How do you get the GP to take iron deficiency seriously?

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Just double checking, what are the units of your results? It's hard to comment without knowing that as the numbers you've given are in the normal range for ng/mL and micrograms/litre which are the most common ways I've seen.

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1000nipples@reddit

My results on the NHS app are in ug/l. The reference range is between 11 and 307 ug/L.

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Banes_Addiction@reddit

Huh, on my page the reference rate is 22-322 ug/L.

Different genders? I'm cis male.

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Ok_Victory_2977@reddit

Your NHS app on the test results will give you the correct range for your test so for women that's 23 - 300 x

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Seafaring_Slug@reddit

The range it gives me is 41-400

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1000nipples@reddit

The range mine gives me is between 11 and 307 ug/L 😂

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Seafaring_Slug@reddit

It seems like everyone's getting something different!

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WildTomato9@reddit

It might be calibrated for age, weight and gender. A woman of menstruating age will have a different requirement to a man of middle age for example.

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ellie___@reddit

No, 15 is no longer considered to be normal, as the post says.

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SneezlesForNeezles@reddit

I've just checked several of my NHS Trusts reference ranges and the adult female range is 11-310ug/L with some sites having a slightly higher lower range of 15. This seems similar in ng/L where the lower range appears to be 15.

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ellie___@reddit

https://www.rightdecisions.scot.nhs.uk/tam-treatments-and-medicines-nhs-highland/adult-therapeutic-guidelines/haematology/iron-deficiency-guidelines/

According to NHS Highland: "Ferritin less than 12 microgram/L indicates complete absence of stored iron and less than 30 microgram/L indicates iron depletion. Between 30 and 50 microgram/L can also be consistent with iron deficiency; especially in elderly patients and in inflammatory states where ferritin may be ‘falsely’ elevated to the ‘normal’ range."

I unfortunately cannot find the article I read the other day about this topic. See my comment above for a link to the NICE guidelines.

Can you see why it's extremely frustrating for a patient experiencing symptoms of iron deficiency to be told that their iron levels are fine because of their postcode, when somewhere else their ferritin level would indicate "complete absence of stored iron”? Most patients aren't even aware that "normal" ranges aren't standardised across the NHS.

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SneezlesForNeezles@reddit

I checked a decent number of mu sites, but don't have any sites in Scotland currently so didn't check those as I couldn't cross check with my stored files. I've listed the links below where I found publicly accessible links. Even doing a broader search, I hadn't found the Scotland difference, so thank you for highlighting.

I can see why it would be frustrating that the post code lottery makes such a difference - it also seems there's a difference between the ranges given and how some GPS interpret them looking at it further both in terms of upper and lower limits. "While lab ranges go up to over 300 ug/L, many experts consider levels around 50 ug/L to 100 ug/L to be a healthy storage zone."

It's strange that there's such a margin and level of interpretation here. We collect lab ranges from every site and whilst they're all slightly varied, its usually within the same ballpark. We query if something looks really iffy, but thats usually with international sites and ends up being a unit error/confusion. I may have to check some other trials with Scottish sites tomorrow as it may just be that given the huge range, 15 vs 30 has been seen as negligible. Which is possible considering the upper limit of 300+.

Links https://www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/haematology/haematology-reference-ranges/

https://www.ruh.nhs.uk/pathology/documents/clinical_guidelines/HAEM_Ferritin_a_guide_for_GPs.pdf

https://www.nbt.nhs.uk/severn-pathology/requesting/test-information/ferritin

https://www.southtees.nhs.uk/services/pathology/tests/ferritin/

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AClockworkLaurenge@reddit

Even within the same health board, results can be interpreted very differently.

I had a blood test after I started displaying intensifying anemia-like symptoms (including suddenly feeling dizzy/faint with ringing ears, which I'd never experienced before). My GP at the time phoned with the results and confirmed my haemaglobin was fine but I had "very low iron" and that he was genuinely very concerned by just how low my levels were, so he was prescribing me iron tablets to be started ASAP. Didn't experience those intense symptoms again.

A few months later, I had to move so switched to a different GP surgery. When I later mentioned the previous low iron diagnosis during an appointment, my new GP pulled up my blood results on his computer to check and was like "I mean, they are low but for a woman your age having periods, I'd consider those normal" (even though those symptoms were very much NOT normal for me). I believe my results were around 13-15 and that he'd be fine with anything over 11.

This was in Scotland within the same city/healthboard, but the difference between the two GPs was like night and day - like I almost felt like I was being gaslit or at the very least that I suddenly sounded like a hypocondriac (even though I know I likely really had needed those iron tablets because something was definitely not right with my body).

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1000nipples@reddit

According to my GPs, it still is (also female)

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Seafaring_Slug@reddit

With what unit? Assuming ug/L there's a lot of conflicting opinions. Most the sources I can find class it as borderline, nothing suggesting 'critically low'. The NICE guidelines are specifically for classing types of anemia with Hb deficiency which op doesn't have. The WHO guidelines are <15ug/l for deficiency in non-pregnant women.

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ellie___@reddit

"In all people, a serum ferritin level of less than 30 micrograms/L confirms a diagnosis of iron deficiency. Low levels of ferritin can result in symptomatic and functional impairment even in those individuals with a normal haemoglobin, especially in women who are menstruating."

https://cks.nice.org.uk/topics/anaemia-iron-deficiency/diagnosis/investigations/

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Poo_Poo_La_Foo@reddit

NHS guidelines and guidelines in other places (even in the UK) will vary.

But if your iron is low take some supplements IN tandem with a glass of orange juice, or other high vit c drinks. And improve your diet so you are consuming it organically too. Particularly if you are having periods and losing iron.

But I'd seek additional tests too if you don't feel right. You don't have to get them at your GP.

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StreetMountain9709@reddit

Something interesting I found out recently was that energy drinks inhibit iron uptake and contributed to lower B12 levels.

Obviously I have no idea if you drink them or not but just incase you do its worth reading up on.

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tieflingteeth@reddit

It's called non-anemic iron deficiency https://patient.info/doctor/haematology/non-anaemic-iron-deficiency

It's very real and much more common than the NHS acknowledges. I ended up going private for an iron infusion to treat mine. Insomnia and anxiety almost vanished overnight.

If you treat it with iron pills, take them every other day. Your iron receptors don't absorb well for 24-48 hours after a big dose, so you'll absorb more from your high dose pills if you take them every other day.

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Seatonmess@reddit

and take them with orange juice as it helps it absorb better

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picasso_baby@reddit

Adding on some more tips to help anyone who needs it.

Take on an empty stomach in the morning. No tea, coffee or dairy for 1-2 hours as these block absorption. (Tannin-free tea like rooibos is probably okay)

Over the counter high doses of iron such as ferrous fumarate or bisglycinate are needed to raise iron levels, not the 14mg daily supplements on the shelf in boots. Check how much elemental iron is in the supplement, e.g. 200mg ferrous fumarate might have 69mg elemental iron so 69mg is the dose.

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SingleLie3842@reddit

How soon after the iron infusion did you start to feel better? I’m really considering going private too

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lyndsayy@reddit

Do you mind me asking how much you paid for private? My ferritin is 6ug/l and has been that low for a good while. Ferrous fumarate increased it a tiny bit but the side effects of constant constipation and hard/sore stomach ache were absolutely not worth it. I don’t think FF is a good long term solution 🥲

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Fantastic_Remote1385@reddit

This.

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scop90@reddit

I had ferritin on 14 and felt like death so solidarity. Iron deficiency is no joke and I can’t put into words how awful it was.

Go back to the GP. See a different doc if possible. Show them the resource where you saw the numbers. I’ve just read the same here https://cks.nice.org.uk/topics/anaemia-iron-deficiency/diagnosis/investigations/

I would show the doctor this if they don’t agree with you them to explain why they feel differently.

Even if they do continue to argue that 15 is the low threshold, yours is not far off and you feel bad. If you feel bad, there’s a problem and bollocks to the numbers. You know how you feel and are your best advocate.

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JennySt7@reddit

I would insist on a referral to haematology, and tell them “where you got it from” is the updated NICE guidelines for iron deficiency 🙄

I was in a similar situation last autumn due to endometriosis and heavy periods. My ferritin was 3 (!) at its lowest! I was getting dizzy and breathless, even though my haemoobin was still “normal” - I suspect my body was depleting all its iron stores In an effort to keep the Hb normal, and it would have all ‘crashed and burned’ soon if I hadn’t had a test/realised something is wrong.

Initially they tried to fob me off with oral supplements (which I struggle to take due to the gastrointestinal side effects). I went back to them and insisted on a referral. I was luck that the NICE guidelines that you are referring to were actually updated to what you are quoting in October of 2025. I saw a haematologist mid November and had an iron infusion and of November. It made a massive difference.

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abyssal-isopod86@reddit

Hair lengths is not indicative of iron deficiency.

Everyone has a genetic predetermined maximum length of their hair and that can very wildly person to person, even full siblings.

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shadowrunnner@reddit

Iron deficiency can cause chronic telogen effluvium so over time hairs becomes shorter and shorter as they are prematurely shedding.

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Adventurous-Idea1473@reddit

how does that work? how does the hair growth at the scalp get the message from the end of the length that its reached maximum?

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abyssal-isopod86@reddit

It's not length persay.

Hair follicles go through a cycle of growth and resting. How long and fast the hair is actively growing for is genetically determined.

Once the hair folical stops growing it goes through a testing phase, at the end of which the hair is shed away and a new growth phase begins.

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Cold-Kaleidoscope974@reddit

Wish you hung about spitting facts in the hair subs

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abyssal-isopod86@reddit

Huh?

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Seafaring_Slug@reddit

https://en.wikipedia.org/wiki/Human_hair_growth

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sadlottie@reddit

thinning hair however, is a sign of iron deficiency

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notcharlesincharge@reddit

I had ferritin of 7 and i was literally almost fainting going upstairs, having panic attacks, heart palpitations, etc - I told a nurse practitioner (NOT my horrible (male) doctor) and she took me seriously, but I also found out from my pharmacy afterwards that you can actually buy the stronger iron supplements over the counter if you show them your blood test results. I’m currently taking 325mg of ferrous sulphate instead of the ones the doctor prescribed me. I take them first thing, at least an hour before food/caffeine. My ferritin is now 33 (last tested April) and I feel a billion times better. So if you can’t get them to take you seriously take it into your own hands!! Also, for women, we need a lot more iron - the test parameters are based on men of course!

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BowiesFixedPupil@reddit

Good luck with that. I can only recommend making their lives hell but it hasn't worked for us.

My wifes ferritin is 13 and she's half dead. She has a thyroid issue and they don't care one bit.

Unfortunately we've had to fork out for private consultations etc and are just on with a specialist now. It's been absolutely soul destroying watching my previously active wife needing to lay in bed for 16 hours plus per day, not work for 2 years and have absolutely no care at all.

She got a thyroid panel done privately and the Dr was so shocked at her results, couldn't believe she was coping but the truth is that she isn't.

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Comfortable-Ad-5823@reddit

Please tell her to join the thyroid Uk charity message board on health unlocked website. They saved my life, I was so unwell like your wife.

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alinalovescrisps@reddit

I've been having the same issue as you OP, my ferritin has been low for years but has been getting worse, last time I asked the GP for bloods it came back as 15. I've been feeling tired and a bit low/anxious but nothing like you describe, still able to exercise etc.

GP advised that I start taking ferrous sulfate tablets which you can buy from online pharmacies, I've discovered. I've been taking them (as well as my usual multivitamin) for about 5 weeks I think and I do feel a bit better, though not had repeat bloods yet. Maybe you should try that, its basically what GP would prescribe anyway.

Oh and also - you probably know this but remember to take iron on an empty stomach, with a little bit of vit c to help absorption and not with caffeine as that blocks absorption.

Good luck 👍

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Dimac99@reddit

Don't take iron on an empty stomach, that's just asking for digestive issues so take it with food. Vitamin C helps with the absorption so orange juice is a good choice to wash it down.

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CassetteLine@reddit

I had the same. Very low ferritin down at 8. The iron tablets brought it up within a few months to a much more normal level.

Can’t say I felt any different though, which is a shame.

For what it’s worth, a lot of people can’t take those tablets on an empty stomach. So take them with/after food if needed to avoid feeling ill.

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Prettyinareallife@reddit

What dosage of iron supplement are you taking and do you have heavier periods?

If you have heavier periods please address this with your doctor

If you are symptomatic with slightly lower ferritin then yes you should eat an iron rich diet and take iron supplements as some people are indeed symptomatic with low ferritin even if Hb is normal. It is worth noting that most over the counter iron supplements are relatively low dosage and aimed more at maintenance than increase of iron levels . You need to take and iron supplement that is a stronger dose - for example 200mg ferrous sulphate, to start to bring up your ferritin levels. You need to ideally take it with vitamin c (or just orange juice), avoid caffeine 2horis either side of taking it and ideally on an empty stomach to increase absorption. Also, consider taking this dose every other day instead of every day as research shows you will absorb more if you take every other day.

Try another gp appointment and see if they will prescribe you a higher dosage based on the fact you are symptomatic , but if the don’t you can buy higher doses over the counter also just will need to do a bit of googling.

Also - worth also asking the ho to check thyroid, b12, vit d etc as well to rule out other causes of your symptoms. A good GP really should be happy to prescribe the iron while also requesting further blood tests for you

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Robzooo@reddit

It will be in the normal range locally but you are totally correct that symptoms can occur with a ferritin below 50. All the GP would initially do is give you oral iron to take and you can buy 200mg ferrous sulphate over the counter. Take regularly with orange juice for a few months.

If it's still not improving you can see if they will test for coeliac disease or other malabsorption causes.

The tricky thing is if those tests come back negative and your still low. In my area it's hard to get any specialist to investigate persisting non anaemic iron deficiency, and they will not offer iron infusions either.

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Zabbie97@reddit

Please get a 2nd opinion and get checked for celiac. My mum had really low iron levels for about a decade before finally getting diagnosed. It didn’t go up even with iron tablets until she stopped eating gluten.

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Apsalar28@reddit

Have you had your thyroid levels checked?

Your symptoms sound very much like an underactive thyroid.

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Sasspishus@reddit

I was told the normal range is 30-300

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Ok_Victory_2977@reddit

23-300 is the range for ferritin x

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Sasspishus@reddit

My results had the reference range as 30-300, so I don't really know what to tell you there!

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I-Am-James@reddit

I may be completely wrong but does that not say your level is 85 ug/L though?

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Ok_Victory_2977@reddit

yes - sorry I was just showing the ranges for women off my own test result.. I don't have an iron deficiency. It just saved the dispute when straight off the NHS app. You can get private labs that measure things differently but the NHS is across the board - men & women obviously have different ranges but you won't find London doing one thing and Manchester another for example ☺️

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freckledotter@reddit

Yes different trusts have different levels, it's not the same all across the board.

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Apsalar28@reddit

According to my biomedical scientist friend you will find Manchester doing one thing and London another.

Each lab has it's own reference range as the specific machines they use have different sensitivity and accuracy levels and some labs may use different methods to others. There's some complicated stats and calibration methods used to work the range for each lab based on what results they get from testing a bunch of samples from known healthy people.

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MerryJoRound@reddit

That’s not OP…

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I-Am-James@reddit

I clearly need another coffee, whoops!

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BlackGoldenLotus@reddit

The range they put on the app changes, my one after this says 30-291.

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Apsalar28@reddit

Are you a man? The normal range is different for men and women.

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Kara_Zor_El19@reddit

I’m a woman and my chart says normal range 30-300

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Sasspishus@reddit

No, I'm a woman. That's the range my doctor told me is normal for women

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linerva@reddit

It depends on the lab and who you ask.

Much of the NHS sees 15 and above as normal but some consultatnt biochemists or haematologist will treat a number that is higher than that.

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jc_ie@reddit

Lab ranges and the Nice guidelines are not necessarily the same. Anything below 30 is an issue.

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jumbo_crayon28@reddit

Damn, I once had a ferritin of 8ug/L that went untreated because they put the lower bound for normal on that blood test as 7 - still have no idea why that was allowed to happen and it took far too long for me to notice

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real-rainicorn@reddit

People start getting symptoms from 30 and below. Optimal levels are at least 50

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Princes_Slayer@reddit

I agree. The symptoms IP mentions are what I have (I’ve been told an iron supplement should help me) but I was diagnosed with underactive thyroid and so many symptoms can be linked to it

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j4rj4r@reddit

And checked for coeliac

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Namerakable@reddit

Have you checked what units they're measuring in? Different labs have different ranges and units. That's the only thing that comes to mind.

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pajamakitten@reddit

I work in the lab and 4-20 is our normal range.

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Dismal_Fox_22@reddit

I’m a nurse and in my hospital this would be normal.

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plantlady1-618@reddit

Normal is not necessarily optimal. Especially when a women is still menstruating

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alyaaz@reddit

Sorry if you know this already but i had low iron for YEARS and doctors just kept telling me to take supplements. Took me five years to find out that tea/coffee (even decaf) and dairy inhibit iron absorption and you're meant to have vitamin c with iron to maximise absorption. This might be obvious to you but no one thought to tell me even after years of repeated doctors visits for low iron

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Playful_Beyond_2218@reddit

In most areas you can’t have an iron infusion on the nhs just for low ferritin if your blood count is normal . This is because it’s pretty common so would be a lot of people, and also because it can have risks involved. Assuming you are a woman , trying things to reduce your periods such as the coil, alongside the oral iron is often the thing to do

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sadlottie@reddit

solidarity ❤️ a lot of the comments that are dismissing you are working on outdated information, and unfortunately a lot of medical professionals havent caught up with the research yet. I would recommend you look at The Iron Protocol group on facebook - they have a document which lays everything out clearly and directions for you to follow yourself. My GP has only started taking my ferritin seriously, after I showed her a graph I made of my levels over the last decade (consistently in the red 🙄) so I really feel for you!

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Namerakable@reddit

Who here is "dismissing" OP?

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sadlottie@reddit

I mean just in terms of people dismissing that ferritin could be the problem is all :)

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Consistent-Sport-481@reddit

15 is normal but on the lower end.

Perhaps it's not this that's your issue?

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sadlottie@reddit

Unfortunately this is outdated. See other comments re. the NICE guidelines

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Consistent-Sport-481@reddit

not according to the information I was given last week by my Dr or the hospital. 🤷

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sadlottie@reddit

I hear you, it’s confusing! All the different NHS trusts set the reference ranges differently. So where I live, the range is 30+ & my doctor backs that up. Unfortunately the ranges arent standardised across the country

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Tall_Opportunity_521@reddit

Get a second opinion. Your GP, I assume, is part of a practise and that practise will have more than 1 doc. Get a 2nd and even a 3rd if thats what you want.

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1000nipples@reddit

Your ferritin levels are not 'critically low'. You're on the low end of the normal range (11-310 ug/L).

Have you asked outright for a course of iron supplements? Alternatively, buy some from an online pharmacy and try it for 6 months and see how you feel after that. It takes a while for iron stores to be built back up and 6 months is the timeline I was given by my doctor.

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sadlottie@reddit

See the other comments from the NICE website - 11-310 is no longer the normal range. Besides, the ranges vary depending on what nhs you fall under - in my area, it is 30-310.

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AnyOlUsername@reddit

The guidelines say below 15 for women, and below 30 for men.

Not diagnosing or giving an opinion on your specific caseother than this may be where the GP is coming from.

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sadlottie@reddit

unfortunately the lab guidelines are different depending on where you are in the country.

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Opposite_Funny9958@reddit

Is there a reason your levels are so low? What’s your diet like?

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Lenniel@reddit

I was told by my GP that normal for menstruating women is lower than for other people. So maybe related to that.

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Spicymargx@reddit

It may be common, but isn’t normal for menstruating women to be iron deficient, that’s a sign of a wider issue. What is unfortunately far more common is GPs blaming every health concern on being a menstruating woman.

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Unlikely_Plane_5050@reddit

It is absolutely not necessarily a sign of a wider issue. Menstruation is a perfectly acceptable cause to be iron deficient and there is no need to scare people into thinking they have something else wrong with them. It doesn't mean she shouldn't have a deficiency treated or have any menorrhagia investigated but at the end of the day the most common cause of being iron deficient is being a menstruating woman.

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Spicymargx@reddit

If your periods are so heavy that they cause iron deficiency, that’s not normal. Generally periods that are so heavy they affect your day to day life and general health indicate other conditions. Many women have these conditions. 1 in 10 have endo and I think 3 in 10 was the last stat I had for PCOS. A “wider issue” isn’t necessarily something to be scared of, many of these conditions are incurable but not life limiting. We should not as women be accepting debilitating periods without asking questions.

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Unlikely_Plane_5050@reddit

It's simply not true that normal periods don't cause iron deficiency. Other conditions are common but that doesn't mean every woman who becomes deficient in iron needs further investigation. Feel free to ask questions but don't get disappointed if the answer after all those questions are answered is that there is nothing medically unusual about one's heavy periods.

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Spicymargx@reddit

A quick google found that 1 in 4 women will have a reproductive health issue. Statistically that is highly significant. Just because it’s common for so many of us to have gynae issues doesn’t mean our issues don’t exist. You’re conflating “common” and “normal”.

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Opposite_Funny9958@reddit

See a different Dr - female, if your surgery has one. In the meantime, adding some more iron rich foods to your diet should help your energy levels a bit. I agree with everyone saying go back to the Dr’s though - just don’t see THAT one.

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ellie___@reddit

Some people are just like that unfortunately.

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Pog_Ping@reddit

that’s worth checking too, thyroid issues can look really similar and get missed if you only focus on iron numbers

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Lucky_Individual_852@reddit

I got told that the number to aim for is 75. You need to take 210mg ferrous fumerate, which you can buy over the cover and take it every other day. Anything less won't do much. My ferratin level was 7 and my GP didn't have much interest, it was only when I saw a menopause specialist privately did I actually get some proper advice.

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leeksbadly@reddit

Guidance is just that - a guide, and your GP is more of an expert in interpreting that guidance than you are.

Given your normal Hb, there is likely another cause for your symptoms.

Don't get bogged down in the low ferritin. Go back, focus on the symptoms, not what you think the cause is - it's your GPs job to figure that out.

Don't give up, keep going back until you find the cause and work with your GP to come up with a plan.

If you really reach your wits end then try another GP, but if it happens with the next one you may need to look inward a little more.

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ImpactWise3672@reddit

I recently had a blood tests done and my iron levels were found to be very low. This would explain why I get tired easily and run out of breath after walking a short distance. Its a combination of low iron levels and low blood pressure (in my case I get frequent headaches too), which starves your muscles and tissues of the oxygen and blood flow they need to create energy. Low iron means less oxygen reaches your muscles. When you walk, your muscles demand more oxygen, but your blood can't deliver it, causing immediate exhaustion and breathlessness.

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gimmematcha@reddit

You don’t unfortunately. But there is a right way to take iron. I raised my ferritin to >100 this way.

I paid for private blood tests to periodically check my iron and ferritin and raised my ferritin myself. Based on info from American Hematology Society, copy pasting my own comment from somewhere else

Take with: vitamin C tablets. I take 1000mg, but 500 mg or lower doses should work too. Optional: take with animal sourced iron, eg half a tea spoon of beef mince, for even better absorption.

Avoid: tea, dairy, calcium 2 hours before and after taking iron.

How much: if deficient, 2-5x of your weight in kilograms. Eg I weighed 65-70kg when I was supplementing so I took about 130 mg of iron. I took 2 tablets in the morning on an empty stomach 2 hours before eating, and then remaining 3 before bed, because I loooove tea so I drink lots of it.

What supplements: any off iHerb. Do not take ones with other nutrients/vitamins in it, but B12, vitamin C, folic acid are OK.

Be very very careful though, as taking too much iron can be dangerous and land you in a hospital. My aunt lost teeth because of high iron. High doses of iron should be only taken with your doctor’s knowledge. Given they’ve been useless this is where your private route blood tests come in.

You are NOT likely to get all your iron from your diet. Women need 14-18 mg per day, most iron rich sources are only 3 mg per 100 grams. Plant based iron does not absorb well. I don’t want to eat 100 grams of boiled spinach just to get approx 1/6th of my daily iron.

Vitamin D supplements may help too if you’re struggling with energy

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gimmematcha@reddit

Re hair - I don’t have the same issue as you but I have been struggling with hair issues for about 10 years. If this or any other advice in this thread works to address your hair issues, you will need at least 3-6 months to notice a difference.

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trippykitsy@reddit

You could go onto depo provera. My levels were like yours and when i went on depo they were back to normal in a year. Or you could have an implant, which is a lot safer for those vulnerable to blood clots like me.

However, what you have been told is pretty normal. My levels were at 15 and I was told it was normal.

You should get a blood test for "anything that would cause fatigue". I was found to have an anomaly in my thyroid. My thyroid is still quite normal but I need to have it tested every 2 years.

You could also visit the gp repeatedly until you find someone who prescribes you iron, but bear in mind, ferrous fumulate tablets have some nasty side effects

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richvoid794@reddit

Have you thought about getting a private blood test? I got frustrated with the GP and got one for £80 that tests everything.

It showed the levels of everything as well as what’s considered normal. You can often get a free GP appointment for them to explain outliers.

With the additional evidence my GP couldt really argue

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plantlady1-618@reddit

You can pay privately to have an iron infusion. I had similar problems with my GP ignoring the NICE Guidlines

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Omadster@reddit

Ate you following a vegan diet ?

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rubys_arms@reddit

Ah mate I feel you. I have the same ferritin level as you, I was hospitalised recently and it was discovered my Hb was 86 (should be 120 minimum). Have you been checked for coeliac? For me my anaemia is most likely caused by fibroids which cause very heavy periods. I'm 43, have been anaemic for years and it's been an uphill battle. I've wanted infusions for years but they just prescribe the ferritin tablets. Am currently looking into whether I can get a hysterectomy as I'm finally old enough for them to stop the "but what if you'll want kids" questions (I never have)

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neverafter55@reddit

Mine was 10 and I was sleeping 22 hours a day, loosing 600-900mls of periods blood a month. They said it was normal. Got a private doctor told them I wanted iron tablets. For years I've been going the doctors saying I'm exhausted and no one listened. As bad as it is I just have iron tablets and the mini pill to help periods. I am not recommending this as you need doctor treatment but I'm sure I'm not the only one.

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_FreddieLovesDelilah@reddit

I’m tired all the time and had soooo many bloods done over the years. Always fine. Turns out I have Ehlers Danlos syndrome. Just thought this might help if you wanna look into it. A few people here have suggested thyroid too, get that looked at.

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Unstableavo@reddit

I was told my levels were fine but when I looked into them the iron was seriously low. I had the same symptoms. Really tired, breathless and dizzy.

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milimilim@reddit

My ferritin was 8 ug/L and the range says it should be 10-120 ug/L. My haemoglobin was 102 and that should be 114-150g/L. I was prescribed 2 tablets of 200mg ferrous sulphate per day but now at 1 per day.

As others said, check how your ferritin level is measured and make sure you're comparing it to the right range. I've got access to my info via Patients Know Best and it gives the specific range for that specific test so I know I'm not comparing things incorrectly.

If you have access to your full blood test and the ranges they should be in you can see other measurements that may be out of whack that's causing your tiredness. My B12 (Holotranscobalamin) was also 8 and that should be between 71-165, which is another common deficiency.

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themadkrivo@reddit

I have low ferritin levels (16) and a normal haemoglobin level, but my GP prescribed iron tablets to take for 3 months. I'd get a second opinion and also maybe look into coeliac disease as that's why my levels were so low

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CassetteLine@reddit

I had the same. My level was 8, and also low for transferritin. Haemoglobin was fine though.

I took the 3 I tbs of iron tablets and it brought my levels up into the normal zone.

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Sasspishus@reddit

Same I got diagnosed with coeliac disease because of chronic anaemia, it seems to be a fairly common symptoms, particularly among women

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Ok_Victory_2977@reddit

23-300 is the ferritin range

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Ok_Victory_2977@reddit

This is from my last test as you can see 23-300 is normal <15 is deficient but <30 can be associated iron deficiency but it's usually in conjunction with other things.

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Educational_March43@reddit

Can I just add, this is me. I have trouble storing iron and have done for the last 30 years, starting when I was your age. It is neither celiac's disease nor thyroid issues (I did have my thyroid removed for different reasons). It is just something my body does. These numbers are averages, not absolutes and everyone has different reactions to similar situations. I was fed up being told I was the low side of normal.

Other people here can better advise you how to get them to listen to you or complain, I just recognised the absolute horribleness of how you are feeling. Don't give up, keep pushing on this, you deserve better and you're not alone.

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KelpFox05@reddit

Unfortunately, you sometimes have to be a bit blunt to get them to actually do their jobs. Some people have suggested that this could be caused by thyroid dysfunction. I don't disagree. However, it sounds like your GP just isn't competent either way because a competent doctor would say that it's not likely to be iron deficiency and then start looking at other possibilities for your symptoms, not just leave you alone and miserable. It's just not fair on you to ignore your health like that. I would recommend following a script similar to the one below:

"Hello, GP. These are my symptoms. These are my last lab values for iron. These are the symptoms of iron deficiency, per the NHS website. These are the acceptable parameters for iron lab values, also per the NHS website. These are the list of symptoms for thyroid deficiency, also per the NHS website. I am not well. It's probably one of those things. Treat my symptoms."

If they don't adequately treat your symptoms, it's time to go to the clinic manager because they're just plain not doing their job.

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HelzBelzUk@reddit

Mate, my ferritin has hovered around 8-10 for about a decade and they still refuse to allow me infusion. Id get it privately but the nearest clinic is 60 miles away and ironically due to the fatigue and symptoms I can't drive that far anymore.

Have you had your TSAT checked? Like, a proper panel looking into the reasons why you don't store iron? My TSAT goes between 12-27% so I'm up taking some... But not reliably and not consistently. Idk anymore, man. Kinda given up at this point.

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SadieLuise@reddit

I was told it’s probably just the menopause. Thanks I’m 41. I told the dismissive female GP if it is fantastic but you need to do something as I cannot function. I don’t care what is wrong with me, but it needs to be fixed. She wasn’t even going to send me for a blood test. Different GP who listened to part of my explanation and stopped me and said I’ve sent a prescription for 200mg iron to your pharmacy. Come back in 3 months and we’ll see how you got on

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BipBapBop28@reddit

I'm going through the same thing at the moment. Apologies for the waffle that follows:

I've been prescribed iron tablets three times in the last 10 years. The routine is the same each time: take iron tablets for 3 months, get fresh set of blood tests to show that ferritin levels have crept into the lower end of the acceptable range again, GP says 'no further action needed', stop taking tablets, ferritin drops, rinse and repeat.

Most recently, I took iron tablets for 9 months and felt better than I had in years. Went to see GP about something else, she asked about iron levels and suggested coming off the tablets again to see how my levels are in 3 months (but didn't order any blood tests for straight away so that we could see where I'm up to).

A month on, I'm exhausted and pale again with the worst anxiety I've ever experienced. Currently waiting a week for a telephone consult just for permission to move my blood tests forward, despite explaining how debilitating the latest changes are proving.

I don't think anything will ever change via my GP, so I'm looking into a private iron infusion (and possibly B12 injections too as those levels are low too but my GP is 'not worried' about them).

I agree with other posters on here that you need to get a second opinion from another GP at your practice who might take this a little more seriously – and going armed with the NICE guidelines will definitely help.

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elgrn1@reddit

Ask what "optimal" levels are meant to be not reference or standard levels.

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is76@reddit

You can buy a cheap stool test for Hpylori This can cause issues with iron absorption

There are fb groups for iron deficiency & anemia

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Kara_Zor_El19@reddit

Go see a second GP for a second opinion

I was put on iron when mine was in the 20s and that was with normal haemoglobin. They might not give you injections or an infusion but they should at least give you iron tablets (ferrous sulphate or ferrous fumerate) and those can irritate the stomach they sometimes prescribe lansoprazole too. Ask for cyclizine though because nausea is really common, I can’t take mine without cyclizine otherwise I’m sick by the next day

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Enwau@reddit

A few years ago, when my level was 4.something, 15 was considered normal. A year or two ago, a gynae said that 15 is the bare minimum but she'd prefer to see 30.

If you're unhappy with the GP response, you could contact PALS in your health board, or ask for a second opinion.

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Paclerin@reddit

I was in the same boat. GP unconcerned with my chronic fatigue and ferritin around 15 for years. Spent a year seriously supplementing the maximum amount with advice from pharmacists but my gut would not absorb much (possible due to other autoimmune issues). Managed to raise ferritin to 20 but still exhausted.

I went private and had an iron infusion (c. £800). Fixed the issue immediately and made a drastic difference to my exhaustion levels. Well worth the money for me.

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WoodenEggplant4624@reddit

If you are having breathing difficulties they should arrange investigation.

You don't say if you are on any medication for anything else. PPIs such as Omeprazole may inhibit your ability to take up iron.

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lakedistrictdweller@reddit

I’ve got the same thing and the same symptoms - no doctor has seen it as enough of a problem to warrant investigation/treatment. You can get a pack of high dose ferrous sulphate from any old pharmacy for like £2, just ask at the counter. Make sure you also consume enough of other relevant vitamins for absorption. I think the NHS doesn’t have the capacity to produce an actual treatment plan which makes sense I suppose, but frustrating.

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thescouselander@reddit

Personally I don't trust the NHS and it certainly sounds like there's something wrong. That said the body is complicated and a deficiency on one area can be caused by issues in other areas. I'd recommend going private and get a wide ranging blood panel with as many markers as possible and talk the results through with a private GP. Somewhere like Medichecks can offer a full service although it's not cheap - I had success there when the NHS wouldn't help though.

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SneezlesForNeezles@reddit

I've just looked up reference ranges used by NHS sites in my workplace and ferritin has a huge range. An adult female range is 11-310ug/L with some sites having 15ug/L as low. If its done in ng/L the range may be 15-205, although i can't find a UK source off hand so that may be a US measurement.

https://www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/haematology/haematology-reference-ranges/

(ng/L) https://my.clevelandclinic.org/health/diagnostics/17820-ferritin-test

It sounds like your GP is correctly assessing the test results, however there may be another issue that you need to get a diagnosis for.

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ellie___@reddit

Comments are making me realise I should probably ask about an iron infusion - 18 is about the highest mine has ever been.

If you weren't previously aware: "normal" ranges are actually set by the individual NHS trust. But you're right, a recent update requires doctors to consider below than 30 as a deficiency for people who have periods. Show this GP the NHS website, as ridiculous as it is that you have to do that.

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Ok-Measurement3564@reddit

Sadly this battle is common across uk. If your gp isn't agreeable after you show him the NICE guidelines, ask for a referral to haematology...he's likely to move rather than getting his knuckles wrapped, or he refers and you get treatment mandated by haematology and he has to follow the instructions (I'm a haematology patient of almost 20 years, low iron sucks balls and needs serious treatment to allow function)

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seshwan33@reddit

My mrs in the same point. They do not take it seriously. But they should. She’s had a year of iron supps now and three different ones at that but the ferritin won’t go up. Only her serum level is going up but that was already ok. She has similar Symptoms.

She ended up in hospital for 3 weeks. Push back and don’t ignore them. Maybe get your phosphate tested too. Her’s was extremely low.

Do you have any chronic illnesses or infection or things that may be using up your iron stores ?

I would Deffo deffo see another GP until one takes it more seriously. Or find literature and take it with you and ask them to put in writing why it is acceptable in your case as to why they are not following guidelines etc. and if you can’t get in your consultation notes on app or whatever ask to read what they’ve written. That usually stops any brush off.

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Bloatville@reddit

Lifelong anaemia strugglebus here.
I had to eventually go private to get iron infusions as I can't tolerate oral supplementation.
If you can afford it i recommend it.

I didn't end up having to pay for it all in the end, i paid for an appt with a haematologist, who said i exceeded the criteria for NHS infusions & got me into the clinic at her hospital.

My GP had declined to refer me to a haematologist at all.

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Alienshe88@reddit

The guidelines are shockingly low, and you can feel absolutely awful with your iron at that level (speaking from experience). What the NHS deems as a deficiency is not what you need to feel normal, never mind well. Request a second opinion!

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OnlymyOP@reddit

For optimal absorption of ferritin you should be taking it in the presence of vitamin C and not have dairy 2hrs eitherside of taking it. I noticed a big difference when I followed these rules after a few weeks as Doctors were telling me at one point I would need a Iron IV solution because my levels were so low.

I've also opted for a slow release iron tablet, which made a difference too.

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BrowsingOnMaBreak@reddit

Have you looked at your b12? I had all those symptoms when I was deficient in b12/folate

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DollySheep32@reddit

There could be an underlying problem - ask for a second opinion, describe your symptoms and don't immediately jump to "I have an iron deficiency" because some docs won't take you seriously if you self-diagnose.

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PolarLocalCallingSvc@reddit

18ng/mL isn't "critically low". It's low, but not critically. Critically low would be below 15ng/mL.

The usual treatment is iron tablets, which are cheaper over the counter than on prescription (I'm assuming you're in England).

Really the GP should be trying to find the cause of the deficiency though. If you don't think they're taking it seriously, ask for a second opinion. They should at least try and find the cause for the deficiency. They may not actually find the cause, but they should try first.

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vientianna@reddit

Lifelong anaemia sufferer hear. Part of my research shows that taking ferrous fumurate daily can be counter productive (due to rising hepcidin levels blocking absorption). The optimum seems to be alternate days taken alongside a vitamin c supplement.

There’s a British haematology consultant called Drew Provan who has a series on tiktok about this subject, he goes into a lot of detail, might be worth a watch so you can arm yourself with info for the next time you see your Dr.

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lavayuki@reddit

It would depend on why you are anaemic, has the cause been investigated? (Eg heavy periods, bowel issue, diet etc)

As for iron supplements, I know some GPs don’t if Hb is normal. But for women, although ferritin of 15 is normal, it should be 30 in women to accommodate for menstrual loss. When I worked in Gynaecology they always said that and prescribed iron.

So in your case I would just book in with a different GP for second opinion, and if not done already ask to investigate the reason for your anaemia, especially if you have heavy periods and never had a scan, or and aren’t vegan or vegetarian to indicate a specific reason.

Some GPs have a special interest in woman’s health so if you think it’s menstrual related it might be worth asking if you can book in with them.

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jus_plain_me@reddit

The issue here re: your iron is that Nice guidelines mainly talks about ferritin within the context of anaemia.

Without anaemia much of the guidelines disregard ferritin, which is where some clinicians may no longer want to do further testing especially in a menstruating pre menopausal patient.

(That said NICE do state that ferritin less than 30micrograms/L without anaemia can still cause impairment.)[https://cks.nice.org.uk/topics/anaemia-iron-deficiency/diagnosis/investigations/] so it's worth speaking to your GP about concerns of "iron deficiency without anaemia (IDWA)" but your GP may have already done this without you realising since a lot of these tests get done in tandem with ferritin such as thyroid/B12.

But just as an added piece of advice, iron is very finicky in its absorption and can be disrupted by having eaten either before or after, so I always tell my patients to have iron just before going to bed (by itself and not with other medications) so that it's been a while since you've eaten and before you'll eat again to maximise it being absorbed well.

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keishajay@reddit

Honestly, I’ve had to cry before to be taken seriously. First time it was with a consultant who had no empathy for my female issue. And the second time, the GP said fine, I’ll send it off to gynae but I’m sure it’s fine.

Shocker: gynae team said noooooo.

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lucwhy@reddit

I had a recent blood test and my levels were 28, no further action needed. You can go back and ask for a second opinion though and they'll usually prescribe ferrous sulfate tablets for about 3 months and then repeat the tests. For women who menstruate then the expected/'normal' level is lower than for others and you can have non-anaemic iron deficiency because of menstruation.

For NHS guidelines (looking at my latest blood tests!) ferritin levels of 13 - 150 seen to be the given range. It then says:

'A Ferritin <15ug/L is highly specific for iron deficiency although levels of <30ug/L are indicative of low body iron stores.'

So it might be that you're just on the borderline, but not actually deficient in the sense that they'd diagnose it. It recommends further investigation (celiac test, FIT test) in certain situations but these are mainly if you're over 50/not menstruating/have GI symptoms. But of course, people react differently to different levels and if you're symptomatic, probably best to seek a second opinion.

Source: have had low ferritin basically my whole life, once had a level of 5.

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Thpfkt@reddit

There's a lot of research currently ongoing that our range cut offs are way too low. Unfortunately guidelines and current practitioners take time to take in the new research and update to current understanding. If your GP is unhelpful here, you can get a private iron infusion but that's pretty pricey.

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RichieRichard12@reddit

Following cause I'm in the same boat

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XihuanNi-6784@reddit

Lots of people are seeing the levels as normal. Have you considered that it could be something else? Doctors can be wrong of course, but with lab results it becomes harder to argue with about something so 'objective' (I'm aware there could be issues with the test). Short of getting a second test done privately, it may be worth pushing more for further investigation of your symptoms rather than insisting it's definitely a ferritin issue.

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Unlikely_Plane_5050@reddit

The dose of iron in the supplements you are taking is almost certainly much lower than used for treatment of established iron deficiency. You could either formally ask your GP for a second opinion about a trial of a prescription of a proper dose of oral iron, given that you have non specific symptoms potentially treatable with iron. This would be in keeping with nice guidelines although it's debatable if iron does any good in this scenario and does have unpleasant side effects. Or you could see if a proper treatment dose of oral iron is available via pharmacies. Presumably they have already tested thyroid etc. At the end of the day a lot of people unfortunately get symptoms like this and never find an answer other than aging and bad luck but it sounds at least like it would be worth trying a proper dose of oral iron given that this is low. I wouldn't panic about it being "critically low" - if it was this low you would be anaemic and you aren't.

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External-Praline-451@reddit

Point out the NICE guidelines to your GP

In all people, a serum ferritin level of less than 30 micrograms/L confirms a diagnosis of iron deficiency. Low levels of ferritin can result in symptomatic and functional impairment even in those individuals with a normal haemoglobin, especially in women who are menstruating.

https://cks.nice.org.uk/topics/anaemia-iron-deficiency/diagnosis/investigations/

Emphasise how debilitating symptoms that are impacting your work/ life.

I've suffered from low ferritin before was prescribed ferrous sulphate. It can have side effects so I came off it after a while. I found BlueIron Liquid Iron better than iron tablets. You can buy it online or in Holland & Barrett.

Ultimately what helped me most was getting the mirena coil, which eventually stopped my debilitating periods.

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Boboshady@reddit

I'd ask for a second opinion - I had shortness of breath which came on very quickly and recovered quickly when I stopped moving, I reported it repeatedly over several years and was dismissed each time by my doctor.

Eventually it got to the point that I nearly fainted climbing the stairs, so I went to A&E and it turns out I had a dodgy ticker, causing a lack of oxygenated blood under any exertion and was causing fatigue. I was also very low on iron. This had been going on for several years so god knows what damage it has done overall.

The meds the hospital put me on perked me right up immediately - from nearly fainting after a slow ascent, I was able to jog up the stairs...and down, and back up again, within 2 weeks. I lost a bunch of weight immediately and am now on a good programme to lose even more. I've had iron infusions and supplements to get my levels back up.

When someone actually looks at your results and knows what they're seeing, it makes all the difference.

Are you overweight? Do you snore, or know you have sleep apnea? Suffer from swelling in your legs? Do you get up to pee a lot during the night? Drink loads but are always thirsty?

Have you been checked for diabetes recently?

When's the last time you took your blood pressure?

Basically - you share some of my symptoms, but even if you don't have heart failure, what I've learned from all of this is, do not take no for an answer. If you're not happy about something, ask for a second opinion. At the very least, push back when they do.

If I'd done so when I first started feeling these symptoms, I suspect I'd be feeling a lot better right now. I implore you to push back.

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Hasenherz89@reddit

Struggling with them taking me seriously as well. Maybe check r/Anemic for more support.

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Unable-Object-8469@reddit

My iron levels were 39, and my GP said that because they were above 30, they were fine. But I wasn't fine , I felt very, very tired, just like you.

I took Feroglobin Gentle Iron (Vitabiotics) every other day for 3 months with vitamin C, and I also started eating liver at least once a week. I'm not sure what my levels are now, but I felt much better after doing all of that.

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greenolivesandgarlic@reddit

I had the same problem two weeks ago. My ferritin was 6.

Get a second opinion or go to another doctor. Ask for iron supplements.

15 is heading towards dangerous territory, and this is an unacceptable response from them.

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Ok-Rain6295@reddit

This sounds more a thyroid issue. Though of course it could be both.

What supplements are you taking? I imagine they’re non-heme iron. Heme iron is more readily absorbed and is found in meat (especially red meat) so if you’re not vegan/vegetarian maybe look into heme iron supplements (or give yourself and excuse to more steak and spinach)

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Milam1996@reddit

Diagnostic criteria for anaemia is based on HB not iron levels. The iron is just the symptom. You need to figure out why your iron levels are low, especially if you’re already supplementing.

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RavenSaysHi@reddit

The NHS is not going to help you unless you fight the battle persistently until the bitter end. Show them the information and if they won’t do anything refuse to leave until they suggest an appropriate treatment. I used to be a very mild and shy person but the NHS has gaslit me to the point of losing my mind. You have to advocate for yourself, no one else will.

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Tiny_Cauliflower_618@reddit

If you can, get a new GP. If you can't, take a man to your appointments and give them the NICE guidance and get them to raise the issue.

Also... Ferritin doesn't just bloody disappear, so you need someone to be investigating whatever is causing the issue in the first place, unless you've been vegan or otherwise diet restricting for years. In my case I had stupid heavy periods all my life and then gave blood twice 🤦 I have been taking iron regularly WITH ORANGE JUICE lol for ..like 8 years. My ferritin is only now getting to good solid levels. Tranexemic acid makes a huge difference if it works for you, it basically helps you clot, so you don't lose so much blood. I went from Super Plus Extra tampons to Regular.

Dr Nighat Arif is the absolute bomb. Have linked her talking about how to access help and not being overlooked, but if you check her back catalogue she talks a LOT about this stuff and you should be able to access some solid advice.

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