How much iron should I take? (29F, low ferritin & hair loss)

April 25, 2020 8:12 AM

I posted a question about my hair loss a few days ago, and I guess the conclusion is my ferritin levels are too low and that's likely why I've been losing my hair. How much iron is it safe to take though? I won't be able to consult this with a doctor nor have my ferritin levels checked anytime soon, and google wasn't of much help.

So my last blood test results (August 2019) show that my ferritin was 18 ųg/l at the time. Apparently the norm is somewhere between 11 - 307, but my ferritin should probably be much higher to stop the hair loss. Also I've been taking a daily supplement containing 6mg iron for about 6 months before my last blood test, so I guess my ferritin levels would be even lower without it. I stopped using the supplement shortly after getting the test results and started taking 20mg iron about once a week, or sometimes not even that. My diet hasn't really changed since, so I guess it's safe to presume that my ferritin levels are roughly the same now, if not lower.

Obviously under normal circumstances I would be consulting this with a doctor and having my ferritin levels checked again before starting taking iron supplements, but I'm not sure how long I'll have to wait to do that due to all the covid restrictions. Also it'll take a long time for my hair to start growing again so I'd like to do something about it now.

I started taking 35mg of elemental iron (ferrous gluconate) a few days ago and I was planning to maybe double the dose and eventually take 70mg a day. However I've noticed that ever since I started taking the 35mg supplement (in the morning at least 1 hour before eating and together with vitamin C), I've been feeling exhausted in the afternoon, and especially in the evening - I'm extremely sleepy and ready to go to bed at 9PM or even earlier. Is this a side effect of taking the iron supplement? Should I lower the dose or will it get better as my body gets used to it? What do you think is the highest dose of iron that I can safely take without consulting a doctor?

posted by U.N.Owen to Health & Fitness (8 answers total)

I'm not sure how much you can safely take. IANAD.

But from personal experience as somebody who also has low iron, my doctor has said I can pick up any over-the-counter iron supplement. Most of them have 60-70 mg.

I've found that dose makes me nauseous though especially given that they recommend taking the iron on an empty stomach or 1 hour before a meal. Gross. It makes me so nauseous I stop taking the supplement.

Now I take a gentler supplement which is 28mg. It's actually called gentle iron, and I've been able to keep up with taking one everyday, so I figure even though the dose is lower, it will be more beneficial over the long run. So I would say keep up with your 35mg a day if your stomach is tolerating it well. I do not think the exhaustion is related to iron supplementation; if anything, it may just be related to the low iron or something else entirely.
posted by spicytunaroll at 9:32 AM on April 25, 2020

I also have low ferritin that mostly causes fatigue for me, though I suppose it might also partly explain my hair loss. Oral iron supplements of any kind I’ve tried make me extremely fatigued, as you describe. I don’t think it’s a standard side effect but it is definitely the case for me. I get iron infusions, which help a ton without side effects for me, but obviously aren’t an option right now. I’m hoping to get my next one as soon as it’s safe to do so COVID-wise. In the meantime my GP suggested getting as much iron as possible through my diet, which doesn’t seem to have the same side effects for me. If I were you’d I’d do dietary iron plus whatever oral iron supplements you can tolerate, including going back to your old 6 mg supplement if it didn’t cause side effects.
posted by bananacabana at 9:55 AM on April 25, 2020

I would take 60 or 70mg per day if you can tolerate it -- though taking 35mg a day consistently will certainly get your levels up; it just won't happen as quickly.

The fatigue side effect is interesting, and I wonder if it would help to also take B12 and folate. Supplement formulas often combine them with iron. There seems to be a synergistic relationship between the three nutrients -- and sometimes taking a high dose of a given nutrient has a knock-on effect of depleting something else.

Depending on what country you're in, you can do finger-prick tests through the mail to check your levels of ferritin and other things, if that would give you peace of mind.
posted by Gamel at 10:22 AM on April 25, 2020

I’m glad that you are taking a specific Ferritin or FE supplement. Those are different than regular iron pills so you are ahead of the game. I’ve struggled with normal hemoglobin/low fe for years so I know your pain. My last ferritin results were actually 0, I get infused every six months to keep them at around 10 or so. It’s not easy. I can’t answer your specific question but wanted to offer a tip. I saw no difference in my fatigue or fe levels when I increased my red meat consumption (as suggested by my dr) but I did see a pretty good bump when I increased my fresh spinach consumption. I try to eat 2-3 large servings a day and you can put it in almost anything and it doesn’t change the taste that much. Add some to your diet, I cook it with eggs, sauté it with meat, in smoothies, salads wherever you can. Might help out till you can do some real bloodwork and get solid answers from your dr. Good luck!!
posted by pearlybob at 11:28 AM on April 25, 2020

My doctor is doing telemedicine and taking in person appts starting next week. Worth a shot.

One other thing to consider- are you taking any medications that reduce stomach acid? That affects your ability to absorb iron. If you've been on PPIs or other medication for an extended period of time it's definitely a factor.
posted by fshgrl at 11:40 AM on April 25, 2020

I struggled with low iron for a long time and I have taken a variety of different iron supplements. If you are a women struggling with low iron, if you are taking the recommended dose, you can probably take the iron supplement for a while. It usually took me at least 3 months to see any improvement. I never felt tired taking iron, but I had to experiment to find something that didn't bother my stomach. The thing that finally improved my iron was getting a hormonal IUD, which basically stopped my period. I realize that's not an option right now, but it's something to consider for the future.
posted by ice-cream forever at 2:58 PM on April 25, 2020

I was diagnosed with anaemia last November and have been taking 400mg of ferrous sulfate in two 200mg doses per day since then, and have had this much iron prescribed to me for at least a year. Everyone I've spoken to about it agreed that it's hard to absorb digestively and my body won't be fully absorbing all 400mg/day but no one has been concerned about other health effects from taking a dose that size, nor have they suggested that I need regular blood tests to monitor this or anything, so I suspect you could take a higher over-the-counter dose if you want to see results more quickly.
posted by terretu at 12:58 AM on April 26, 2020

Thanks everyone. The finger-prick test is a good idea! I ordered one and will see what my ferritin levels are right now.
posted by U.N.Owen at 4:11 AM on April 29, 2020