Low Ferritin - Anything I should know about my prescriptions?
November 20, 2019 4:00 PM Subscribe
I (38 cis F, never been pregnant) just had a check up and am not at all surprised to find my ferritin is low. I've been prescribed a daily dose of 325mg of Ferrous Sulfate (w/ orange juice) and 100mg of Colace to prevent constipation. Anything I should be aware of?
YANMD
My RBC, Hemoglobin, and Iron / TIBC all came back normal but Ferritin was 7. I've had borderline anemia in the past but was prescribed iron supplements due to low hemoglobin. I've seen people here complain about their supplements but I wasn't sure which ones they were referring to.
If you have taken Ferrous Sulfate and Colace, how did they make you feel? I will see my doctor again in a month so I can address any issues with her, of course. I do know about the infusion but I'm happy to try the supplements first to see if they're sufficient.
I also have low Vitamin D at 18.2ng and the doctor has asked me to take Vit D3 1000iu daily for the next 3 months.
I think it's obvious that I'm fairly low energy. Assuming my body does well with absorption and getting my levels up, how quickly might I start to notice a change in my energy/fatigue?
YANMD
My RBC, Hemoglobin, and Iron / TIBC all came back normal but Ferritin was 7. I've had borderline anemia in the past but was prescribed iron supplements due to low hemoglobin. I've seen people here complain about their supplements but I wasn't sure which ones they were referring to.
If you have taken Ferrous Sulfate and Colace, how did they make you feel? I will see my doctor again in a month so I can address any issues with her, of course. I do know about the infusion but I'm happy to try the supplements first to see if they're sufficient.
I also have low Vitamin D at 18.2ng and the doctor has asked me to take Vit D3 1000iu daily for the next 3 months.
I think it's obvious that I'm fairly low energy. Assuming my body does well with absorption and getting my levels up, how quickly might I start to notice a change in my energy/fatigue?
I take ferrous sulfate and colace too. The iron makes me both constipated and nauseous. I usually take 2 colace a day, but sometimes need 3. Generally speaking, I can manage the nausea with ginger, but I do have a prescription for Zofran when I need it.
I take calcium + D3 everyday for Osteopenia and haven't noticed any side effects from that.
It's been a while since I started, so I can't remember how long it took.
Another thing you might want to get checked is your B12. I take a supplement once a week because I had bariatric surgery and don't adsorb it very well.
posted by kathrynm at 4:29 PM on November 20, 2019
I take calcium + D3 everyday for Osteopenia and haven't noticed any side effects from that.
It's been a while since I started, so I can't remember how long it took.
Another thing you might want to get checked is your B12. I take a supplement once a week because I had bariatric surgery and don't adsorb it very well.
posted by kathrynm at 4:29 PM on November 20, 2019
Response by poster: My B12 was also checked and came back high, 1025 pg. My doctor hasn't yet advised me on that, though.
posted by acidnova at 4:33 PM on November 20, 2019
posted by acidnova at 4:33 PM on November 20, 2019
I had low ferritin and after a couple of months taking ferrous gluconate I started to feel a bit better. I kept improving for several months.
posted by burntflowers at 4:56 PM on November 20, 2019
posted by burntflowers at 4:56 PM on November 20, 2019
I take a "slow FE" supplement and find that if I take it with food (breakfast or lunch - don't take it at night), I don't have the nausea. Slow FE is a lower dose than what you've been prescribed. I haven't needed Colace. My ferritin was 6 when I tested, and I felt noticeably better within 4-5 days. My first clue was that mid-afternoon tiredness went away.
posted by xo at 5:09 PM on November 20, 2019
posted by xo at 5:09 PM on November 20, 2019
If the ferrous sulfate bothers your stomach (it bothered mine but I have a lot of issues—I can’t actually have orange juice, too acidic, so absorption was an issue too), try a heme iron polypeptide supplement. ProFerrin and Hema-Fer are two I’ve tried and they are both fine.
My ferritin was at 9 and I switched to this type after stomach issues with the other iron supplements; it didn’t bother my stomach as much and brought my ferritin up to an acceptable level in a couple of months.
Drawbacks: It’s NOT vegetarian and is more expensive. Pros: 10x better absorption than ferrous sulfate and is not as hard on stomach.
posted by hurdy gurdy girl at 6:13 PM on November 20, 2019 [4 favorites]
My ferritin was at 9 and I switched to this type after stomach issues with the other iron supplements; it didn’t bother my stomach as much and brought my ferritin up to an acceptable level in a couple of months.
Drawbacks: It’s NOT vegetarian and is more expensive. Pros: 10x better absorption than ferrous sulfate and is not as hard on stomach.
posted by hurdy gurdy girl at 6:13 PM on November 20, 2019 [4 favorites]
I had low ferritin a few years ago—20 when I was tested, and that was after a few weeks of iron at the same dose you were recommended.
1. Think marathon, not sprint. You’ll start to feel better within a few weeks, certainly, but it will take at least a year of daily supplementation to get your ferritin levels up where you want ‘em. But hey, that year’s gonna go by either way. Focus on making the daily pill a habit.
2. OJ is good because vitamin C helps absorb iron. Many people feel nauseous with iron supplements if they don’t take them with food, and for me, OJ must count as “food” because I don’t get nauseous.
If you feel nauseous anyway, try taking your supplement shortly before bed. They also make different forms of iron. Iron sulfate is the least expensive, and you probably got a bottle of about 300 tablets for like $10. However, there are other formulations that might make it easier on your stomach, so don’t be afraid to try a few brands. I like Vitamin Shoppe’s house brand of Comfort Iron (ferrous bisglycinate chelate, about $7 for 90 capsules) and also Blood Builder, which was the most expensive of the brands I tried (a 3-month supply was about $30). You might need to take two of those (e.g. morning and evening) but just be aware that you have choices. Both those brands are vegan.
3. Expect your poop to be greenish black. That’s extra iron that you haven’t absorbed. It’s okay.
4. Don’t take iron within 2 hours of consuming caffeine or dairy, since both caffeine and calcium prevent iron absorption. If you have to do something fun like take iron AND calcium supplements, just set a notification/alarm so you don’t forget. Let’s say you drink your morning coffee before you leave for work, and then you take your iron dose at lunchtime. You get the idea.
5. I also didn’t need to take Colace (the iron didn’t constipate me) but magnesium and caffeine (see #4) will also keep the mail moving if that turns out to be a problem. Try taking iron for a week to see if you do get constipated. If you don’t, well, that’s one less pill.
It took me about 4 months to get from 20 to 65, and after a year I was at 90. YMMV depending on your daily habits and menstrual cycle (heavy bleeding means it’ll take longer to get your levels up—I was not dealing with that issue). But that should give you a ballpark of progress. Now I take the Comfort Iron a few times a week to keep my iron in a decent range.
posted by Autumnheart at 6:27 PM on November 20, 2019 [2 favorites]
1. Think marathon, not sprint. You’ll start to feel better within a few weeks, certainly, but it will take at least a year of daily supplementation to get your ferritin levels up where you want ‘em. But hey, that year’s gonna go by either way. Focus on making the daily pill a habit.
2. OJ is good because vitamin C helps absorb iron. Many people feel nauseous with iron supplements if they don’t take them with food, and for me, OJ must count as “food” because I don’t get nauseous.
If you feel nauseous anyway, try taking your supplement shortly before bed. They also make different forms of iron. Iron sulfate is the least expensive, and you probably got a bottle of about 300 tablets for like $10. However, there are other formulations that might make it easier on your stomach, so don’t be afraid to try a few brands. I like Vitamin Shoppe’s house brand of Comfort Iron (ferrous bisglycinate chelate, about $7 for 90 capsules) and also Blood Builder, which was the most expensive of the brands I tried (a 3-month supply was about $30). You might need to take two of those (e.g. morning and evening) but just be aware that you have choices. Both those brands are vegan.
3. Expect your poop to be greenish black. That’s extra iron that you haven’t absorbed. It’s okay.
4. Don’t take iron within 2 hours of consuming caffeine or dairy, since both caffeine and calcium prevent iron absorption. If you have to do something fun like take iron AND calcium supplements, just set a notification/alarm so you don’t forget. Let’s say you drink your morning coffee before you leave for work, and then you take your iron dose at lunchtime. You get the idea.
5. I also didn’t need to take Colace (the iron didn’t constipate me) but magnesium and caffeine (see #4) will also keep the mail moving if that turns out to be a problem. Try taking iron for a week to see if you do get constipated. If you don’t, well, that’s one less pill.
It took me about 4 months to get from 20 to 65, and after a year I was at 90. YMMV depending on your daily habits and menstrual cycle (heavy bleeding means it’ll take longer to get your levels up—I was not dealing with that issue). But that should give you a ballpark of progress. Now I take the Comfort Iron a few times a week to keep my iron in a decent range.
posted by Autumnheart at 6:27 PM on November 20, 2019 [2 favorites]
After years of trying supplements and just being miserable while on them and, well, anemic while off of them, I switched docs and she takes everything very seriously and it is amazing to be heard. She referred me to a hematologist after several months of chronically low iron counts and he took me seriously too (it was like magic, I swear) and I got my first iron infusion that week. I've had two, and I go back this week to see what my numbers are. I honestly do feel a difference.
I hope the supplements work for you, but if they don't, the infusions are pretty great.
posted by cooker girl at 6:28 PM on November 20, 2019 [1 favorite]
I hope the supplements work for you, but if they don't, the infusions are pretty great.
posted by cooker girl at 6:28 PM on November 20, 2019 [1 favorite]
Another vote for the infusions if the supplements don’t work for you. I took a variety of supplements for about five months, felt nauseated and even more fatigued on them, and my numbers didn’t move much. I am prone to GI discomfort/issues in general anyway, so hopefully this won’t be the case, but if you do end up needing infusions, don’t worry. For me, they had no side effects, each one jumps my ferritin level up by 50 or more, and I feel better within a week.
posted by bananacabana at 6:32 PM on November 20, 2019
posted by bananacabana at 6:32 PM on November 20, 2019
I had the same sort of thing (low ferritin levels but normal other markers) and got put on the same sort of thing (although I was given psyllium fiber instead of colace). I don't remember having any particular ill effects from taking the iron supplements (and my doctor had me taking 3x as much after the 1x dose wasn't making enough of a difference).
I don't remember it making much of a difference in my energy levels, though I don't think it was ever a specific complaint for me. My doctor discovered my ferritin levels were low coincidentally as a result of other complaints and was pretty concerned about the low ferritin level.
posted by that girl at 8:48 PM on November 20, 2019
I don't remember it making much of a difference in my energy levels, though I don't think it was ever a specific complaint for me. My doctor discovered my ferritin levels were low coincidentally as a result of other complaints and was pretty concerned about the low ferritin level.
posted by that girl at 8:48 PM on November 20, 2019
I can't speak to the ferritin, but when my vitamin D was 11ng I noticed improvement with supplementation within the first month, but I got put on a much higher temporary dose, and I'm a little surprised you weren't as well at 18. IANAD, but many people supplement much higher under doctor supervision for a very short period of time (think 10,000 iu daily) and then retest. On that protocol I felt less completely exhausted pretty quickly, and I have experienced the same 1-3 weeks to response whenever I forget to start supplementing at 3-5k iu daily in the fall and then go get tested in December because I feel terrible and realized I'm bouncing around at 30ng +/- 10.
posted by deludingmyself at 10:10 PM on November 20, 2019
posted by deludingmyself at 10:10 PM on November 20, 2019
My B12 was also checked and came back high, 1025 pg. My doctor hasn't yet advised me on that, though.
High is fine, you can't OD on B12. B12 is water soluble so you just pee out the excess. If it's low, you'd worry about Pernicious Anemia, an autoimmune disease that is often discovered due to low ferritin.
posted by DarlingBri at 10:03 AM on November 21, 2019
High is fine, you can't OD on B12. B12 is water soluble so you just pee out the excess. If it's low, you'd worry about Pernicious Anemia, an autoimmune disease that is often discovered due to low ferritin.
posted by DarlingBri at 10:03 AM on November 21, 2019
Response by poster: Thanks so much for all your responses!
Thought I'd jump back in for anyone who might be curious. It's been about a week and I am starting to feel a little better already. No real issues with nausea or constipation.
My regime right now is Vitamin D with breakfast which is usually cereal (calcium) and coffee and colace + iron at lunchtime with a glass of orange juice. I discovered that if I take the colace first and the iron about 10-15min later, I don't have any issues. The first day I took them at the same time and didn't feel great (but not awful).
posted by acidnova at 11:19 AM on November 29, 2019
Thought I'd jump back in for anyone who might be curious. It's been about a week and I am starting to feel a little better already. No real issues with nausea or constipation.
My regime right now is Vitamin D with breakfast which is usually cereal (calcium) and coffee and colace + iron at lunchtime with a glass of orange juice. I discovered that if I take the colace first and the iron about 10-15min later, I don't have any issues. The first day I took them at the same time and didn't feel great (but not awful).
posted by acidnova at 11:19 AM on November 29, 2019
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posted by Countess Sandwich at 4:28 PM on November 20, 2019