can iron deficiency without anemia cause extreme tiredness?

[trc1962]

Hi, I have been super tired for about 6 weeks now. First I thought it was from a difficult school year, but school ended and I was still tired. The MD/NP ordered bloodwork and I was iron deficient, but not anemic. I started on iron capsules a month ago. but still so tired. Going to see my GP and ask him for a thyroid panel and see if anything shows. I have been borderline low at times in the past, but no shedding and not tired. I have dealt with some weight loss this Spring, but have gained much of it back this Summer and I sweat so much. Any ideas?

[Carolina]

Dear trc,

My Immune Disorder has 3 basic signs of a flare:

Profound fatigue
Total body pain (particularly in my joints)
Depression

I also get a sign that is specific to me:

All over itching

The best way for me to interrupt a flare is take a prednisone taper.

If your fatigue is the result of a flare of your autoimmune Sjogren's, try a prednisone taper. 

Oral: 30 to 40 mg/day given once daily or in 2 divided doses until symptom improvement (usually 2 to 5 days), then taper gradually as tolerated (typically over 7 to 10 days); a slower taper (eg, over 14 to 21 days) may be required, particularly in patients with multiple recent flares

Elaine

[trc1962]

Thank  you Elaine, since I have all of those symptoms I will ask my rheumatologist. I believe the osteitis pubis could be a sign my immune system is working overtime and it is causing fatigue while it is inflaming areas. Thank you.

[meirish]

I have to ask if you got more information on the fatigue issue and the cause. It is really strange that you can be iron deficient with out a low hemoglobin. I assume you are speaking of the ferritin level. The old thyroid can also be a culprit also. Good luck. meirish

[trc1962]

Hi, here to update my situation. The dr. said my ferritin was low so I am iron deficient, but no anemia as my hemoglobin looked fine. I am still tired, so dr. testing thyroid, folate and an ultrasound of my liver as it was quite tender (although my labs for enzymes are fine). If nothing shows up, he wants a sleep study as I snore sometimes. I will update when I know more, thanks to all for replying.

[trc1962]

Here to update. My ultrasound showed no issues with my liver at all. Thyroid was 3.1 and primary said you might try a tiny dose of levothyroxine and it might help. They won't retest my iron yet as it has only been 10 weeks. I do not absorb vitamins and take them sublingually, but that's hard with iron. It is strange that my ferritin is low, but my rbc, hemo and hematocrit all slightly high, but doctor was not concerned.  I sometimes want to lay down wherever I am and rest, even on the floor. I have no idea how to start school in 2 weeks! If you have ideas please post. I would like to see a hemotologist, but my dr. said not warranted...sigh and on we go. If you have any info I would love to hear suggestions as I am open to getting my life back to function level. Thank you.

[Deb 27]

This is a good topic.

I have been having a lot of issues too with fatigue too and was wondering if my low ferritin is causing my restless legs at night. My hemoglobin and hematocrit are A++. My former rheumatologist used to monitor my B 12 ( which was low) and my ferritin, which was also low. Since my restless legs have gotten pretty bad, I started taking some iron. Perhaps your doctor can tell you what to do about your low iron and absorption problems. Maybe you should try a tiny dose of Synthroid.

I think it's really difficult to find out the source of fatigue for those of us with auto immune disease. I also have Hashimoto's. I need to get my TSH drawn but Covid is so bad where I live, I am not going out until it gets back under control.

Keep us posted about how you are feeling and the fatigue. Good luck.

[Carolina]

At one point, recently, I had normal iron, but very very high ferritin.  I immediately stopped the iron supplement which I had taken for over 10 years.

I did see a Hematologist who said, 'don't worry'

In addition very low copper was detected in my blood/urine for about 3 years.

I  am always low in sodium and encouraged to eat more salt.

I think those of us with immune disorders have absorption issues.

Elaine

[meirish]

Yes, low ferritin does cause restless legs....I found that out years ago and instead of putting me on the drug for the restless legs which is related to antidepressants My doctor just increased my Zoloft for depression and that took care of the restless legs. I would not take the other drug because it was like taking another antidepressant in a way and who knows just how I would react. Better to increase a known drug I was on.

This was around 2005 and I have been struggling with the low ferritin and hgb since. If  you take iron on your own it is wise to let your doctor know just because it could interfere with some drugs you already on plus having Hgb checked periodically is a good thing to do to know if you have gotten too high a number. This is seldom likely but not the best thing to have occur. Good luck to you all. meirish

[trc1962]

Hi, I am wonder meirish about your restless legs and how it presents itself. I always move my feet or legs when I am sitting still and I always thought is might be due to ADHD or genetics as my grandma did this. When I am asleep they do not move, but as soon as I wake up, I want to move them, is the restless legs? I have been dealing with the movement for a few years and probably lower than normal ferritin. I usually have low normal MPV, MCHC and MCH but my platelets are high normal. I interpret that as very small rbc's that are pink or light red and each one doesn't have a lot of hemoglobin in it. However, I have a lot of platelets, so I am not anemic.

Elaine, I am low in sodium too and have been encouraged to salt my foods, which I love to do! I read though that salt can hamper bone building as it blocks phosphorus as I am very small I have been concerned. My dr. said it was okay to have the salt as I need it.

Autoimmune stuff is crazy.