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If she has impaired iron absorption, she might not be getting the full benefit of the iron.
If the serum ferritin initially went up, her body was absorbing at least some of the iron, but if it dropped again fairly quickly (and given her previously very low ferritin level), then it sounds like whatever originally caused the low ferritin, like menstrual bleeding, a GI bleed, or some other cause, is still going on. If she has normal absorption of iron, and the ferritin keeps dropping, she has to be losing iron from somewhere. I would think the doctors still need to find the cause of the iron deficiency anemia and treat that. Then she would be able to get iron therapy and her system would incorporate the iron into the making of new red blood cells as normally occurs.
I wish I could be more help. I just know that treating any anemia without determining the cause is ineffective.

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