For years’ patients would come to me and complain of fatigue or complain they could not exercise because they would get short of breath so quickly. I would give them B12 injections and it would help somewhat but a large number just never felt that good. A few years ago I started to look a little deeper at this problem and started to realize a lot of the patients would say they get short of breath but if they stop exercising they recover in a few minutes. So I started looking at their ferritin (a protein that stores iron) levels. Iron is carried in the blood on ferritin. The less ferritin on a blood cell the less oxygen that cell can hold on to so that means the organs in the body have less oxygen to run on and when they run out of oxygen the body slows down to try and recover.
I am very surprised as I am checking ferritin levels on my patients and only about 20% have low ferritin. Ferritin levels can range from 8-388 on your labs. However, I have patients that if their level drops to 70 they can barely exercise. The sign of low ferritin can be dizziness, pale appearance, leg pain, balance problems, poor concentration, headaches, fatigue, restless legs, brittle nails, palpitations, ringing in the ears, and hair loss as you need a level of 90 to grow hair. So, as you can see low ferritin can cause a host of problems. A lot of patient’s problems mimic chronic fatigue syndrome, adrenal fatigue, and thyroid disease. I often would treat a patient with thyroid medications and they would not really improve much. So. what I have done for my patients is to give them an IV of ferritin followed by an IV of Vitamin C. Most of my patients see a great difference. This is because with the increase of ferritin the cells of the body can become oxygen loaded in a few minutes. You can do oral ferrous sulfate but it can take 6-9 months to feel better.
There are a number of conditions that lean toward a person having a ferritin problem. History of celiac disease, chronic gastritis, and the use of proton pump inhibitor such as Nexium along with chronic renal and liver conditions and any chronic diseases like auto immune, etc. About 20 % of Women who menstruate have ferritin deficiencies. The labs often show no anemia (no low hemoglobin or hematocrit) To really diagnose low ferritin you would need to do a bone marrow biopsy. It will show very little iron. Not too excited about doing that! The National Institute of Health (NIH) is doing more and more studies on this problem and in some articles the doctor will just treat with IV ferritin. IV’s do it within days to weeks. The level the NIH suggests is 80-100 on the labs and any level less than 30 on the lab is considered ferritin deficiency. The reason so many doctors miss this problem is that the CBC lab shows the hemoglobin and hematocrit are normal. Once again if you follow only the lab you will miss it. You must go on the patient’s symptoms and actually listen to the patient’s complaints. Talk to your doctor as low ferritin could be a reason for some of your symptoms.