Low Ferritin

Hello,

I am 5 years postop and recently my PCP noted my ferritin level was low and told me to start taking an iron supplement daily for a couple of months.  Ever since I started taking them I have had horrible constipation and bloating issues.  Anyone else experience this?  A friend mentioned having issues with supplements and them not helping to raise her levels, so her PCP has her doing iron infusions now.  At what point do you resort to infusions?  My ferritin was 6, but iron and trasferrin were within the normal ranges.  I have been experiencing dizzy spells and feeling tired and sluggish for awhile now.  When I went to my doctor previously he told me it was probably dehydration and directed me to drink more water.  But now I'm wondering if the tiredness and dizzy spells are from my low ferritin count.  Any advice/suggestions? 

Find hematologist that deals with people post op WLS. Maybe your surgeon can give you recommendation.. Mine sent me to one.  MY ferritin was 9, and I was tried and anemic. I got infusions. They helped, but looks like I may need another one soon..

 I asked my doctor about infusions, but he said I am not anemic since my iron count was normal.  I told him I'm having trouble with the supplements and he suggested I try an herbal one instead.  Is your iron low in addition to ferritin being low?

Eventually it went that way – low iron.  But my hematologist did not care really. I took oral iron for over a year trying to bring my ferritin up only to deal with abdominal pain, constipation and low energy. Add depression, RLS symptoms (that indicated low iron) and low RBC - and he really did not care what the other number were...
His words " you tried oral iron and it did not help you... you have issue absorbing and you feel bad... let’s get you infusions and then we monitor..Lets help the person...". I felt much better after the infusions.  It took me a while.  A few weeks to really feel the full results.  It took 6+ months for my RBC to get back to normal.
Also my hematologist told me that the test lab numbers have an error in calculation... and that can be off by 10%... or even more... So he goes for long term repeated results - like ferritin, and how patient feels... I am lucky...
The problem with herbal - is that most of them are loaded in sugar.  I dump on that. And get RH ... so that was not an option for me... he got that..
BTW: I was taking carbonyl + C (kill me... it hurt so much, mostly lower parts of my belly or my pouch - really painful) I was also on proferrin-  heme iron - 3 a day. That didn’t hurt much (but a little) but beside costing me a lot of money - that did not do much. But I was not taking it as I needed to. I was told we can take that with calcium and coffee.. but it is not so. I am trying again now.

Last time I took iron - the pain was very unpleasant. Cramping and pain . I even started drinking strong alcohol - because that would help the cramps. It was either the brandy or pain pills... I do not want to do either... really...

Is that your PCP or your bariatric doc telling you that? Or Hematologist?  If Hem doc - you need to find a new one. Iron infusions is not "walk in the park". They do work - but there is severe risk associated with them... They do pump iron into your blood and hope it will work...and not kill you or damage your internal organs... (One smart doc explained that the iron may be compared to "nails in your delicates in wash cycle"). Benadryl pumped into your body prevents the body reaction... (Like putting a gag on a person that you stick with a needle- you will not hear them screaming... )
Will I get iron infusions in the future? - You bet... but only if I have to.

Amen. Had them monthly for a year and it was definitely no fun, but certainly corrected the problem!

I went into anaphylactic shock on the first kind they tried (even with benadryl!), and was very scared to try a different type of iron. I'm glad I did though. I ended up doing really well with the Venofer.

What kind of iron are you taking?  Ferrous sulfate frequently causes constipation, and the other iron salts like ferrous gluconate and ferrous fumerate sometimes do, too.  Carbonyl iron, which is all elemental iron, usually does not cause constipation or other stomach issues.

And yes, ferritin that low can cause fatigue and dizziness, as well as headaches.  You might want to see a hematologist to discuss infusions with your ferritin that low.

 I have been taking the Celebrate brand which is the carbonyl form combined with vitamin c.  I have had problems with constipation ever since my RNY anyway, so I think maybe taking even this form of iron is just exasperating the problem.  Hmm, maybe I should press the issue with my PCP in light of what you are saying about low ferritin levels.  The problem is that I am no longer able to see my surgeon as I changed insurance companies due to a job change.  I now have Kaiser which has a bariatric program, but they are way down in the Bay Area.  So when my previous PCP suggested a referral to them I declined.  I was doing and feeling fine at the time though.

I got severe constipation from iron supplements a few years ago. Under the advice of a bariatric surgeon, I stopped taking the iron supplements. Then earlier this year, I was Dx with iron deficiency anemia. I have been on iron supplements since March and the constipation is not much of a problem as long as I take Metamucil and Colace. In fact, sometimes my BMs get too loose and I have to dial back the colace. It works pretty well for me and I hope it will help you, too.