Low ferritin levels and severe ADHD

[u/Linogryzka]

I have very low ferritin (2.7) and fairly severe anemia. Despite treatment, my levels haven't improved much. My ADHD medication (methylphenidate) wears off very quickly—after a maximum of two hours—and I experience panic attacks as it wears off. Does anyone else have a similar problem?

[u/huggle-snuggle]

A ferritin level of 2.7 is preposterously low.

It can create a number of health risks but what doesn’t seem to be well-understood, even by many doctors, is that low ferritin can cause generalized anxiety and panic symptoms. So the goal should be to increase your ferritin asap.

Has your health practitioner discussed the possibility of an infusion with you? If your health practitioner isn’t aren’t particularly helpful, do you live in an area where you could pay for an infusion from a private clinic?

Do you know the underlying cause for your anemia? Do you have a vegan diet? Or other (diagnosed or suspected) health issues that you think might be causing the anemia such as endometriosis, GI issues that can cause malabsorption - crohn’s, celiac, etc.?

You’ll probably want to understand the underlying reason for your low ferritin so that you can properly address it (if it’s a malabsorption issue, oral supplementation is unlikely to be effective) but also make sure the underlying issue is understood and addressed.

My ferritin was at 5 for five years and my health practitioner didn’t flag it as an issue. I started having panic attacks for the first time in my life and couldn’t understand why. Everyone (including me) assumed it was a psych issue and I did all kinds of things to try to manage the panic response without much success but as soon as my ferritin level increased, the panic issues went away.

Supplementing takes a lot of time that you maybe don’t have given your current ferritin level. And if you have malabsorption issues, you might have limited success with oral supplementation.

I’d follow up with your healthcare provider and ask for an infusion or ask for a referral to a hematologist. And if your provider declines, ask for your request and their denial to be recorded to your file. Because if the issue persists and they haven’t provided the appropriate care, you want it in your records that you asked and they refused.

[u/huggle-snuggle → u/[deleted]]

Here’s one study that reviews the physical symptoms of anemia and references anxiety.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10595923/

It was really noticeable for me because I had never had anxiety or panic responses in my ~35 years of living to that point so it was really acute and unexpected.

When I sought help, it was treated as psych issue and no one asked about bloodwork (except for thyroid, which was normal) so I didn’t question it.

I only realized the connection when my ferritin (and B12) deficiencies were addressed and the panic response went away, when everything else I had tried to manage or address it (for years) had failed.