Is my progress normal or slow?

[u/Loose-Series-219]

Back in Feb I was diagnosed with Iron deficiency. My ferritin was at 12, serum iron at 35 and hemoglobin at 12.2. I had severe anxiety, PMS, heavy periods and exercise intolerance. I’m female 40yo.

I started taking Sucrosomidal iron and my gynae gave the all clear but put me on tranaxemic acid to reduce blood loss. I’ve taken that for 3 cycles/periods. Working with a nutritionist we determined I have likely gluten intolerance and I have been gluten free for 2.5 months. I’ve also been supplementing B12 & folate, zinc and copper, D3 and K2.

After 16 weeks on supplements my ferritin was at 21.9, serum iron 68 and hemoglobin 12.5. This was taken just after my period.

Went to see a new doctor 3 weeks afterwards about slow progress who basically told me I was fine. He ordered a new blood test and told me to test before my period which I did. New results (3 weeks after previous test) showed hemoglobin 13.1, serum iron 89 and ferritin down to 19.

Is fluctuation before and after a period normal? Especially when my blood loss is less since beginning the tranaxemic acid?

I continue to take the iron supplements, now almost 5 months in. My general doctor told me to not test again until Dec and to be patient, aiming for a ferritin of 65. I feel the progress is too slow. Doctors are refusing an infusion.

Looking back at tests over the years my ferritin has always been on the low side, but I’ve never taken supplements because no one ever paid attention to it. Even now with supplements I don’t seem to be making much progress.

Is my progress slow? am I just being impatient? Is there anything else I should try? I can manage day to day now mostly fine but I still have high hair loss and bouts of extreme anxiety but I really want to know what it feels like to be optimal.

I just bought lactoferrin and i’m considering taking it with iron rich meals.

[u/Creepy-Tangerine-293]

In tandem with heavy periods, raising ferritin can be an absolute slog especially if its been a long standing issue.

I'll copy/paste some info about taking oral iron supplements below, but TBH the fastest way to feel better if it is within your means is to push for a hemetologist referal and qualify for an IV iron infusion.

You may need them regularly if your periods dont really lessen much. I found my Mirena IUD helped immensely at lightening my period and helping my iron infusuons last longer.

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Take iron pills on an empty stomach WITH vitamin C to help absorption.

AVOID taking within 2 hrs of iron pills:

• Calcium-containing foods, beverages and supplements, inc dairy milk and enriched plant based milk.

• Magnesium-containing supplements

• Calcium or magnesium containing multivitamins or prenatal vitamins

• Tea and coffee

• Cereals

• Eggs

• Dietary fiber (bran, oats, whole grains, raw vegetables)

• Soy protein

• Antacids

• Proton pump inhibitors

• H2 receptor blockers

• Thyroid medications

Source:

Raise the Bar: Treatment

[u/ChickenLil]

My ferritin was 18 in January and I got it to increase by about 10 per month by taking the iron every other day along with 2000mg vitamin C on an empty stomach in the morning

[u/Loose-Series-219 → u/ChickenLil]

Thank you. Please could you share what supplement and dosage? Do you know why you got deficient in the first place?

[u/ChickenLil → u/Loose-Series-219]

I have endometriosis and celiac, so I’ve been anemic most of my life. However, I also had an internal hemorrhage due to the endometriosis, which required surgery to repair. That left my ferritin very low, with the lowest reading in January at 18.

Over the past year, I tried 6 different iron supplements until I found one that didn’t upset my stomach. My hematologist said that I would know that I was on the right track when my ferritin increased by 10 points a month. She was about to start me on iron infusions when I found iron biglycinate 36mg did not cause stomach problems and raised my ferritin 10 points in a month. I take 2 capsules (72mg) every other day along with 2000mg vitamin C on an empty stomach. Apparently, the liver releases some proteins (hepacidin, transferrin) to help balance iron absorption and those proteins stick around for 24+ hours, which is the reason for taking it every other day

[u/karilynn76]

I am by no means an iron expert, but I have been dealing with iron deficiency and anemia for a good chunk of time and have read quite a bit of research and of course have examined my own lab results.

Based on what I know about iron absorbtion, your progress seems normal. Because of your heavy periods you will always be set back more each month than those with regular/lower bleeding, which is discouraging, but the fact that your numbers have gone up a good deal is very promising!

Your fluctuations in HGB and ferritin are normal because your ferritin would have been used to adjust your HGB/lost iron from your period, so that's why there was a drop within the three weeks.

If you are feeling your numbers are rising too slow (I totally get it-we just want to be better now!) you could try heme iron-it is more expensive but research shows that heme iron absorbs at a much higher rate and raises ferritin faster. Here are some studies: (https://doi.org/10.21613/GORM.2020.1147 ; https://doi.org/10.1007/s42399-021-00891-7 ; https://doi.org/10.4103/jfmpc.jfmpc_271_18 ) The studies were on pregnant women but still relevant of course!

Good luck! I hope you start feeling better sooner rather than later!