low ferritin fatigue

An Often Overlooked Cause of Fatigue: Low Ferritin

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Fatigue is a very common complaint, reported to general practice doctors up to 25 percent of office visits. The incidence of fatigue is even higher than this, however, since many people experiencing fatigue do not report it to their doctors. Many people are tired because of busy lives, work and home obligations, and not getting enough rest. Fatigue is also a component of many illnesses and chronic diseases. Often fatigue is dismissed by doctors either as being a normal part of life, or as being a result of emotional disturbances or stress. Women are three times more likely to have fatigue than men.

Iron Deficiency Anemia

One common cause of fatigue in reproductive age, menstruating women is iron deficiency anemia. A lesser known cause but possibly equally prevalent is low ferritin, caused by low iron stores. Iron deficiency anemia occurs when there is not enough iron in the body, and the production of red blood cells is affected. It can affect up to 20 percent of women. Causes of iron deficiency anemia in menstruating women include heavy periods, gynecological diseases such as fibroids or adenomyosis, gastrointestinal bleeding, and gastrointestinal malabsorption.

Iron deficiency anemia is often assessed by taking blood and measuring the hemoglobin level: hemoglobin is a protein in red blood cells that binds to iron, and transports oxygen in the blood. Hemoglobin is measured as part of a complete blood count (CBC). Normal hemoglobin range in the blood is usually 12 to 15 g/dL, but the normal range can vary slightly depending on the lab. In iron deficiency anemia hemoglobin values are lower than 12 g/dL.

Symptoms of iron deficiency anemia include:

  • Fatigue
  • Shortness of breath
  • Dizziness
  • Headaches
  • Cold hands and feet
  • Pale skin
  • Chest pain
  • Weakness
  • Restless legs syndrome

Iron deficiency anemia is usually easily recognized and treated. The CBC is a very commonly performed blood test, and low hemoglobin, plus other results contained within the CBC panel, is a good indicator of iron deficiency anemia. It is treated with oral iron, which can be obtained in drug stores without a prescription. Side effects of oral iron include nausea, vomiting, constipation, diarrhea, dark colored stools, and abdominal pain. Iron supplements should not be taken without having a doctor monitor the blood levels of iron, since too much iron can cause buildup of excess iron and organ damage.

Low Ferritin and Fatigue

Although the importance of treating iron deficiency anemia is well recognized, many health practitioners do not test the body’s iron stores, and low iron stores, indicated by low ferritin levels, can also cause fatigue. Ferritin is a protein that stores iron in the body. It is not measured by the CBC, but can be measured by a separate blood test. Usually the only consequence of low ferritin is thought to be that it might put a person at risk for developing iron deficiency anemia. However, low ferritin on its own, even without anemia, can cause fatigue.

Several studies have shown that in people with fatigue, with normal hemoglobin levels, oral iron supplementation can improve fatigue. This was particularly true when ferritin levels were below 50 µg/L. Intravenous iron supplementation is another option for treatment and may be particularly appropriate if the ferritin levels are below 15 µg/L. Most labs use 12 -150 µg/L as the normal range for women for ferritin, although this may vary from lab to lab. Therefore, many women who could benefit from iron supplementation for fatigue may be classified as having “normal” ferritin levels.

The normal reference ranges are obtained by sampling ferritin concentrations in populations of women, many of whom may have had iron deficiency, and whether the lower limit of the normal range is actually too low has been brought into question. The fact that iron supplementation improves fatigue when ferritin levels are below 50 µg/L would suggest that this is the case. Therefore, all women should be aware that low iron levels can contribute to fatigue even if anemia is not present, that checking ferritin is an important part of an investigation into unexplained fatigue, and that even if their ferritin levels are deemed to be “normal”, that if the levels are below 50 µg/L, iron supplementation may improve their fatigue.

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Photo by Andrea Piacquadio.

This post was first published on April 2, 2014. 

Philippa is a scientist and writer currently working as a medical writing consultant and as the Executive Director of The Endometriosis Network Canada, a non-profit organization whose mission is to provide education, awareness, support, and hope to people affected by endometriosis. Philippa has previously worked in molecular diagnostics at Luminex in Toronto, Canada. Philippa's academic experience includes a Ph.D. in Medical Genetics and Microbiology from the University of Toronto.


  1. In early 2018, I contacted my Dr for fatigue. My ferritin and iron levels were tested with a ferritin level of 31 with normal iron levels. All considered normal so no supplements were taken. In 2020 I contacted my Dr. again with extreme fatigue. my Ferritin levels were 6, with below or lower end of normal levels. I also was given and took an at home stool test and that was negative. I was advised to take an iron supplement. After 2 months, my ferritin went up to 22 and iron levels leveled out. I stopped taking the supplements. Now, in early March of 2022, after having a hysterectomy in summer of 2021, I started feeling fatigued again. It is now July 2022 and my ferritin is at 24 and my iron levels are all fine. My fatigue is unbearable. I am on the verge of falling asleep while driving, trying hard to keep my eyes open. 2 different Dr.s want to test me for sleep apnea. I sleep great, I wake up refreshed, I don’t snore. I don’t think its this. One Dr. advised to take iron supplements since my ferritin was on the low end of normal but he does not thing that is the cause of my sleepiness. After just 3 days of taking iron, I am already feeling more energy and less sleepy. Not sure if it really could be my ferritin levels. I’m so confused.

  2. A dermatologist specializing in hair health said that hair starts to fall out more once ferritin levels are below 80.

    • True. I find hair balls stuck to the carpet, in the washer/dryer. Ferritin doesn’t stick tho, just keeps decreasing with no definitive reasons why.

  3. I am due tomorrow to begin infusions once weekly leading up to delivery (due March 20) My ferritin is 7 and just also have low HGB MCV etc
    I am praying it will build me up for birth
    This is my 11th pregnancy
    My concern is I keep seeing in some online Iron Deficiency groups that the infusions are risky for anyone with low D levels, low Phosphorus or low thiamine etc
    I likely have all those running low
    I can’t help it. I’ve been malnourished for years and have difficulty eating well due to POTS and Mast Cell issues. I can’t tolerate any Oral supps. My stomach barely takes Whole Foods.
    I want so badly to just dive into the infusions and pray for healing but I know vitamins and minerals have a delicate balance and I am worried I will further worsen something. But at the same time I need my iron up for be birth or they’re concerned with hemorrhage and blood transfusion. My symptoms of low ferritin match perfectly. My POTS doctor thinks it may even be part of my POTS. Anyone have advice or thoughts?

  4. Hello! My ferritin was at 21 some 6 months ago and now at 15. I suffer adenomyosis so the root cause is known in my case. My hemoglobin is at 12.4 but my hematocrits at 35% which was below the lab range and my erythrocytes were also below lab range. My corrected reticulocyte count at 0.6% and my Reticulocyte Production Index at 0.6. I started taking Floradix Iron but I see no improvement. I am these “extreme fatique attacks”. Like I’m fine one minute and the next I simply just really want to sleep. I feel sudden energy blackholes. Can it be cauded by all this?

    • That’s been my experience and once I got my ferritin levels up (~100), I didn’t have that problem anymore. I did oral supplements for a few years but only went up 20 point.. then I did an iron iv and that got it up around 100.

  5. Hi there. I have a ferritin level of 5. I have taken iron for 5 weeks now but not feeling much better ! My biggest concern is the fact that I often feel like I can’t get enough air and my breathing is shallow. I am scared about this! Any advice? Thank you

    • It will take quite a long time to bring your levels up with oral iron. If you are concerned about shortness of breath, I suggest visiting your primary care physician to do a more complete workup since there are many other causes of shortness of breath that could be contributing.

    • With Ferritin at 5 you must be feeling like you are dragging across the earth. I did when I was at 5. Breathlessness would be expected at 5. Can you be referred to a hematologist for iron infusions. What will need to be ruled out first is internal bleeding.

  6. Philippa could you point me towards all that research about ferritin levels below 50 causing anemia symptoms, I’d like to show them to my GP. My haemoglobin is at 13.1 and my ferritin is at 31 and none of the doctors I have seen believe that my ferritin level is causing my symptoms. I’ve been taking iron tablets for a month now and there’s already been a reduction in symptoms (brain fog, dizziness, anxiety) but I’m still very limited in energy (fatigue, shortness of breath, tingling in body was there all the time and mostly at night, now only if I’ve exerted myself) and I’m unable to work. I’m so tired of hearing doctors say that my ferritin falls within normal range and is not responsible for my “anemic” symptoms. Thank you.

    • Hello Joy, if you click on the pink text in the article, it will take you to the articles describing the research that I’ve referenced in the article. A hematologist usually has a better understanding of these issues, if you are able to get in to see one.

      • Hi my ferritin was a 10 been on iron for 6 weeks it’s now a 19 but the test says between 15-150 is normal. Are you saying I should try and get my ferritin to 50? I don’t think my ferritin has ever been over 20. I’m 46 and in Peri pause I have heavy long periods and sometimes 2 or 3 periods in a month Wich only leaves me with 1 week no bleeding.

        • If you don’t feel like you have symptoms, you don’t need to try to get it higher, but many people will have symptoms with ferritin under 50. With heavy periods that is very difficult to do, so you would need to reduce your period bleeding. There may be an underlying cause of the heavy bleeding that you can treat. Have you talked to your gynecologist?

    • I went to several doctors before I figured out my ferritin is the cause of my symptoms (similar to yours). I don’t know why do many doctors are so clueless about this. I ended up going to a private clinic and requesting an iron iv. That made all the difference for me.

  7. The comments in here are great. I love all the suggestions. I have low ferritin but normal hemoglobin (most of the time…). In May 2018, my ferritin was a 7. It was great because it finally explained a lot of the weird symptoms I was experiencing (anxiety, major brain fog to the point of an almost out of body experience, irritability, insomnia, restless leg syndrome, fluttery and rapid heart rate, etc). I was taking a 30mg iron supplement (Rainbow Light) and after 5 months, in October 2018, I was up to 14. Stupid me, since I also addressed the cause of heavy periods (which was Copper IUD), I assumed that in addressing that and just making sure I consumed iron-rich foods, that I would probably be fine and when I ran out of supplements, I did not replenish and stopped taking them. 8 months later and I am back down to 7 🙁 So bummed. But the symptoms were creeping up on me clear as day and I recognized it immediately. Guess I will need to get back on supplements and get myself higher up this time before I try to forgo the supplements again.

    • I have been dealing with the same exact symptoms, I was wondering if you got better from the iron supplements. I am on day 2 only, and really hoping this would help.thank you.

  8. Following a pulmonary embolism at the end of May 2018 I’ve been taking anti-coagulants (Xarelto quickly changed to Eliquis) I was diagnosed with anemia in late November.
    Blood tests showed ferritine levels of : 10.8 ug/l before I started taking prescribed iron supplements; 4 months on I’m up to 14.4 ug/l, but am still feeling as wiped out as ever.
    14.4ug/l is apparently in the normal range – is it normal to still be this wiped out & how long can it take for the symptoms to pass?

    • That is still pretty low. Most hematologists say that in order to feel good, your ferritin needs to be over 50. It does come up slowly though. The low end of the normal range for ferritin is probably just too low for most people. Keep in mind that the normal ranges are set by sampling a group of “healthy” volunteers. Probably some of them have low ferritin without realizing it. So many women do, because of heavy periods.

  9. Hi I am 44 yrs old women.For last couple of years I have been facing problem when i go upstairs or walk with little bit of space. A pain around my chest, neck.jaws and with a rest of a minute it goes away. I always been a person withlow himoglobin. Rwcent test reveals a hb level of 8.4 and ferritin is as low as 3.8.
    Doctor has given me some oral iron supplement along with medicine for calcium blocker
    Pls suggest.

    • Have you had a full cardiac workup? This would be a good thing to do to rule out any serious issues. Chest pain should probably be investigated.

      • Hi all! Here is a healthy all natural thing to do to boost your iron stores. In addition to the iron pill you get at the drugstore or your liquid iron supplement, take one tablespoon of unsulfured blackstrap molasses twice daily for the rest of your menstruating years. It will help a lot. If you can only manage one tablespoon once a day then that is better than none at all. Heavy periods cause low iron but also low iron can also cause periods to be heavier. So what I mean is this is to be taken every day of the month and not just one or two weeks per month. Every day until you are in menopause and no longer have any periods.

  10. Hi . I am perimenopausal, and had been running a few times a week but I the spring I started feeling reconditioned.I didn’t have endurance, kept stopping frequently to walk. I also felt short of breath and leg fatigue just going up the stairs at home. I was very tired.My Hgb and hct were borderline low. I started Slow FE daily for a few months. I started feeling better the first month.I have slow transit , had myoplasia in my stomach 3 yrs ago which has healed with Omperazole 40 mg daily. I had Barrets esophagitis dxd 2 years ago on f/ u endoscopy for the myoplasia. My GI doc must have gotten it early with the bx , because this past November , my f/u bx and endoscopy was clean. I started HRT recently . I never had heavy periods. I don’t eat fatty , fried or spicy foods. I don’t have much of an appetite
    My fecal occult blood was negative. I stopped the iron and had blood work a week or 2 later. My levels came up. My iron was elevated 177. My ALT was borderline high at 34 . I had stopped exercising regularly in mid September. I lost motivation..I haven’t been excercising. No desire. I’ve had depression and I know perimenopause and anemia contribute. I have been on Zoloft.
    So my CBC labs were re done a few days ago.My levels are all WNL except my Ferritin is 1 !!!!. I didn’t have it done before to compare. I also didn’t have another ALT, although I understand that can be acute change with exercise .my other LFT s were normal.my HGB went down from 13.4 to 12.4 in 2 and a half months. My iron was 159. I am wondering why my ferritin would be low while the other values are normal. Also I had done dome squats and jumps a few weeks ago and couldn’t finish the workout. Didn’t feel up to pushing any more.my legs were sore for almost a week and I was crippled walking and up n down the stairs for like 4 days.
    My primary doesn’t seem concerned. He wants to re check in a few months. I left a message for my GI.
    Any insights?

    • It can take a while for the ferritin to increase after you start taking iron. It is hard to know what is happening with you because you didn’t have a baseline ferritin number to compare to. If your GI agrees with your primary, it seems reasonable to recheck in a few months, and if you start feeling worse, check back in with your primary to see if they would be willing to do it sooner.

  11. hi, i was hoping to get some clarity and advice, while i try find another doctor for a second opinion. i did a blood test and all my hb levels were normal, but my serum ferritin was low (17 where the range starts at 30), however, my transferrin saturation was high at 51% as was my serum iron (33, just over the range of 30 being the highest value). im really confused why i would have low stores but high saturation? is it safe to keep taking iron supplements, im scared i might overload? are there disorders where your blood is high (i assume the saturation is the blood, im a bit confused) but your body wont store it? is that bad? help!!!

    • It sounds like your situation is complex–you will probably need to get answers from a good family doctor or a hematologist. Yes, it can be dangerous to take iron supplements if you are risk of overloading, and there are situations where your blood can be high.

  12. Hi, Thanks for the good article. My 14 year old has a Ferretin level of 4.0 and Hemoglobin of 11.5. She has heavy bleeding every two weeks. She’s an athlete, but has short endurance considering her great physical condition. Her doctor prescribes iron and we’ll work on diet to help. However, wouldn’t a hormone pill that can regulate her periods and reduce the bleeding be a good way to fix the blood loss and help improve her iron levels? I don’t see much about this and just see articles saying people with low Ferretin suffer from heavy menstruation. Wouldn’t it help to correct the menstruation issues? Not to mention that massive bleeding every two weeks is difficult for any young woman to manage.

    • Yes, it would definitely be helpful to address the root cause of the heavy bleeding, as well as correct the iron deficiency. However, a birth control pill will also just be a bandaid over the root cause of the heavy bleeding. Ideally your daughter would have a complete gynecological investigation to assess possible causes of heavy bleeding, and then the appropriate treatment can be prescribed. If a gynecological cause is not found, you might want to investigate hematological causes (a bleeding disorder), as 20% of women with heavy menstrual bleeding actually have a bleeding disorder causing it. It would be important to know this information as it could have health implications beyond her periods.

  13. My 14 year old daughter recently had blood work & we discovered her ferritin is 4.6. The doctor put her on a very other day iron pill with vitamen c to help with absorption. Reading up on low iron that level seems extremely low. She complains of being tired all the time, I’ve noticed her hair has gotten thinner over the last couple of years; which now makes more sense. Should I suggest iron infusions for her? Do you think that’s something that’s necessary for levels so low? Her doctor didn’t even seem very concerned. (We are currently overseas & see a military doctor so I don’t have many choices in the very small clinic where she has to be seen)

    • Her levels can still rise with oral iron, but it will take a lot longer. Also, if you don’t address the cause of the low ferritin, then the oral iron might not help much because she will be continuing to deplete her ferritin. Is the low ferritin from heavy periods? If you want her levels to come up faster, then an IV infusion of iron would be helpful. Even then, you’d want to address whatever was causing the ferritin to be low in the first place.

  14. Hello~
    I was just put on iron for about 2 months now. I am not feeling any better fatigue wise, and I have noticed diarrhea as well as some bad stomach pain and urgent bathroom visits. There are no signs of blood though, just a change in stool and feeling too tired to do certain things I have done in the past. This started just last year going into College.

    Thank you in advance. Just want a second opinion~

    • It can take a while for your hemoglobin to get back to normal when you are taking iron, so you might not feel better fatigue wise. You might need to try different formulations of iron to find one that agrees with your stomach.

  15. I should probably add that I’ve been on pantoprazole since sept 6th for acid reflux.. and I’ve just read that these types of medications can interfere with iron absorption!!! Why on earth didn’t the original Dr pick up on this? He prescribed me these meds and then 2 weeks later he is telling me to get an iron infusion cos my ferritin is low and reminds me to continue taking the reflux meds for another 4 weeks?! Wtf?! I’d say that the reflux meds have affected my iron levels but I actually wouldn’t know because the blood results are for my bloods pre-reflux meds! I’m so annoyed. I even asked the female Dr if the reflux meds would make me feel this exhausted! Perhaps the relationship / drug interference isn’t widely know.

    • IN my personal experience with pantoprazole, it made me very tired. I would ask your pharmacist whether this could be a side effect of the medication. Also, the absorption issue is a concern for oral iron treatment also. Many doctors aren’t necessarily aware of those types of interactions.

      • Thank you Phillipa. I turned a corner in the afternoon (5 days almost to the hour after the infusion!) Indidnt feel so weak and wa able to walk about quicker! If I continue going up then I know it was iron deficiency. Interesting about the pantoprazole. My pharmacist friend said PPIs are known to affect iron absorption and magnesium absorption too. But when I asked the Dr if tiredness could be a side effect of the pantoprazole she dismissed it.

  16. Background – I have endometriosis (symptoms of which have eased since having my son 4 years ago – no longer have heavy periods), hypothyroidism (treated and currently under control). I miscarried (#3) in May. Had a d&c (#3) in June. My 1st period afterwards in July was horrendous – heavy with huge clots, changing hourly (even through the night) for 3 days, finally completely finishing after a week.

    Also because of the recurring miscarriages and hypothyroidism I’ve had approx 30 vials of blood taken in the last 3 months to rule out any cause for miscarriage and monitor my thyroid.

    My haemoglobin has always been borderline low (105 -118) and i have been taking iron tablets for approx 6 months now.

    Present state: My iron stores (ferritin) have dropped from 135 in April to 22 on 5th Sept. Tests in July showed ferritin of 34 so I started 1 sachet of liquid iron (spatone) too.

    My new male Dr (we moved 30 mins away from our old one) suggested ferinject especially as we’re trying to conceive again and said the iron tablet isn’t strong enough for me.

    Since the Sept blood test and that GP consultation though I’ve had a normal period and experienced iron deficiency symptoms (extreme fatigue despite sleeping well and loads, to the point where I’m slow moving which is not like me AT ALL, can’t concentrate, am forgetful; weak, breathless, anxious feeling in my chest, dizziness, faint, low blood pressure, headaches and last night restless legs).

    I told the female Dr (different Dr to the one above) who did my pap smear, about the extreme fatigue (at that point kicking in around 3pm) – she reckons I’m just exhausted as says a ferritin level of 22 wouldn’t cause such acute symptoms. Although she did agree it’s a huge drop.

    I had the ferinject on Mon (24th) but apparently it can take a while to kick in (5-10 days to feel better; 1 month to feel normal; 2-3 months to be back to optimal levels).

    I saw my old Dr who I trust and have known for years and he thinks it’s multifaceted and that it could be a mix of everything- potentially the iron and perhaps I’m a bit depressed by our last loss. I know I’ve been feeling like I’m struggling to cope with the stress of life at the moment; juggling work and a very busy (like me!) 4 year old who’s curious and challenging (doesn’t do as we ask), running a home, without family around, but I have an amazing husband who does his fair share. And I am still grieving our last loss but I don’t feel depressed – I’ve been depressed before and this is very different; I’m positive, hopeful and still laugh without force.

    He advised to stop the oral iron until I go back in a week’s time for a reassessment (I guess to see if the ferinject does its thing without additional iron supplementation at play!) If I’m feeling perkier then he says it’s the iron and if I’m not then it’s external factors.

    But the exhaustion is worsening and I can’t do anything quickly without feeling worse, ALL day and is starting to get me down as I can’t do what I want! I feel worst in the mornings (I don’t snore so my old Dr ruled out sleep apnea), feel better after eating and laying down and doing nothing. I eat very well (rarely eat junk food, limit sugar and always have protein/fats/carbs).

    Is it normal to have mid-range iron levels with low haemoglobin and low ferritin (but not out of range) and feel acute symptoms too?

    We’re supposed to start IVF (takes us approx 18 months to conceive) next month but I’m too weak and can’t even walk without being puffed and light-headed, let alone undergo IVF!

    Looking at previous blood results after my 2nd d&c (Dec 2016) I had low haemoglobin and low ferritin but didn’t feel this bad but I was on liquid iron for 6 months – it took ages before my ferritin rose again which I understand is normal.

    If you had ferinject, how long did it take before you felt normal…a month seems a lifetime away. I can’t work, look after my son, even the washing is an effort!

    Is it possible for my ferritin and haemoglobin to be even lower now than they were on Sept 5th given I’ve had another period and the symptoms only kicking in on Sept 15th?

    • I’ve talked to numerous women who have been told by doctors that their low ferritin levels should not be causing symptoms as severe as they describe. However, fatigue does have multifactorial causes, and they are very difficult to tease out. I think the easiest way to manage this is to get your ferritin up to a higher level, and see how you feel. In my experience, it actually takes more like 6-8 weeks before you will really notice a significant difference in how you feel. If you still don’t feel well then, you’ll need to pursue other possible explanations for your fatigue.

    • Miscarriages can be because of having Hashimotos (Autoimmune Thyroid Disease). Hashimotos can make one very fatigued and not being able to bring oneself to do anything, except what is absolutely necessary.

  17. Thank you Philippa For the time you make to provide us with answers,while some of the used to be worried sufferers who are now fully recovered dont visit these sites to give light to the new sufferers anymore.That is what i call love(giving your time and advise to strangers),Bless you!

  18. Hi, I have a ferritin level of 10 and due an iron infusion on Monday. I have ulcerative colitis that is constsntly flaring despite being on meds (including steroids). My fatigue is the most crippling of all my symptoms and Is massively affecting my life. Will the iron infusion help with my fatigue? Im not anaemic. If it doesn’t help, I don’t know where to look next for a solution. I’m a busy mental health practitioner currently training in CBT so really could do with some energy to get me through this intense course!!
    Any advice would be much appreciated 🙂

    • In my experience, the iron infusion did help with my fatigue, but medications are also a very common cause of fatigue, so it depends on whether your fatigue is more related to the low ferritin or to medications. If the iron infusion doesn’t help you (and you need to give it a few weeks to start noticing the effects), then I would discuss your medications with your doctor and a pharmacist to see if anything can be changed or adjusted to help you feel better.

    • Hello everyone, for over 18 months I had been suffering from:
      Extreme Fatigue
      Pins & Needles down all left leg, hands & feet
      Chronic neck pain & shoulder pain
      Extreme dizziness
      Brain Fog
      Inability to concentrate
      Heavier Menstrual Cycle
      Thinning breaking hair
      Freezing hands & feet (during hot weather)

      Symptoms were quite mild at first until I was feeling so unwell, I visited my G.P.
      They took bloods. Then wanted a stool sample and an ultra sound of pelvic area.
      Both tests were ok.

      I had a ferratin level of 12.

      So I have improved my diet.. plenty of juicing of beetroot, spinach. Lots of dried apricots, and a liquid iron supplement called Spatone.

      Within 2 weeks, my neck pain that I had suffered with for 4year, that went down to my shoulders more recently was gone.
      Dizziness improved dramatically.
      Anxiety reduced, probably because dizziness improved.
      Energy improved vastly.
      Pins & needles gone.
      Improved brain function and concentration.

      And after 6 weeks my ferratin level was 26.
      Even though this is still low, all my debilitating symptoms disappeared or dramatically reduced.

      Going to see a Dr to get bloods was vital. The rest is up to me now.

      I know my body better than anyone else, I listen to all experts information and fine tune what they say to me personally.

  19. Last year July, I was diagnosed with mild iron deficiency (Hb – 114g/L, Serum Iron 6 umol/L (10-33)
    Transferrin IBC 64 umol/L (45-70), Transferrin Saturation 9 % (16-50), Serum Ferritin Assay 7ug/L (20-290). Then doctor recommended an oral Iron supplement for two weeks. Thereafter, I was feeling well. Two months ago, I started to feeling fatigue and night sweating in some days same as last year before diagnosing anemic conditions. I recently checked my Hb level and it was 122g/L as within the range. As Hb is within the range, doctor did not recommend any iron supplement or any serum ferritin studies. But still I am having night sweating. Could you please let me know if there is co-relation between low serum ferritin and night sweating? As my Hb level is now within the range does it need to do Iron Studies? Thanking you in advance.

    • I don’t know of a correlation between night sweats and low iron/ferritin. However, your Hb may now be in the normal range but your ferritin could still be low. It would be worth repeating the iron studies if you have symptoms you feel may be related to low iron.

  20. My ferritin is 6.12 & haemoglobin is 10. Had got it tested since have hair loss problem. The test was suggested by my trichologist.

    Few years back also my ferritin had gone to 6.5 and to even 3.5. But with the help of iron supplements I had managed to increase my ferritin to 40 & haemoglobin to 14.6. and increased my hair density drastically then.

    But now I am back to square one..

    I have realised that although I eat lots of veggies, dry fruits, chicken, fruits etc on daily basis but still my ferritin and haemoglobin is always low.

    My Menstrual cycle are regular but very heavy for first 2 -3 days and with bad cramps in stomach.Is this the reason of low ferritin?

    Will I be needed to take iron supplements for my life time to maintain my ferritin to normal?

    • Rather than taking iron constantly until you stop menstruating, it might be better to try to address the causes of your heavy period bleeding and treat that. Here is an article with more information about that: http://www.hormonesmatter.com/heavy-menstrual-bleeding/. If you can get your period bleeding to be more reasonable, you should not need to continue taking iron all the time.

  21. Hi,

    I have question and was hoping to get a response . I struggle with fatigue and had my iron levels checked. My total iron and percent saturation levels are good but my ferritin level is low 16 even though I have been supplementing with reactive iron for a while now. I have MTFH gene mutation which from my understanding implies inability to absorb folate and possibly iron. So even though I take iron supplements my body cannot absorb it enough thus I have low ferritin level. My question is what is a good supplement I can take for this issue?

    Thank you

  22. I’ve had to have IV iron supplementation for 3 years in a row now. My lowest ferritin level was 7. I have Celiac’s Disease, so my body doesn’t absorb iron propertly. Also, when I do intense exercise, my ferritin drops very quickly. There are doctors who do not understand how much low ferritin can affect a person; I know I’m low when my legs are tired at the top of the stairs and I just cannot do normal things without feeling exhausted. If your doctor won’t treat your low levels, find one that will. Going to for IV treatments once a week for a month or two is painless and makes such a difference!

  23. My ferritin levels 6 weeks ago was 14. Now at ten. Taking feritin, iron supplements 2 x daily. Feel as if if I’ve been run over by a freight train. Also anemic. Dr sending me to hematologist asap. Don’t know how much longer I can keep on. Exhausted

    • It will be good if you can get some iron by IV–it will bring your levels up faster than oral supplements. Hope you feel better soon!

  24. HI Philippa, I have almost given up on modern medicine. I have pernicious anaemia and hashimotos and am told that everything is fine. However I have not been able to raise my ferritin about 35 in almost 8 years. the lowest it dropped was 10 and after months of oral iron it went up to 30, but my gut couldn’t tolerate the iron for much longer. anyway I eat folate rich foods such as raw spinach, brussel sprouts, beans, lentils, greens, oranges etc and despite this my ferritin was 17 when checked 6 months ago. I have headaches, fatigue, breathless and now constant nausea, but my doctor says that my ferritin isn’t a concern. 🙁

    • Hi Polly, I don’t know much about pernicious anemia? Are you being treated by a hematologist for that? Do you have heavy periods? I am wondering why your ferritin keeps going down. Your ferritin isn’t terrible, but it’s not great either.

    • My thyroid hormones are low, and I read that ferritin should be above 50 to my thyroid work well! Interesting that I was never aneamic, however, my ferritin is always around 25.

    • HiPolly. Some people with B12 deficiency have also been found to have copper deficiency. Copper is needed to transport iron so that could be part of the issue. How often are you getting B12?

  25. Hi Philippa,
    I just got the results of my blood work, with normal hemoglobin levels but a ferritin level of 26. I have been suffering from a lot of fatigue, shortness of breath, palpitations, and a general inability to focus, and I was hoping to find some answer. My PCP said that everything is normal per my bloodwork, but your post gives me hope that I might have low iron, and there possible is a solution to my horrible quality of life. Would you recommend any specific type of specialist that I could contact for more answers? Thank you, PK

    • The best specialist would be a hematologist. IN the meantime you can start taking some oral iron. It does take a while to get your numbers up though, so don’t expect a quick improvement. Good luck!

  26. My ferritin level is a 7, my iron is 12.5… significant hair loss (which is why my iron was tested by my dermatologist and the reason im going through all of this)… my Pcp is not concerned… just saw an Endocrinologist after a month of trying to get in… all he told me was to take OC iron (didn’t tell me what kind or how much) He didn’t seemed too concerned about anything. I am having a hormone panel done Saturday (for fatigue), but no one is concerned about the hairloss (which is my major concern currently). Tried to see a hematologist, but I need to be referred and be on iron for months, but with no one else concerned, don’t know how im going to get into a hematologist. I have always had trouble getting pregnant (I am 35 yrs old) , have migraines, alopecia (confirmed this hairloss is not my alopecia). I have a normal menstrual cycle (not a heavy bleeder) and im not over/under weight (5’2 / 121 lbs). I eat plenty of iron (spinach, red meats, beans)… I am so frustrated at this point. I don’t know what else to do and my already baby fine hair is falling steadily without regrowth…. Any advise on what my next step should be??

    • The low iron can definitely cause hair loss. I have had that happen. Can you try taking oral iron supplements for a few months? You can ask the pharmacist or your PCP what dose to take.

  27. Hi Phillipa,

    My iron levels are normal but my ferritin is 26 (30-120). I have body aches and pains. Could lower ferritin contribute to this? All my other blood tests are normal. The doctor feels that low ferritin levels cannot be the cause.

    • Those would not be typical symptoms of low ferritin. You should probably take supplements though to increase your ferritin. If the symptoms go away once your levels are normal, then you have your answer. I’ve been told many times by doctors that something can’t be the case, and it turns out they are wrong, so you never know.

      • Thanks for the reply, I am on ferrous sulfate 325 mg 1 time a day. How long do the ferritin levels take to rise?

        • I would guess that you should see a difference if you retest your levels in 3-6 months, but if levels are low, you will need to take iron for at least a year. Keep checking your levels so that you know where they are at.

  28. Over 2 years ago, I was having severe menstrual bleeding with a hemoglobin of 6.7 and I ferritin of like 18 .. I was first given an iron infusion and then later a blood transfusion so that I could have a hysterectomy. Six weeks later my blood levels were mostly normal other than MVP at 5. One year later… I kept having horrible fatigue and symptoms and was checked and my levels were borderline anemia like hemoglobin 10 or 11 with Ferriton 13 .. then last month I was rechecked and my ferritin was 11 but hemoglobin was normal at 12 and my MPV was 6.8 My doctor was unconcerned at what has caused it and said this would not have cause my symptoms of ringing in ears, headaches, weakness and more. She said ferritin are just stores and not for me to worry and it wasn’t my reason. She is a hematologist. Now I don’t know what to do or how to find out what has and keeps causing my problem. One year ago, I Had a colonoscopy when numbers were borderline and no findings but I didn’t have my stomach scoped. Can you make any recommendations ? Any idea what causes low Ferritin with no known bleeding source ? Thanks ? And please tell me my doctor was wrong and it does explain my symptoms even if my hemoglobin has returned to a normal number.

    • The most common cause of anemia aside from heavy periods is gastrointestinal bleeding. I would follow up with your family doctor to see if you can figure out why your ferritin is low. I am not sure whether it would cause the symptoms you describe, but if your doctor approves you can take an iron supplement. Also, I would suggest having your vitamin B12 level checked.

  29. Hi Philippa, Thank you for writing this. I know your site (and this article) is targeted towards women. I hope you do not mind my posting.
    I am a 47 YO male, and have given blood regularly for the last 2-3 years. My hemoglobin is always tested at the time of donation and almost always would be 140-145.
    Approx 6 months ago, I cut almost all meat for my diet, and at my 2nd to last blood donation I was refused due to low hemoglobin (118).
    This got me looking into iron a lot more, and I started cooking with the Lucky Iron Fish as well as taking an Iron supplement (10mg). Last blood donation was 2 weeks ago, hemoglobin back up (14) so I thought I was in the clear.
    In the meantime I had contacted my PCP (who is a nurse practitioner and way way more into “health” than any GP I ever dealt with) about getting blood tests, and those were done approx 1 week after last blood donation.
    My lab results
    Hemoglobin: 132
    Ferritin: 8

    I seem to be ok to function in the day (semi physical work) though I nap usually an hour in the afternoon and lately another hour in the evening, and sleep 7-8 hours at night.

    Occasionally (just prior to my naps) am very sleepy, irritated for no reason.
    Going to see pcp in 2 weeks, so will ask about IV and also confirm if low ferritin is likely due to blood donation or if other causes need to be ruled out. Can’t even BEGIN to imagine having to flow out blood every month ONTOP of the rest (you ladies are such troopers)..anyhow, thanks for the article!

      • Hi Dr. Marrs, can low ferritin cause problems in the thyroid? I have heard about it. My ferratin is always low, but has been like that forever. I am skinny, don’t have constipation, and although my TSH is normal my T3 free and T4 free are in the very lower limit of their range. And, I don’t have a lot of energy. I am already taking 120 mgs of alothiamine 500 mgs of Magnesium elemental, taurine, and a good multivitamin for a while. Last month, my naturopath suggested taking a complex with supplements to support my thyroid. (zinc, selenium and L-tyrosine ).

    • I agree that it would be good to rule out any other causes of low ferritin, but I would suspect that it is due to the blood donation. Cutting out red meat, it would be good to make sure you are eating other sources of iron such as those described in this article: http://www.vrg.org/nutrition/iron.php. To ensure maximum absorption of you iron supplement, take it on an empty stomach with a small amount of food of drink high in vitamin C (and avoid anything with calcium within 2 hours of the supplement, as calcium interferes with absorption.

  30. Hello Philipa,
    My ferritin just came in at 12, hemoglobin at 125, rbc 4.27, hematocrit 0.38, mcv 88, mch 29.3. Since nothing is flagged as low on the report my doctor says everything is normal. What do you interpret? Was a very heavy bleeder for years, now no periods since February (thank goodness!). Thank you for your insight!

    • Your ferritin is low–having heavy periods for years can cause that. Even though you stopped having periods, it could take a long time for your ferritin to increase. In women with heavy menstrual bleeding who have a hysterectomy to treat it, it can take longer than a year for the ferritin to become normal. You can talk to your doctor about some iron supplementation to get your ferritin up faster.

  31. I just got my ferritin tested, and it was a 23. My doc didn’t call me up about it so i’m assuming she is one of the ones that doesn’t care about that. She probably thinks it is fine. I did start taking iron a few days ago and I’m feeling a tiny bit better. I’d love to find a PCP that would do iron infusions for me. 🙁

    • I can be hard to find a PCP who understands the importance of higher ferritin. You maybe ok with oral iron, but it will take longer. I would ask to get your levels rechecked every three months or so.

  32. Hi my haemoglobin is 13.8 and my ferritin is 35. My GP is giving me iron injections. How long Will it take for me to feel well again.? Sometimes I can sleep for over a day. Spend a lot of time sleeping as I am just so tired.

  33. Thank you for this information, my CBC is all normal but i am having PROFOUND fatigue (have for years and years and thought it was something else), exercise intolerance, severe allergies, anxiety and what prompted me to check my ferritin test for this time last year was my PVC’s. I’m scheduled for a cardiologist tomorrow for very frequent palpitations and i found out my ferritin is 30, from what i understand, for a hypothyroid woman to feel better (i’m being treated) i should have ferritin levels at least 70, so i started supplementing with 100 mgs of a good iron from the health food store with vitamin C and low and behold, within a day or two, the palpitations went WAY down and fatigue slightly better and i’m even less depressed!! All within a couple days??? And supposedly by my HCT i’m not anemic?
    i wonder how i’ll feel in a months time! I’m going to ask my cardiologist to test my ferritin, i hope the iron doesn’t skew the results but i’m going to keep taking it, i’m so wanting to feel better and now maybe there’s hope….

  34. Hi. I just recently found out that my ferritin was low at 11 (a week later up to 12 since I saw another doc). Anyway, when I was tested, they tested my total iron which was high at 175 but my ferritin was extremely low. I asked about whether it was safe to supplement with iron. Everyone acts like I don’t really need it but that it shouldn’t hurt either. My concern is the total iron being high. Is it still safe to supplement since my ferritin is low? I was experiencing severe back spasms, and those are so much better since starting the iron along with my cold fingers and toes. Just worry about iron overload due to the high total iron. I would think that for iron overload, my ferritin would be high too, but that is just a guess. Thanks so much!

    • Just wanted to see how you are doing? I’ve had low ferritin, but high serum iron. I was afraid to take iron as well. My ferritin dropped lower. I became extremely exhausted and barely able to function. So now I started a low dose of iron. About a week ago. Still very lethargic. Hope to feel better. Soon..

  35. Hi, for last year or more I have suffered with tiredness but kept putting it down to ither things like work etc athough deepmdown realising its not normal to feel so tired. Then the last 3 months started getting lightheaded (more so) dizzy and then tremors, heart fluttering/pulpitations, RLS, hair thinning… Finially got blood tests done and it came back that my hemoglobin is within range although the lower end, iron os liw but not terrible but my ferritin came back at 3.9 very low, which reading up here in the internet explains many of my symptoms, my doctor didnt think tje low ferritin was a cause of this anf said it was my work .. I know it not that. Anyway after doing my own investingations i went back and asked about iron infusion for quicker recovery as im now so tired/sick im off work. But he said that is not possible for low ferritne… Please can anyone tell me if the had iv/infusion just on low ferritine (3.9). At the moment im on iron pills but feeling no better.

    • I have hemoglobin of 13.8. I have Ferritin level of 35. My GP is giving me iron injections. Feeling really tired and sleep a lot, sometimes a whole day and a half. How long Will it take me to feel well again?. Thanks

    • Well hello there I’ve been suffering in the same boat as well, my ferritin level is still low as a 5, I really don’t know what to do either where is the help for us strong women that need it. I’m a mother of five,please anybody with an answer please respond….

      • I would ask your doctor about getting iron infusions by IV. Your ferritin will come up a lot faster than with oral iron. Also, if you are that low because of heavy periods, you might need to treat your heavy menstrual bleeding so you don’t keep losing so much blood.

  36. How bad have you seen/heard fatigue in people with a low ferritin? Currently, I am pretty much house ridden and have done multiple test with nothing alarming coming on the test results. The only thing that is a little low was my ferritin. In October 2016, my ferritin level was 13 and January was 27.5. I am due for another lab work to get an update in the next couple of weeks. i have been conscious about my eating and taking iron for the fatigue. Not sure if I feel any difference. Have you heard anyone who has gotten their ferritin over a certain amount found relief? Any insights would be appreciated. Thanks

    • Sorry it’s been an interesting road for me( with some dead ends) and I am just looking for some answers and more importantly symptom relief. I have been trying to hang on to hope. I am hoping that my ferritin is the cause so hearing some anecdotal evidence is something that I need right now.

      • It is hard to say whether or not the low ferritin is the cause. But I do know that I was surprised at how bad I felt with low ferritin, and how much better I felt after 3 IV treatment of iron. Taking iron orally it can take a very long time to get your levels up, and if you have heavy periods you may never get ahead of the blood loss. I would suggest having a talk with your doctor and asking if he/she would be willing to treat the low ferritin more aggressively, with iron IV infusions. You will have to wait 6-8 weeks to see the full effect, but if you feel a lot better then, you’ll know it was the ferritin. I think some of us with low ferritin just feel it more acutely–that is my theory.

    • Yes, my heme doc gives me iv iron, 200mgs. of Venofir, once a week for 4-6 weeks when my ferritin is under 59, even if hemoglobin us normal, as mine usually is. The fatigue is extremely debilitating. Oral iron does nothing for me. I read that one doc likes to see ferritin between 70-100 for women with periods. IV iron helps a ton, but it takes several weeks to feel the results. I usually go in twice a year to get the IV series of iron. My hemoglobin is 14, but ferritin is always low. Under 50, and life feels quite impossible.

  37. I am an otherwise healthy 35-year-old female. My iron levels are normal, but my ferritin is 30…which I believe is causing my hair loss. I don’t have any symptoms of hypothyroidism or anemia. I’m not fatigued or out of breath. The main issue is massive hair loss. How do I raise my ferritin without going into iron overload? I started taking 10mg of liquid Ferrous Bisclycinate Chelate with 100mg of Yellow Dock just a few days ago. Is this too little supplementation? I’ve been consuming an iron-rich diet the past few months (4 months) but my blood tests show this hasn’t really changed my numbers. Hemoglobin and Iron saturation have gone up a little–but ferritin actually went down from 30.9 to 30.6. Diet alone doesn’t seem to do the trick for me. Here are my latest lab results and my hair is shedding more than ever!

    (MAY 2017)
    Iron total: 143
    Transferrin: 263
    TIBC: 329
    Iron Saturation: 43%
    Ferritin: 30.6
    RBC: 4.97
    HgB: 15.1
    HCT: 45.5%
    PLT: 269

    (JAN 2017)
    Iron total: 111
    Transferrin: 280
    TIBC: 350
    Iron Saturation: 32%
    Ferritin: 30.8
    RBC: 4.59
    HgB: 14.5
    HCT: 42.8%
    PLT: 249

    • Hair loss can also be caused by hormonal changes. However, in my experience it is safe to supplement with iron when your ferritin is low. My hematologist likes the ferritin to be above 50, and some say women feel best if ferritin is over 70. Check with your doctor, and recheck your blood work frequently (every 2-3 months). Iron supplement are best absorbed on an empty stomach with a little bit of vitamin C (for example, take the pill with some orange juice). Be aware that calcium will inhibit the absorption of iron. These are a few things I’ve learned from my doctors over my 20 year journey with anemia!

    • Hi Julie
      I hope I can help. This is what worked for me. I am 43 I had massive hair loss and shedding for years, it was horrible, I had lost so much hair, all my blood results were Ok but no one tested my Ferratin. I did my own research and asked to be tested, my ferratin level was 29. For hair growth you need to get your ferratin level up to 100+ and keep it there for over a year or more. It took about 18 months to get my Ferrarin levels from 29 to 100 (taking 2 doctor prescribed iron tables – ferous fumerate 210mg x 2 a day). You will never get your levels high enough taking iron tablet from the shops they are not strong enough – (you can also buy the ferrous fumerate from amazon if needed). Now my hair is growing back, yes it takes time but its now filling in. Nothing else I tried for years and years worked, so much money wasted on trying other things. Hope this helps, Sally

    • If you have low ferritin you won’t have to worry about iron overload for quite a while. Keep checking your ferritin every 2-3 months. When your levels are high enough, you can stop taking it. (As long as you are taking the prescribed amount of iron and not more). If the iron supplements aren’t doing enough, you can ask for IV iron infusions. You should have good reason to ask for that if it has been several months and you aren’t seeing any improvement in your numbers.

    • I have low ferritin related hair loss, apparently, according to my trichologist, you need to have ESR tested in the blood too – because; an ESR level of over 10 means that you need to halve the ferritin level (ESR is: erythrocyte sedimentation rate which relates to inflammation markers in the blood) – basically inflammation can give a false reading. I hope this helps.

  38. Hi. Biochemistry results: My haemoglobin level is at 12, ferritin at 4 ug/L, transferrin saturation at 5, transferrin at 3.36 g/L and iron at 4.1 umol/L. I am constantly tired, experience very frequent dizziness and shortness of breath more often lately. I also have very low blood pressure which makes this worse. Even with iron supplementation, it has done little to my haemoglobin levels. Would I need an iron infusion to bring all my levels up or is an iron infusion only applicable to very low haemoglobin levels?

    • My hematologist will do an iron infusion if oral supplementation is not working and my ferritin is low, even with normal hemoglobin. I think there is a lot of evidence in the literature that you can experience symptoms even with normal hemoglobin. I’m not sure if primary care doctors are as aware of this or whether you would have to see a hematologist to get this treatment.

  39. My ferritin is at the border of being normal/low. My doctor thinks Its fine. Im exhausted, have anxiety, feel down, dizzy every other day and short of breath. My Chinese medicine doctor says I’m low in iron. I’ve found this iron that is suppose to be absorbed better. Carbonyl Iron by purelabvitamins.com How much should I take? I’ve felt like this for over a year now 🙁
    And for how long?

    • When you say borderline normal, do you mean around 20? I personally do have symptoms when mine is that low. I’ve had several doctors tell me that you may feel better if your ferritin is at least 50. I made some suggestions in a comment above about the best way to supplement so that it will be well absorbed.

      • Hi there, I can’t see the post where you suggested more easily absorbed forms of iron. I’m in the UK, GPs will not prescribe me IV iron; unfortunately. Could you please indicate which post you mentioned about more bioavailable sources of iron? Thanks in advance.

        • Iron supplement are best absorbed on an empty stomach with a little bit of vitamin C (for example, take the pill with some orange juice). Be aware that calcium will inhibit the absorption of iron. None of the iron supplements are all that well absorbed but you can affect the absorption by what you eat or drink at the same time.

  40. I take levothyroxine for thyroid and it says not to take certain supplements within 4 hours, so how can I time my calcium to be within 4 hrs of that plus another 2 hrs for iron, esp when I have to take it 2-3 times a day?

    • Which one are you taking 2-3 times per day? The levothryroxine? Would iron first thing when you wake up work? Then the levothryroxine at breakfast, lunch and dinner, and calcium right before you go to bed?

  41. Thank you for writing about this. My general practioner is acting confused by me having symptoms because my ferritin is low, but my hemoglobin is normal. She says I should have no symptoms, but I feel similarly to when I was anemic before (severe, chronic migraines, fatigue, etc). I think it’s time for a change of Doctor, so many articles point to those with low ferritin experiencing symptoms. Especially since I have heard low iron can upset hormone balance, do you know anything about that?

    Thank you

    • I am not familiar with the effect on hormones. However, you deserve to have the low ferritin treated and feel better! It seems that a lot of GPs are not familiar with the fact that low ferritin can cause problems. My GP was not familiar with the problems that can arise from low ferritin, but my hematologist was.

    • From what I’ve read on the subject (I am not a doctor, but I feel like I know more about this than most PCP’s and even a few hematologists with all of the books and medical studies I’ve read.) is that your hemoglobin won’t be that low if your ferritin is doing its job. By the time your hemoglobin drops, more than likely your iron and ferritin are depleted and you may have a long road ahead of you w/ oral supplements. Most doctors don’t tell patients to take them w/ vitamin C and even w/ heme based iron (red meat) for best absorption and some supply with laxative. My understanding is if you need a laxative its not even absorbing where it needs to. No coffee, no tea for 2-3 hours before or after and no antacids. You need a very healthy and neutral gut to absorb iron. Linked a FB group that’s been helpful as the website for my comment.

      • That is all true. Also, you should not take iron within 2-3 hours of taking anything high in calcium, as calcium inhibits the absorption of iron (that is why you shouldn’t take antacids close in time to iron supplements). So, no calcium supplements, high calcium foods like dairy, or calcium fortified foods like orange juice with calcium, within 2-3 hours of taking iron.

      • I have been diagnosed with anemia and low ferritin. I am soooooooooo fatigued ALL the time and no one seems to believe how tired i am all the time. I dont know much about it but my pcp has ordered colonscopy and an endoscopy to see if theres any reason there why my ferritin is low. My level is 12.4 so not sure if this is considered the normal range or low. What is the facebook page link I dont see it. Good luck to everyone!

  42. Thank you for your post. I was diagnosed in early March’16 with severe Iron deficiency anemia and felt horrible. My doctor put me on a pretty strong iron supplement that was not helping much and I started doing my own research on more natural supplements etc.and after one month got my iron back up and my ferittin levels are now at 21 (totally depleted before) My doctor said that I can now stop all supplements but I told him that I was still feeling tired and just not 100% yet but he said it may just take time to recover. I started doing some more research on ferittin levels and it does seem that even low normal ferittin levels can make you feel tired and just not normal. I am kind of concerned about stopping all my supplements and just wonder if getting my ferittin levels up some more would be a better choice.

    • I am not a doctor, but from what I’ve been told you will feel better if you can get your ferritin into the 50-70 range. If you do continue your supplements, I would suggest asking for another check of your ferritin in 3-6 months to see where you are at. If you have ongoing heavy menstrual bleeding you may need to continue the supplements as well and monitoring of your ferritin is a good idea as you figure out what dose you need to keep your ferritin up.

  43. Thank you so much for this article. In the recent past I had a hemoglobin of 8.4 and ferritin level of 6. I had also recently had an MI and been diagnosed with diastolic heart failure, so my fatigue and shortness of breath were off the charts. Thankfully I have a great hemotologist and received 2 iron infusions which leveled things out. Here is where your article fits in. My most recent hemoglobin was 12, and two weeks prior 11.2 . This was down from 4 months ago at 12.4. My transferrin was 23. My Dr. Explained, as your tines that she likes to see it at at least 50. She is recommending an iron infusion and we are waiting to see if insurance will approve. I am hoping so as I have been more fatigued. When I saw blood work and levels were listed as normal, I did not realize what you and my Dr. Explained . I was concerned it could be heart related so glad to have this info. !

    • I hope your insurance will approve it. There is a lot of research that support the idea that ferritin below 50 can cause symptoms of fatigue and other anemia-like symptoms. I hope you feel better soon.

  44. Thanks for the excellent post, Philippa! Supplementing iron (Pur Absorb – 5 mg. per day) helped me with fatigue and some other fluoroquinolone toxicity symptoms, more than any other supplement. I’m a menstruating woman, so I wasn’t too worried about taking an iron supplement. People who aren’t menstruating should be more wary and careful. With that disclaimer made, I can’t even begin to describe how much it helped me. My energy levels went up and even my connective tissue issues improved. I got my iron levels tested after 9ish months of supplementing iron and they were right in the middle of the optimal range.

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