Whether you have been told "everything looks normal" yet you're suffering unexplainable symptoms or you have been told you are iron deficient - both can be very confusing situations. You want more answers - I get it!! That's what lead me down the garden path of studying health sciences. Why? How? What!? Let's take a little dive in to why you could be suffering low iron, or having high AF ferritin - why are your blood results showing these numbers?
Unfortunately in routine blood tests, iron deficiencies, iron overloads, functional iron deficiencies and even anaemia’s can be missed.
Did you know that iron deficiency (with or without anaemia) is one of the most common disorders in the population??!!
There are typically some signs and symptoms that can point us in the direction of potentially low iron - whether it’s a deficiency, that is; your iron stores are not adequate to support your body’s needs. Or, you’re in fact anaemic, whereby your iron stores are severely deficient that your body cannot form red blood cells normally (thus bringing your haemoglobin levels down).
Some signs and symptoms we consider -
Pale skin, pale lips, pale gums and pale inner eyelids
Poor capillary return (this is when you press on your nails and it takes a while to see the white go back to pink/red).
Brittle hair, brittle nails
Anxiety with or without heart palpitations
Sensitive to the cold
In clinic, if I hear only a few of these symptoms experienced, I will send my client off for a full blood examination to look at their red blood cells and also an iron studies test to look at serum iron, stored iron (ferritin), and the binding sites and protein that transports iron in the blood (transferrin, transferrin saturation).
Once these blood results are returned we are able to see how the red blood cells match up to the iron studies -
Is there a functional deficiency caused by chronic inflammation? Heavy blood loss (maybe heavy periods).
Is there an iron overload? This often gets missed by GPs - why is there a lot of ferritin or iron, but low haemoglobin? It is important we rule out any absorption issues, inflammation, if medication is effecting iron, pregnancy, oxidative stress…
An issue I see too often is-
A) People taking iron that is either the wrong dose or/and form
B) People self prescribing iron supplements which can be the above but also cause an excess, resulting in oxidative stress
Iron can be a little complicated and many of my past + current clients can vouch for this - they’ll get a blood test and are told nothing. But when I analyse their results we have seen deficiencies, functional deficiencies, anaemias and overloads. I have even had clients been referred on to haematologists (blood specialists).
So what can causes demand for MORE iron?
low dietary intake
vegan/ plant based/ veggo diets
gastrointestinal issues ie SIBO, IBS, Coeliacs
heavy periods, Endometriosis
some medications ie the birth control pill
coffee and tea
consumption of lots of dairy products
If you’re considering starting to try for a baby - it is crucial your iron stores are adequate for your body’s needs now.
The iron in first trimester helps us to extrapolate iron levels in third - which is a critical time for them to be adequate.