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Your iron stores could have been dropping slowly over a long period. As you are vegan, has your doctor checked your B12 levels? Are you total vegan as in no dairy or eggs? In this case you need your Vitamin D checked too. A lot of people who are low in ferritin are often low in Vitamin D and some in B12, even if they are meat eaters.

Yes, it 'might' be internal bleeding.

You could have developed gluten intolerance. Have you been tested for this? It's just a basic blood test, but an internal biopsy is best as sometimes the blood tests can give false positives/negatives. Gluten in wheat, rye, barley and sometimes oats affects some people and it causes malabsorption of nutrients.

It could be a digestive issues too. I tried for a couple of years to lift my ferritin levels and it was such slow going. In the end i found out i had a thyroid problem and low ferritin, especially difficulty to raise, is common also with thyroid sufferers. After testing my results showed that my pancreas was not producing sufficient digestive enzymes to help digest protein foods. Now i'm on prescription digestive enzymes and thyroid meds. Since then my ferritin has risen much faster. It's taken me over 3 years though, but at least i know what's cuasing mine, which is what everyone should be doing if their levels are not rising.

Some people's doses of iron supplements aren't very high. When i first started out i didn't know what to buy and what i was taking wasn't a high dosage. My then doctor told me i could take this one till i was 70 and my levels wouldn't be where they ought to be. So check that what you are taking is of a decently high dosage.

Going from anemic and getting back 'within range' eg: up in the 20's helps some people get some energy back, but everybody is an individual. I didn't start feeling better till mine was in the 40's but then again, i had thyroid and adrenal fatigue holding me back and making me tired. YOu have only been on iron for 4 months, if your dosage was decent and nothing else was wrong, most people tend to feel better and their ferritin shoots up quite easily. Those of us who are still tired, taking decently high dosages of iron and our levels haven't barely moved, usually have a harder time of it and often there can be side issues. I'm not sure how it affects vegans though as protein from meat is different to protein in a vegan diet from nuts/pulses etc.

Good luck and hope you see results soon :)

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