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About a year ago, my doctor noticed both my hemoglobin and ferritin levels were low (7 and 3, respectively). I went on 10 weeks of iron infusions to bring my hemoglobin up to 13 and my ferritin up to 64. Three months later my hemoglobin was still normal, but the ferritin had dropped back to 6, and just last month it was down to 4.

My doctor said that a low ferritin level would not be the cause of my fatigue. I am just really tired again . . . . similar to how I felt before the iron infusions. She said I don't need to take any oral supplements since my hemoglobin is normal and I'm not anemic.

However, I can't stand being so tired anymore. Has anyone else received this guidance? Are you taking oral iron supplements for a low ferritin with a normal hemoglobin? I may start taking them in the interim as my doctor cleared me for a 6 month bloodwork instead of the usual 3 months.

I'm also hypothyroid, which is not helping my case at all.

Thanks!
[QUOTE=jmartinisu;5105846]About a year ago, my doctor noticed both my hemoglobin and ferritin levels were low (7 and 3, respectively). I went on 10 weeks of iron infusions to bring my hemoglobin up to 13 and my ferritin up to 64. Three months later my hemoglobin was still normal, but the ferritin had dropped back to 6, and just last month it was down to 4.

My doctor said that a low ferritin level would not be the cause of my fatigue. I am just really tired again . . . . similar to how I felt before the iron infusions. She said I don't need to take any oral supplements since my hemoglobin is normal and I'm not anemic.

However, I can't stand being so tired anymore. Has anyone else received this guidance? Are you taking oral iron supplements for a low ferritin with a normal hemoglobin? I may start taking them in the interim as my doctor cleared me for a 6 month bloodwork instead of the usual 3 months.

I'm also hypothyroid, which is not helping my case at all.

Thanks![/QUOTE]

I have not received this guidance. Quite the opposite actually and that is from my primary and my OB. I have normal hemoglobin and normal hematocrit after 8 months on iron and my Dr. says as long as my ferritin is low the anemia diagnosis sticks. One of the very first things that starts to drop with anemia is in fact your ferritin.
I had normal of both and very low ferritin and I felt terrible, still very tired losing hair, major anxiety, etc. Most people don't report even feeling well till their ferritin in the 50-70 range.
I take 160 mg. of iron a day with a normal hemoglobin/hematocrit. My Dr. says now that these numbers are high my ferritin should rise a bit faster. My OB says I can plan on taking iron for another year.
There is a reason this is happening, this is just a symptom of a larger issue be it blood loss, Celiac's etc. You need to find the problem as to what is causing your numbers to continue to plummet and fix it to clear up the anemia.
[QUOTE=jmartinisu;5105873]Thanks for the reply! I thought that maybe I was getting some bad advice. We have no idea what is causing it. I have normal periods on birth control and no period when not on it. I had an endoscopy and colonoscopy and swallowed a camera capsule, all showed no signs of blood loss. The latest is that I need to have my gallbladder removed. I don't know if that is a cause or not (I'm guessing not). It all seems so odd, but I really have no signs of internal bleeding. And we never would have caught this except I had to have surgery earlier this year and the pre-op physical bloodwork caught the numbers.

I wish I could figure it out, but my doctor said she is ok to just keep monitoring it until my hemoglobin drops again. Maybe I should get a second opinion?[/QUOTE]

Have you been checked for Gluten Intolerance? I know it's a huge guess but sometimes can be the cause when no other reason can be found. Might be worth looking into. With a ferritin of 6 you can't really afford to sit around and wait for things to continue to drop. Having a low ferritin can cause so many issues and problems. I know exactly what you are going through, it's horrible! You are lucky to have gotten infusions, it's a very fast route rather then taking oral and ferritin takes forever to build back up. I have been taking iron for 8 months. Started with a ferritin of 2 and finally am up to a 33. It's not gonna just shoot right back up. I would just ask her to reevaluate your situation and if she won't budge maybe do seek a second opinion, through a hematologist...or someone that seems to have more knowledge. Dr's seem to either really want to help or just brush this off as minor. Really easy to do when they aren't the ones feeling bad. If you are feeling horrible, you need to trust your body and you know something isn't right. Here are a few symptoms of low ferritin:

Minor aches
Fatigue
Weakness
Heart palpitations
Increased pulse
Loss of energy
Loss of libido
Confusion
Irritability

these are just a few....you can look them up. Also have you had your vitamin B levels checked? Sometimes anemia and low b12 go hand in hand and this is a vitamin that you don't want to be running low on.
Sounds like what I am going through. I was severely anemic last December. I ended up in the ER with really low hemoglobin levels and ferritin was undetectable! They got my levels back up with two infusions. Six months later, again, no ferritin but, technically not really anemic due to my hemoglobin being 11 (that's really good for me!). The doctor said that the ferritin drop just tells them that the hemoglobin drop will soon follow and then it can be even more serious. At that point I was really fatigued again but not having the heart palpatations I get with my anemia when it is bad. I had one infusion then and had a bad reaction. Fortunately my ferritin went up just enough that they didn't have to start my infusions again until last month. Again, ferritin was super low but hemoglobin not bad at all. I go in for more testing to see if this round of five Venofer treatments worked. I already know they did though because my mind feels much clearer and I've cut way down on the naps again.

Really, if your ferritin level is that low it's time for the infusions.
Sounds like what I am going through. I was severely anemic last December. I ended up in the ER with really low hemoglobin levels and ferritin was undetectable! They got my levels back up with two infusions. Six months later, again, no ferritin but, technically not really anemic due to my hemoglobin being 11 (that's really good for me!). The doctor said that the ferritin drop just tells them that the hemoglobin drop will soon follow and then it can be even more serious. At that point I was really fatigued again but not having the heart palpatations I get with my anemia when it is bad. I had one infusion then and had a bad reaction. Fortunately my ferritin went up just enough that they didn't have to start my infusions again until last month. Again, ferritin was super low but hemoglobin not bad at all. I go in for more testing to see if this round of five Venofer treatments worked. I already know they did though because my mind feels much clearer and I've cut way down on the naps again.

Really, if your ferritin level is that low it's time for the infusions.
The geogal! My problem is that my doctor doesn't really seem to think there is a problem. I told her how tired I was feeling and her response was to "buck up and hit the gym." It takes just about everything I have to get out of bed each morning, and when I get home from work, the gym is the last thing I want to do. Honestly, I'd love to get a few more infusions to bring me back, and keep doing them once or twice every three months or so. Is this something worth seeing a hematologist for instead of my gp?

I know what you mean about the clear mind. After my last round of infusions, I noticed so much more clarity in thought - made me much more productive at work. I think it also messes with my moods. I guess the tiredness just brings you down on all levels.

I'm really hoping to get my system jumpstarted soon. In the meantime, I started taking an OTC iron supplement because I can't stand to not do anything!
[QUOTE=jmartinisu;5111383]The geogal! My problem is that my doctor doesn't really seem to think there is a problem. I told her how tired I was feeling and her response was to "buck up and hit the gym." It takes just about everything I have to get out of bed each morning, and when I get home from work, the gym is the last thing I want to do. Honestly, I'd love to get a few more infusions to bring me back, and keep doing them once or twice every three months or so. Is this something worth seeing a hematologist for instead of my gp?

I know what you mean about the clear mind. After my last round of infusions, I noticed so much more clarity in thought - made me much more productive at work. I think it also messes with my moods. I guess the tiredness just brings you down on all levels.

I'm really hoping to get my system jumpstarted soon. In the meantime, I started taking an OTC iron supplement because I can't stand to not do anything![/QUOTE]

Absolutely! Please go see a hematologist. I could kick myself for not going sooner. Actually, before we moved to another State three years ago, my doctor was getting ready to refer me to a hematologist but when I got here, the new doctor wanted to start from scratch. It took me ending up in the ER and them telling me to see the hematologist before I went. They see this all the time. I really empathize because I totally get what you are saying. When my ferritin is that low, I can't seem to function and my brain seems 'cloudy' (best description I can come up with). Infusions take about a month to work but so worth it when they do!





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