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Hi everyone, this is my first time posting. I've tried to do some research on my own, but I am at a loss. I will start out by saying that I had a baby back in April 2014 at which time my other labs were within normal limits except for my Hgb and Hct (7 and 24 I believe). I recently followed up with my primary care doctor for symptoms of chest pain, shortness of breath (especially with exertion), and the biggest symptom- extreme fatigue. When I get up in the morning I feel like I've never slept, and by the afternoon I feel like I need to go back to bed for the rest of the day. I realize I have a 3, almost 4 month old baby, but she sleeps through the night for the most part, so it's not like I'm not sleeping at all through the night. I had labs drawn last week and the main results were as follows:

Ferritin, Serum- 7 (15-150)
TIBC- 415 (250-450)
UIBC- 368 (150-375)
iron saturation- 11 (15-55 %)
iron, serum- 47 (35-155)
rbc- 4.93 (3.77-5.28)
hemoglobin- 11.5 (11.1-15.9)
hematocrit- 37.5 (34.0-46.6)
mcv- 76 (79-97)
mch- 23.3 (26.6-33.0)
mchc- 30.7 (31.5-35.7)
rdw- 17.1 (12.3-15.4)
platelets- 317

WBCs, Thyroid, B12, and HgA1C all looked good. From what I've read, it seems that I may have iron deficiency, but because the hemoglobin and hematocrit are within normal limits it is not classified as anemia. What I don't understand is I just spoke with my Dr. office, and the nurse said the doctor checked off my lab results and didn't put a note in that she needed to see me for a follow-up. The nurse asked me if I had any concerns about my lab results. I guess I'm just not sure if my lab results are "off" enough to be causing my symptoms, or if something else is going on. Should I be started on iron supplements? I'm just not sure where to go from here. Any help would be appreciated. Thanks!!
Your numbers are off!! I can't believe your doc thinks this is acceptable. something is going on! The MCV, MCH, MCHC, and RDW (geesh, 17 is way high!) are all indicative of your body struggling to make red blood cells. They are not healthy ones according to these numbers (now I am not a doc, but I am struggling with low iron and have researched quite a bit about all these lab numbers since docs are so unhelpful). Being that your ferritin is unacceptably low, I would assume your iron deficiency is to blame for the numbers, although you may also have a folate or b12 deficiency also. You could have more than one deficiency. I would ask for these to be checked, although it won't harm you to take folic acid and b12 anyway.

I have a ferritin around 26 right now. It was at 15 and I was getting mildly anemic but docs would pass it off as normal. The "normal" range is based on cumulative testing numbers and only reflects how deficient americans are. A number below 30 is NOT normal in and of itself. Its only "normal" according to docs because A. you aren't technically anemic so its not a crisis, and B. because its many other people in the population have numbers this low who are "healthy". I have been feeling like death, (I feel weak, shaky, tired but can't sleep, foggy, headaches, muscle pain) for a while and not sure if deficiency is the only problem I have (docs can't find anything else) but I am aiming to get my level above 50 and hoping this will help me feel better. From what I have read, many people feel this way... so I am hoping its the iron! My neuro and hematologist have both thought the low iron even around 20 can make you feel crappy and they recommend getting up to 50.

Bottom line is, you ARE iron deficient. Your body is struggling and making unhealthy red blood cells right now, but if you don't start supplementing you will only go downhill. I take 325mg of ferrous sulfate 2x daily. Some people dose 3x daily but most doctors tell you 2x. As long as you keep track of your ferritin numbers and get an iron panel done every few months, it will not hurt you to supplement with iron with the low numbers you have. Having a baby really depletes your stores and I think nursing may too. If you don't need a referral, call a hematologist and get to the bottom of things. They will easily sort things out for you. Take control of your health and tell the docs what you want rather than taking their lead. They aren't always right and don't see how you suffer everyday, they just see numbers and if you aren't in crisis they tend to overlook your experience when dxing. Good luck to you! Feel better!

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