One of the most misdiagnosed conditions, and quite common, is iron deficiency. These people are told by their doctors that they have perfectly normal iron levels, although that’s not the reality.
Symptoms of Iron Deficiency
People with iron deficiency can have the following symptoms in different manifestations; some of them will experience many of the symptoms, and others will experience only one symptom in an extreme version.
- Constant feeling of tiredness
- Feeling cold all of the time
- Weak nails
- Restless sleep
- Pale nailbeds
- Muscle spasms
- Restless leg syndrome
- Shortness of breath when exercising
- Pale skin
- Palpitations
- Low blood pressure
- Hair loss
- Healthline and post-partum depression
- Brain fog
- Chronic fatigue
- Random sharp stabbing left-sided chest pain
- Dark bags below eyes
- Poor blood sugar control
Why Does My Doctor Say I’m Fine, Though I Have Iron Deficiency Symptoms?
There are several reasons for this. Ferritin is used for medical iron testing which measures its storage. It was used to check free iron, but since it was affected by what a person has eaten in the past 24 hours it wasn’t considered a precise measurement. Most labs have a terrible ferritin reference range. For many of them, the range is too broad, or from around 11-291ug/L.
According to many doctors, if the ferritin is 12 the patient is fine, but if it is 10 the patients need to take an iron supplement. However, this is outrageous, since the patient will have an iron deficiency for more than 4 months, till s/he gets anywhere near 11.
Most symptoms of iron deficiency won’t disappear until the patient’s around 80ug/L. However, this varies for every individual. The previously mentioned reference range accounts for 95 percent of the population, so we have to view it functionally.
You have good chances of low iron levels if you have hair loss, and you feel tired and cold all the time. Every individual is different though. There were some people reported to have been losing their hair with ferritin around 50ug/L. When their ferritin was raised to 80-100ug/L, their hair stopped falling. On the contrary, some patients showed no symptoms at all, although their ferritin was 40ug/L.
The metabolism and requirements of each organism are different. Many doctors think that healthy hemoglobin levels mean healthy ferritin levels too. But this isn’t always the case, so another reason why lack of iron is not always diagnosed is that it goes without being tested.
Reference Ranges of Proper Ferritin
Ferritin (ug/L) Interpretation
- <12 Iron deficiency
- 12-29 Depleted iron stores
- 30-79 Lowered iron stores
- 80-150 Proper iron stores
Complete Blood Count (CBC) and Iron Levels
Another great indicator that is also ignored is the Complete Blood Count. Hemoglobin is a protein that distributes oxygen from the lungs to all tissues. The normal hemoglobin reference range is 120-160g/L, and if a patient’s range is at 122g/L, he is probably anemic.
Although many doctors aren’t worried if their patient’s CBC level is a bit off, they have all reasons to be. Patients with anemia symptoms and not proper CBC should have it normalized to eliminate those symptoms. The Complete Blood Count shows a person’s hemoglobin (oxygenation of tissues), MCV (the size of the cells), hematocrit (how many cells vs. fluid), RDW (red blood cells distribution), and if their immune cells or white blood cells are raised or lowered.
Anemic people usually have lower levels of white blood cells. In some cases, checking the CBC will tell you that the person has iron deficiency. If RDW is high, and MCH or MCV is low, that’s a good sign of low iron. A complete Blood Count is done almost every time a person gets a blood check. In some instances, however, an iron panel is too required.
Ferritin can be increased as a result of inflammation, so some people might have raised ferritin but low iron. In such instances, an iron panel can provide more information, and hs-CRS and ESR inflammatory markers can be tested too.
Why Iron Deficiency Causes You to Feel Cold?
If your body lacks iron, you will feel cold, since iron is a heat conductor. On the other hand, people with too much iron (Hemochromatosis) are constantly feeling very warm. Lack of iron also appears with low blood pressure, as the blood is thinner. Low blood pressure means lower blood supply to the extremities, which will result in cold hands and feet.
Conditions with Similar Symptoms to Lack of Iron
The major symptoms of iron deficiency, feeling tired, cold, and weak, can also indicate Hashimoto’s thyroiditis, hypothyroidism, low blood pressure, and chronic fatigue syndrome.
There’s also the possibility of having more of these conditions at the same time, so a person might have iron deficiency, hypothyroidism, and low blood pressure simultaneously. If hypothyroidism slows down a person’s digestion, the person won’t be able to secrete the proper amount of stomach acid to extract iron from the consumed food, resulting in a lack of iron and low blood pressure.
Causes of Lack of Iron
- Insufficient iron intake
- Vegan or vegetarian diet– plant sources provide about 2-18 % of iron, whereas animal sources provide 50-70 %
- Wheat consumption-in some people, wheat can cause intestine inflammation, causing improper absorption
- Dairy intake- the same as wheat
- Food sensitivities- there won’t be optimal absorption of nutrients if your stomach is bloated
- Diarrhea
- Excess consumption of black tea or Juicing for health– the tannins in their content can reduce the absorption of all nutrients
- Donating blood-Check your ferritin levels before donating blood, since each time you donate, you will drop 20-40 units of ferritin
- Heavy periods
- Celiac disease-in this condition, there’s a deficiency of all nutrients
- Acid blocker medications- long-term usage of Prevacid, Nexium, and Pantaloc can cause iron deficiency
- Stress
- Excess caffeine
- Hypochlorhydria (low stomach acid) if food isn’t properly broken down, you won’t get iron from it. This might be a result of a zinc deficiency, high carbohydrate diet, acid blockers, stress, eating on the go, anxiety, etc.
- Colon cancer- in some cases, iron deficiency is the first sign of colon cancer
Proper Iron Supplementation
Most prescribed iron supplements are in awful forms, such as ferrous fumarate or ferrous gluconate which aren’t properly absorbed by the digestive system. So, many people avoid them as they cause abdominal pain and constipation.
Iron bisglycinate is the best form of iron supplement, which allows much better absorption. Some patients had their ferritin raised by more than 40units after only 3 months.
Moreover, you should take vitamin C along with iron to improve its absorption. On the other hand, iron shouldn’t be taken with magnesium, calcium, zinc, copper, eggs, fiber, peppermint tea, chamomile tea, and milk thistle as they prevent its absorption.
Not Testing Ferritin Can Be Irresponsible
Ferritin testing isn’t required during and after pregnancy, which is really confusing, since proper iron stores are crucial for the health of the baby, raising the survival rate in case hemorrhaging appears, preventing the appearance of post-partum depression, and preventing high tiredness of the mom while trying to take care of her baby.
Although ferritin testing is recommended for anyone, pregnant woman, vegetarians, post-partum woman, and vegans should especially test it.
Via ABC | Dr. Justin Gallant ND
