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Who has had low ferritin and what did you do about it?

40 replies24 peopleMay 4, 2026☆ Follow
Summary

low ferritin causes and personal management experiences

Users report low ferritin linked to heavy periods, prior weight loss surgery, blood donation, ulcers, polyps, or unknown reasons, with symptoms like fatigue and restless legs. Management includes various oral iron forms taken every other day with vitamin C, liquid options, dietary changes such as iron-rich foods plus citrus, and periodic infusions when pills fail. Several emphasize investigating the underlying cause via scopes or specialists rather than treating blindly, especially outside of menstruating women. A few saw normalization after stopping TRT or surgery.

What this discussion establishesWhere people disagree

Whether low ferritin in premenopausal women always warrants full GI investigation versus just supplementation

Still open

Why some people continue having low levels despite multiple interventions and what the optimal long-term maintenance looks like

Nothing here is advice.

40 replies · 24 people
NorthWillow36archiveopening postMay 4

Your ferritin reading shows low iron stores that can lead to tiredness, poorer workouts, and slower progress on body composition goals even when hemoglobin is normal. With your current regimen it may help to increase iron from food or a supplement and test again after a few months.

GreenMeadow54archiveMay 4

I had the same low reading despite normal iron numbers. A colonoscopy found polyps that explained it. Depending on your age you might want to consider that too. I plan to retest in a month and expect it will be normal again.

QuietBramble77archiveMay 4

I need iron infusions every few years. Mine was much lower than that earlier this year and I just had another round of shots.

CopperQuill49archiveMay 4
↳ replying to @QuietBramble77

What was your actual number? My last reading was 12.1 with iron at 17.9 and my provider just keeps testing without acting. I wonder how much better I would feel with normal stores. To the original question I use daily over-the-counter iron and try to eat shellfish often.

NorthMarble18archiveMay 5

I like a liquid iron product. It is the only supplement that raised my levels without causing constipation.

KeenAlder60archiveMay 5
↳ replying to @NorthWillow36 (opening post)

I was started on iron supplements taken three times a week along with vitamin C. I have also needed infusions a few times. My specialist explained that after certain surgeries or with age many people do not produce enough acid to absorb one common form well, and that every-other-day dosing can work better than daily.

KeenAlder60archiveMay 5
↳ replying to @CopperQuill49

Switch to a different form that absorbs better. If the usual one has not helped you are probably not absorbing it. I stayed anemic for years on the standard version.

NorthKettle98archiveMay 5

I stopped TRT and levels returned to normal within a few months.

ClearWillow59archiveMay 5

Being mostly vegan makes this an ongoing issue. I add iron-rich ingredients throughout the day, including in coffee and smoothies, and always pair them with citrus for better uptake. Cooking in cast iron or using an iron piece in water also helps, along with lentils and spinach. These steps have kept my levels normal for years.

NorthWillow36archiveMay 5
↳ replying to @ClearWillow59

Keep the cast iron pan lightly oiled after use and it should not rust. Baking it with the oil creates a protective layer that needs occasional refreshing.

CopperSignal27archiveMay 5
↳ replying to @NorthWillow36 (opening post)

Low ferritin itself is not a diagnosis and usually needs an explanation. In younger women it is often not urgent to investigate, but in older adults or men it typically is. Without blood loss most people will not become deficient, so checking for gut bleeding with scopes is often warranted. In my case similar levels came from ulcers caused by low-dose aspirin.

GreenWillow59archiveMay 5
↳ replying to @CopperQuill49

As a provider I would at least recommend supplements. Some patients respond well to a slow-release version that causes less stomach upset. Sublingual drops are another option some like, though taste can be an issue.

SlowLedger21archiveMay 5
↳ replying to @KeenAlder60

Thanks for the tip. I just ordered a different form hoping it will absorb better than what I am using now.

ClearWillow59archiveMay 5
↳ replying to @NorthWillow36

I tried seasoning it but the constant oiling and humidity here made it impractical and messy.

AmberLantern34archiveMay 5

I have had low ferritin for two years due to heavy periods. I now take a chelated form every other day with vitamin C and it is a slow process to raise the number.

ClearWillow37archiveMay 5

My ferritin is high at 355. Have you thought about eating more red meat? That is what raised mine.

CopperLedger65archiveMay 5

Mine is currently 19. I get achy joints, restless legs, low stamina, shortness of breath on stairs, wired-but-tired feeling, and poor sleep. I have a genetic iron overload condition and my specialist sometimes removes too much blood, dropping me below 40 where symptoms appear. Starting TRT has made keeping hematocrit in range harder. Supplements have not worked so far and I will try a different type after learning more here. I have another specialist visit soon.

KeenAlder60archiveMay 6
↳ replying to @ClearWillow59

Seasoning is more than a light coat and there are good videos showing the process. I live in a very humid area too and have used cast iron my whole life without rust except when packed away during a move.

KeenAlder60archiveMay 6
↳ replying to @ClearWillow37

I love red meat but wish that alone solved it for me.

SlowLedger21archiveMay 6

It arrived today. I already take a good vitamin C and will keep it away from calcium. Thanks for the advice.

KeenAlder60archiveMay 6
↳ replying to @SlowLedger21

You are welcome. I learned these details through nursing, my own surgery, and working with an endocrinologist, so I pass them along when they might help.

SlowLedger21archiveMay 6
↳ replying to @KeenAlder60

I appreciate it. My endocrinologist and primary doctor are not helpful. Only my radiologist is good but limited in what he can order or follow up.

KeenAlder60archiveMay 6
↳ replying to @SlowLedger21

I was frustrated to learn I had taken a standard form three times a day for ten years when my body could not absorb it after surgery. A specialist finally explained the better option. I often wonder about older patients still prescribed the same unhelpful version.

KeenHarbour58archiveMay 6

A male without clear dietary reasons for low iron should have it checked out. My cause is obvious from irregular heavy bleeding after weight loss. I have tried several forms and now use a chelated version every other day on an empty stomach with vitamin C later. It works better for me than other types even though some people push heme iron. There are many absorption blockers so I keep the timing strict.

AmberLantern34archiveMay 6
↳ replying to @KeenHarbour58

I had the same experience with a doctor not knowing much about iron options. My hemoglobin was critically low when I tried to donate and I had been tired while raising young kids without realizing why. I researched ahead and asked for a chelated form instead of what was prescribed, but the office could not confirm details so I refused the standard protocol. Levels are rising very slowly and my smaller stomach from surgery does not help. This group has been great for sharing what works.

CopperSignal27archiveMay 6

I want to stress again that unless you are a menstruating female, low iron needs investigation rather than just starting supplements. Gut cancers can show up first as anemia from slow bleeding, and treating the iron without looking for the source can delay diagnosis. Ulcers or celiac can also be the reason. Most doctors will decide based on age and sex whether further tests are needed.

AmberCompass54archiveMay 6

My specialist started me on a gentle form twice a day along with blood-building nutrients and vitamin C. I am still on the lower side but better than the very low reading last year.

AmberLantern34archiveMay 6
↳ replying to @CopperSignal27

Yes that is really important. Never just start iron on your own. They usually check stool first and order scopes if blood is present. For me it was a relief to learn it was just heavy periods and inflammation from an IUD. When in doubt get checked by a specialist.

SharpCompass32archiveMay 6

First identify the cause. Mine was 4 and the hematologist wanted scopes and a full gyn workup even though I had already done most of them and knew heavy periods were responsible. I delayed one test because of upcoming surgery, had infusions, but levels dropped again after six months. After the hysterectomy and more infusions they stayed normal a year later. If they had dropped I would have done the remaining test. See a GI and hematologist.

ClearCompass37archiveMay 6

Mine has been as low as 4 and I have needed infusions almost every year since. I agree that if you are male it definitely needs checking out.

SlowHarbour21archiveMay 6
↳ replying to @AmberLantern34

Yeah I would not do that. I would just head over while drinking coffee.

AmberLantern34archiveMay 7
↳ replying to @SlowHarbour21

Yeah I meant check the stool sample. English is not my first language.

SteadyTimber49archiveMay 7

Mine was 4. An infusion made me feel much better. Right after it reached 20 but now it is 11 and they will not do another until it hits 5, which is frustrating. I do not know why my body does not hold iron and pills have not helped.

WryLedger77archiveMay 7

Mine was 11. A hormonal IUD that stopped heavy periods fixed it completely.

CopperQuill49archiveMay 8
↳ replying to @CopperSignal27

I know that was not the intent, but it feels like women get less thorough checks here. Is it not possible for menstruating women to have colon or stomach cancer too? I am mostly annoyed at paying a lot for insurance that gives me one yearly visit with a provider who does not investigate why my levels are so low.

CopperSignal27archiveMay 8

You are right. Statistically menses is the most common reason in younger women so they simply need more iron, while in men or non-menstruating women a serious cause is more likely. That probabilistic approach can still miss early cancers in women though. You cannot test everyone for everything because of false positives and costs, so decisions depend on how high the chance is. Primary care can be limited unless you have more resources.

BlueCompass38archiveMay 11
↳ replying to @CopperSignal27

I was going to say the same. Anemia can be serious and should be evaluated by a doctor. Blood donations are another frequent contributor. When mine dropped from donations one particular supplement helped raise levels, confirmed by follow-up tests.

WryCompass65archiveMay 11
↳ replying to @NorthWillow36 (opening post)

I donate blood often because of being on testosterone replacement. My latest labs came back a week after giving blood. That accounts for the gap I see between my iron and ferritin readings. It makes me think I should cut back on how often I give since there aren't any problems from the therapy that call for it. I put all my lab results, medication timing and amounts, exercise logs, donation records, and weight tracking into an AI tool and had it review everything. The odd parts in the numbers were easy to account for, along with what needs attention and what came from training or when things were measured. It helped me get ready to talk with my physician, since they probably glance at the labs right before the appointment and skip over the background details that fill out the story.

PlainThistle36archiveMay 11

I have low ferritin plus an iron-binding issue that predates TRT, GLP-1, and peptides. I have already done upper and lower scopes, oral iron, stool tests, urine tests, genetics, diet changes, supplements, new cookware, labs, and imaging. After three years and significant cost the current plan is one infusion per year. It is not a big deal and takes about 45 minutes.

KeenAlder60archiveMay 12
↳ replying to @CopperSignal27

I am 63. I have never had heavy periods and have been postmenopausal for 20 years.

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