing in my stomach, then wait a minimum of 1 more hour before any food. So many things can get in the way of absorption that I'd rather sidestep the whole issue. Alongside meals I take vitamin C or eat something rich in vitamin C. Even if you've got potent absorption blockers in your system, vitamin C neutralizes the problem.
At this stage I'm thoroughly fed up with doctors who keep handing out the iron forms that are hardest on the gut and poorest at being absorbed, dosed in the least effective manner possible. Anemia and iron deficiency are extremely widespread. There's simply no excuse for such poor management.
I tried to give blood at the bloodbank, and my HB came back at 5.3. That was the moment I learned I was severely anemic. Sure, I felt tired, but I was also raising 2 small kids, so I had no idea anything was actually wrong.
After further bloodwork, my GP wanted me on iron supplements. Before the appointment I looked into it myself and asked whether I could use a double dose of iron bisglycinate rather than whatever other type he had prescribed. Neither the doctor NOR the apothecary could tell me whether iron bisglycinate matched their standard protocol!
Their advice was to stick with the protocol (I dislike protocols, since every body is different), and I said no.
At this point my ferritin is climbing, but extremely slowly, and my smaller stomach (bariatric sleeve gastrectomy) isn't making it any easier.
I love this forum and everyone here helping each other pick up new things!
lessthanhalf
Explorer
I want to restate and underline something, since almost every thread here centers on taking iron supplements: if the person is not a menstruating female, then a low iron finding has to be worked up. At the very least, a physician should decide whether that step is necessary.
Why does this matter? A lot of GI cancers first show up as anemia or low iron, because of slow bleeding from a tumor in the colon or stomach. 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. If you simply give iron for this kind of presentation of a gut cancer, that is how it reaches end stage before anyone diagnoses it. Peptic ulcers or coeliac disease are other conditions that also need to be identified.
When most doctors order the test, they will act on a low ferritin according to what they judge necessary, and that judgment will differ a great deal by age and sex. Iron stores can be low for a very large number of reasons, but you only treat it once you know the reason. Only after that does it make sense to argue over which iron replacement option is best.
Why does this matter? A lot of GI cancers first show up as anemia or low iron, because of slow bleeding from a tumor in the colon or stomach. 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. If you simply give iron for this kind of presentation of a gut cancer, that is how it reaches end stage before anyone diagnoses it. Peptic ulcers or coeliac disease are other conditions that also need to be identified.
When most doctors order the test, they will act on a low ferritin according to what they judge necessary, and that judgment will differ a great deal by age and sex. Iron stores can be low for a very large number of reasons, but you only treat it once you know the reason. Only after that does it make sense to argue over which iron replacement option is best.
leeann82
Explorer
My endocrinologist started me on Palafer, 2 doses per day. Because my stomach is sensitive after bypass, it's been really easy on me. I pair it with blood builders and vitamin C. My levels are still toward the low side, but they're no longer at 4, which is where I was last year when my blood looked brown and murky...
RaveBaddie
Explorer
Absolutely! This matters a ton! I'm completely on board with what you're saying!
Don't ever jump straight into taking iron on your own!
Right, they start by testing your stool (have fun collecting that sample at home
), and if blood shows up, I think the next step is a colonoscopy or something along those lines. In my case, it turned out to be a relief that none of that was needed — the real culprit was heavy periods plus adenomyosis, which came from inflammation triggered by a copper IUD. Ladies: if you're unsure, get a specialist to take a look!Start by identifying why your ferritin is low. In my case it sat at 4. A hematologist I was sent to was adamant that I undergo a colonoscopy, an endoscopy, and a complete gynecological workup. By the time I sat down with him, all of those were already done, and I felt sure heavy periods were the culprit. Even so, he pushed for a capsule endoscopy to rule out anything the earlier tests had missed. Because a hysterectomy was already on my schedule, I postponed the capsule endoscopy. I received multiple iron infusions, yet 6 months later my ferritin had dropped back to 4. Eventually I had the hysterectomy, followed by additional iron infusions post-surgery. A year on, my levels are normal. That said, if they had fallen again, I would have gone ahead with the capsule endoscopy without question. Book appointments with both a GI and a hematologist. Good luck and hope this gets resolved soon!
My ferritin has dropped to 4 at its lowest, too. Since then, I've needed iron infusions roughly once a year. That said, I'm with what others have said: if you're male, getting this investigated is a must. Wishing you the best!
Rolltide61
Explorer
Nah, that’s not something I’d go for. Instead, I’d swing by the lab tech’s place with my second morning coffee in hand.RaveBaddie said:
Absolutely! This matters a ton! I'm completely on board with what you're saying!
Don't ever jump straight into taking iron on your own!
Right, they start by testing your stool (have fun collecting that sample at home
RaveBaddie
Explorer
Yep, yep, yep — what I was getting at was getting your stool looked at.Rolltide61 said:
Nah, that’s not something I’d go for. Instead, I’d swing by the lab tech’s place with my second morning coffee in hand.RaveBaddie said:
Absolutely! This matters a ton! I'm completely on board with what you're saying!
Don't ever jump straight into taking iron on your own!
Right, they start by testing your stool (have fun collecting that sample at home
My first language isn't English
Mine came in at 4. After an iron transfusion, I felt a LOT better. The number sat around 20 right after, and it's 11 at this point, but they refuse to give me another transfusion until it drops to 5, which really irritates me. I have no idea why my body has so little iron, it's strange. Nothing I've taken in pill form has made a difference.
PineCone99
Explorer
My level came in at 11. What solved it for me was a Mirena, since it put a complete stop to my heavy periods. That took care of it.
I realize that wasn't what you meant, but I can't help pointing out that it feels like women come out on the losing side when it comes to medical care. Can't someone who menstruates still develop colon or stomach cancer? So we're only going to screen men for it, huh?
Regardless, what irritates me most is shelling out more than $800/mo across so. many. years. for health insurance that only gets me 1 appointment per year with a PA who couldn't care less why my iron and ferritin are so low, while I'm stuck buying peptides on the grey market. Sometimes it boils over.
lessthanhalf
Explorer
Naturally you're right. Still, when you look at likelihoods, for a female aged 15-45 with low iron, menstrual bleeding is by far the usual explanation — their requirements are simply higher for that reason, so stores run down far more frequently. Men obviously don't have that going on, which means a graver underlying cause becomes considerably more probable among men or among females who aren't menstruating. The trouble is that reasoning by probability like this means women harboring early GI cancers get overlooked for longer stretches. On the other hand, running every test on every person isn't feasible either; that approach brings its own problems, false positives among them. So testing becomes better justified once the chance of uncovering something treatable is high enough to outweigh the expense and the potential harms. Whether a perfect solution to this kind of dilemma even exists, I doubt. And yes, the US generally offers fairly mediocre primary care and preventive medicine — unless you happen to be wealthy.
I was about to say the exact same thing. Anemia can be something very serious which is best evaluated by your Dr.
Donating whole blood or red blood cells is another frequent cause.
That said, after blood donations left me with low iron, the supplement that raised my levels the most — confirmed through blood testing — was Naturesplus hema-plex iron.
#-
Cannonball72
Explorer
Has a blood donation happened on your end lately?
TRT is part of my routine, and for years I've been giving blood on a regular schedule. My labs got drawn 1 week after the most recent donation.
For me, that fairly well accounts for the gap between iron and ferritin.
It also makes clear that I should cut back on donating, since there's no TRT-related problem on my end that genuinely calls for it.
FWIW, into Claude I put everything: all my bloodwork, my pharma schedule (dosage and frequency), workout history, blood donation history, weigh-in history. Then I told it to "assess".
Whatever stood out as odd in my data was explained without much trouble — what deserves my attention, what came from exercise or timing, and so on.
It was a great way to get ready for a conversation with the Dr., who in all likelihood glances at the blood data only 5 mins before seeing me and won't dig into all the details needed for the full picture was able to Laos