Can borderline iron deficiency still cause symptoms?
October 18, 2011 1:21 PM   Subscribe

Can borderline iron deficiency still cause symptoms?

I had iron deficiency about a year ago - always tired, heart pounding, out of breath easily - and at that time had a Ferritin of 11, though my CBC was otherwise normal.

Supplements made me feel better in a few months, though for the most recent couple months I got lazy with them since I'd been OK for a while. For the past few weeks I got the exact same symptoms, but my Ferritin came back as 42! My results say this is still a "probable iron deficiency" according to my health system's latest guidelines, but this is almost 4x the iron I had when I had the symptoms before.

My CBC was all in normal range (though my RBC count and Hematocrit are on the low side), I had a negative test for mono, TSH thyroid test was normal and so was Vitamin B12. Could low iron be my culprit or should I start looking for another cause? My doctor says it's iron (or stress) but I want another opinion. Thanks.
posted by vanitas to Health & Fitness (6 answers total) 5 users marked this as a favorite
Yes, lowish iron can cause symptoms (according to my doc). But when I last had similar symptoms, my iron and thyroid (can't remember which thyroid test now; I had several done) were low-ISH but my vitamin D was REALLY low. I started taking iron, prescription vitamin D, and Cytomel for the thyroid, and the three together really helped a lot. Did you get your vitamin D checked? That's another common cause of exhaustion, and many people are deficient these days. The thing I love about my doctor is that she works with he symptoms, rather than just the blood test results, based on the theory that "normal" may mean slightly different things for different people-- so lowish might still be really low for you.
posted by instamatic at 1:51 PM on October 18, 2011

When I got tested for iron deficiency a few months ago, they did an iron binding profile after my ferritin came back low. That said I was low on iron serum and transferrin saturation. An iron binding profile might point out some numbers that are still lowish.
posted by disaster77 at 1:58 PM on October 18, 2011

Response by poster: I've never had my Vitamin D checked, my doctor said that they aren't supposed to test it because everyone is deficient here in the Northwest. Which seems like strange reasoning, I do take daily 500 IU D supplement already though.

I've never had a transferrin or iron serum test either, maybe I'll ask for those. I'm curious why my Ferritin would be nearly OK while these numbers were low though.
posted by vanitas at 2:28 PM on October 18, 2011

With a ferritin of 14 I was prescribed iron supplements (after 6 months of 200mg per day I got up to 42) and my doctor was convinced I should be feeling "much better" even though I hadn't had any symptoms. I felt fine at 14 and I felt exactly the same at 42... she wouldn't accept that though - just said that I must have had the problem for so long that I didn't notice and the improvements were so gradual that I didn't notice the difference. It was never specified what exactly those symptoms should have been though
posted by missmagenta at 2:33 PM on October 18, 2011


I've heard of symptoms anywhere below a ferritin level of 50.
Also, for women with low-ferritin related hair-loss, a lot of reports online indicate that they don't start regrowing hair til they get over 70.
Which does look suspiciously like the optimal level is a good way above what is classed as the bottom of the 'normal' range.
It is a ridiculously large range, often between 15-300.

Also, ferritin levels can be raised if there is an mild infection (eg virus etc). So low ferritin is proof of actually low ferritin/iron depletion, but a high result doesn't necessarily disprove it, y'know?

If Iron helped before, I would keep taking it, and try and get it into that 70 range (you've had a good improvement in the last year!), and at the same time, still keep an eye out for other possible reasons as well.

Also, if you've been low in iron, it's marginally more likely you might have other nutritional deficiencies, they all affect each other, and can be impacted by the same causes (eg poor absorption etc).
The supplements I've really heard of as helping people, and the most likely culprits in your case are a Zinc & Magnesium combo (unfortunately zinc interferes with iron uptake, so take at a different time of day as iron & calcium).
And if you're taking them anyway, add some Vitamin D (4,000iu a day - which is equivalent to about 4 mins full-body sun on caucasian skin [if you can do that daily instead, do!], just to put another example of minimum versus optimal supplementation into perspective).

More on non-anaemic iron deficiency - Bunch of studies, overview.
posted by Elysum at 3:50 PM on October 18, 2011 [2 favorites]

Response by poster: Thanks Elysum, that was super helpful. Considering that I just got over a dreadful 3-week sinus infection, I think I can hit the iron for a while and put aside the hypochondria.

I already take a Vit D supplement and a multivitamin, but I'm nowhere close to 4000 IU in D so I'll try to up my intake. I'm in Vancouver where we don't see the sun much in the winter so it's hard to get it naturally.

What you say about hair loss is interesting because I feel like I've been 'shedding' a little extra lately. Could just be my imagination, though...
posted by vanitas at 5:55 PM on October 18, 2011

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