I have ferritin question. My PA has me taking iron for a low-ish blood ferritin level + symptoms. If ferritin is an iron-storing protein, does supplemental iron actually increase it, or just compensate for low ferritin by adding more iron to the equation? And if ferritin decreases further with supplements (from 31 to 12) is that cause for concern? Like your poster, all other iron-related levels are normal.
Ferritin is a measure of your total body iron stores. Supplemental iron increases it; blood loss and/or iron deficiency decreases it. Note that ferritin is also what we call an "acute phase reactant" ie marker of acute inflammation. So, if i were to check your ferritin when you had the flu for example, it would be high - not because you have a sudden increase in your iron levels but because of systemic inflammation.
If your ferritin drops while supplementing with iron, it's possible that you aren't supplementing enough.. or that your original ferritin was falsely high. The nuance here requires a medical professional weighing in on your specific situation.
Thanks for this about ferritin. I have had low ferritin since I've been taking Olaparib after my second chemo. Still chasing down why I have fatigue, so if my numbers go up now that I'm not taking it, and I feel better, then that answers a question.
So glad you addressed this topic! For years, I had very low ferritin and no symptoms, so I was not treated (which was fine with me). Last year, for some reason, I started developing symptoms. Since then, I take an oral supplement (65 mg elemental iron/day). No cause can be found. I've had bloodwork, colonoscopy, & endoscopy and am post-menopausal. I feel much better taking daily iron, and if I stop my ferritin goes down and the symptoms come right back. Do you have any concern regarding the risks of taking long term daily iron? Thank you!! :-)
Thanks for answering my ferritin question, Dr. McBride! Looks like this topic is a hot one. I’m not vegetarian, but was over 15 years ago and have never been a big meat eater. But I am of menstruating age and very active so that could be the culprit. In any case, I have some iron supplements in my cupboard that I’m trying to get the courage to take. Anything with the possibility of nausea sends me into a panic, so my doc suggests I take them at night. Also looked up some of the “gentler” formulations so hoping that leads to fewer stomach issues. I’m trying to stop saying “but I don’t have any symptoms” and start saying “if I feel good now, maybe I’ll feel AMAZING.” Thanks for the context/framing!
I think a ferritin that low is problematic for multiple reasons. Iron is involved in 180 biochemical reactions and the body can pull back these functions when storage levels get low. This can increase the risk of thyroid dysfunction (iron is needed to make thyroid function), depression, heart issues, and increases in oxidative stress, etc. I write more about it here https://maryannjacobsen.substack.com/p/make-ferritin-screening-standard
Night-time hypoglycemia registering on a CGM may possibly be compression lows. If you wear your CGM on your left arm and sleep on that side, it may falsely dip as CGMs measure interstitial fluid, not blood. Look at your data, if it dips down low and then bounces up quickly (as it might if you've turned over or changed position), then it is probably a compression low. If your alarms wake you up but you feel fine, wait 10 minutes and see what the CGM reading is and verify with a finger prick to measure actual blood glucose levels before treating with food or meds.
I have ferritin question. My PA has me taking iron for a low-ish blood ferritin level + symptoms. If ferritin is an iron-storing protein, does supplemental iron actually increase it, or just compensate for low ferritin by adding more iron to the equation? And if ferritin decreases further with supplements (from 31 to 12) is that cause for concern? Like your poster, all other iron-related levels are normal.
Ferritin is a measure of your total body iron stores. Supplemental iron increases it; blood loss and/or iron deficiency decreases it. Note that ferritin is also what we call an "acute phase reactant" ie marker of acute inflammation. So, if i were to check your ferritin when you had the flu for example, it would be high - not because you have a sudden increase in your iron levels but because of systemic inflammation.
If your ferritin drops while supplementing with iron, it's possible that you aren't supplementing enough.. or that your original ferritin was falsely high. The nuance here requires a medical professional weighing in on your specific situation.
Thanks...helpful!
Thanks for this about ferritin. I have had low ferritin since I've been taking Olaparib after my second chemo. Still chasing down why I have fatigue, so if my numbers go up now that I'm not taking it, and I feel better, then that answers a question.
So glad you addressed this topic! For years, I had very low ferritin and no symptoms, so I was not treated (which was fine with me). Last year, for some reason, I started developing symptoms. Since then, I take an oral supplement (65 mg elemental iron/day). No cause can be found. I've had bloodwork, colonoscopy, & endoscopy and am post-menopausal. I feel much better taking daily iron, and if I stop my ferritin goes down and the symptoms come right back. Do you have any concern regarding the risks of taking long term daily iron? Thank you!! :-)
this is great advice!
It seems like we have matching interests with womans health? I just wrote about my 2.5 years without bras or panties, and why I’ve never been calmer👙👋
Sounds insane? Maybe.
Read the madness 👇
https://calmfeed.substack.com/p/why-i-stopped-wearing-underwear-benefits
Thanks for answering my ferritin question, Dr. McBride! Looks like this topic is a hot one. I’m not vegetarian, but was over 15 years ago and have never been a big meat eater. But I am of menstruating age and very active so that could be the culprit. In any case, I have some iron supplements in my cupboard that I’m trying to get the courage to take. Anything with the possibility of nausea sends me into a panic, so my doc suggests I take them at night. Also looked up some of the “gentler” formulations so hoping that leads to fewer stomach issues. I’m trying to stop saying “but I don’t have any symptoms” and start saying “if I feel good now, maybe I’ll feel AMAZING.” Thanks for the context/framing!
I think a ferritin that low is problematic for multiple reasons. Iron is involved in 180 biochemical reactions and the body can pull back these functions when storage levels get low. This can increase the risk of thyroid dysfunction (iron is needed to make thyroid function), depression, heart issues, and increases in oxidative stress, etc. I write more about it here https://maryannjacobsen.substack.com/p/make-ferritin-screening-standard
Night-time hypoglycemia registering on a CGM may possibly be compression lows. If you wear your CGM on your left arm and sleep on that side, it may falsely dip as CGMs measure interstitial fluid, not blood. Look at your data, if it dips down low and then bounces up quickly (as it might if you've turned over or changed position), then it is probably a compression low. If your alarms wake you up but you feel fine, wait 10 minutes and see what the CGM reading is and verify with a finger prick to measure actual blood glucose levels before treating with food or meds.