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Why does iron deficiency cause fatigue, even in the absence of anemia?
- bpye 4y agoThis was a surprise to me when I had a panel of blood tests and my ferritin was very low, but haemoglobin was normal A few weeks on iron supplements did lead to a notable improvement day-to-day and reduced fatigue. I always find it surprising how much difference this sort of thing can make.
- lalwanivikas 4y agoDo you buy it over the counter?
- bpye 4y agoAt least here (BC, Canada) you have to talk to a pharmacist to get it, but there is no prescription required. You should also have your levels checked semi-regularly if you're taking supplements to ensure that your levels aren't getting too high.
- rahul1141 4y agoDo you know the root cause? I have exactly the same problem for last two years, and I took Iron supplements for 6 months, still same situation. I do have a autoimmune disease, just wondering if it can cause things like this.
- bpye 4y agoStarting working towards that with my GP but we don’t really know yet, no.
- hprotagonist 4y agoToo high isn’t good either; the solution is downright medieval. https://www.mayoclinic.org/diseases-conditions/hemochromatosis/symptoms-causes/syc-20351443 https://www.mayoclinic.org/diseases-conditions/hemochromatos... https://www.webmd.com/men/features/too-much-iron-in-your-blood https://www.webmd.com/men/features/too-much-iron-in-your-blo... So don’t go gulping down the supplements all willy-nilly, either.
- DelightOne 4y ago> Treatment includes regularly removing blood from your body. Just regularly donate, no problem.
- hprotagonist 4y agoyup!
- seper8 4y agoDonating apparently also removes microplastics from your body...
- CoastalCoder 4y agoI'm curious if the donated blood is processed in a way that removes those microplastics.
- plorkyeran 4y agoProbably not, but if you're in need of a blood transfusion you have more immediate concerns.
- SoftTalker 4y agoAny references for that? What about just drinking a lot of water so you have to pee more often?
- robonerd 4y agoIf there are any synthetic textiles in your home, it's probably a lost cause; plastic dust everywhere. Every time you eat, drink or breath, you'll be taking more in.
- deluxeroyale 4y agoI think op might have been referring to this assuming PFAS and microplastics are all disposed off https://www.independent.co.uk/independentpremium/world/blood-donations-remove-forever-chemicals-b2063500.html https://www.independent.co.uk/independentpremium/world/blood...
- armchairhacker 4y agofor a long time, until I started eating meat I had low ferratin. Iron supplements didn’t help and even some weird ferratin supplements didn’t seem to work. But iron is not ferratin (it’s some kind of stored iron) and I’m not sure if it really had any affect. I was low ferratin but could I have been not low on iron? Either way iron deficiency is common in vegetarians and vegans, but there are plenty who are just fine. They get iron from tofu and spinach which is different from the iron from meat and maybe affects their levels differently, but it seems to work out.
- aaaaaaaaaaab 4y ago*ferritin
- danachow 4y agoFerritin is the protein that stores iron in cells in almost every organism from bacteria to humans - but its exact structure and mechanism do differ. As a blood test, endogenous ferritin level gives an indirect measure of iron stores. Ferritin <25-30 ng/mL is consistent with iron deficiency anemia - levels higher than this are more difficult to interpret - they don't rule it out. Whether or not consuming plant ferritin (when you buy "ferritin" supplements that is what you're getting - usually a pea plant) is an effective iron supplementation is another question entirely. And as far as I know there is no great evidence that it is non-inferior to typical oral iron products (salts and saccharide compounds). The ideal treatment for iron deficiency anemia is typically IV iron (or blood transfusion if the anemia is profound enough to warrant it - but IV iron replacement is one of those things coming back into fashion finally after many years of being feared for reasons with poor evidence.
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- xkbarkar 4y agoWas twitter really the right place for this? Very informational piece, I liked it. But having to read it in 12 sections was awkward. Disclaimer, I already dislike twitter.
- dclowd9901 4y agoNot sure why people are defending this. It’s not like separating a page into paragraphs. This is so jarring it’s distracting.
- hombre_fatal 4y agoOn the other hand, I’m not sure I would have sat through an entire blog post on the same issue. The tweet format is a highlight reel, especially for subjects I don’t even know I’m interested in yet (this wouldn’t go looking for long form content).
- amenghra 4y agoThere’s bots to unroll threads. Eg tag @threadreaderapp and type unroll. Or just tag @UnrollThread.
- Blahah 4y agoFor a lot of people it's both the most effective way to communicate atomic components of a stream of thought, and to reach an audience. Very few other platforms offer the same opportunity.
- wrs 4y agoWhat I don’t get is why it’s good to communicate “components of a stream of thought” as opposed to, you know, a complete thought.
- heavenlyblue 4y agoProbably for the same reason bible is separated into verses. Easier to find more profound meaning in a small atomic bit of a though taken out of context.
- rvp-x 4y agoI've noticed the same. I'm a woman so bleed often, I'd feel the fatigue but my blood work didn't show anemia, so my primary care physician didn't feel the need to prescribe it yet. I decided to take supplements on my own and monitor the ferritin levels to make sure I don't over-do it. Note, if you aren't bleeding regularly, it's very unlikely you need it, and iron might be harmful. Make sure to test your ferritin levels before and regularly as you do it.
- Faaak 4y agoHow do you monitor ferritin levels ? Blood test ? I couldn't find any auto-test where I live
- rvp-x 4y agoFrom blood tests, yes
- danachow 4y agoFrequent monitoring of iron/ferritin levels while on oral iron supplementation is likely not necessary -- barring a genetic disease, you're extremely unlikely to get iron toxicity or overload at instructed oral doses. Periodic monitoring is more to assess a positive response - since if your levels are not going up on supplementation it warrants further investigation. Oral iron is now recommended given only every other day to avoid GI side effects and there is evidence that the response is just as good to more frequent.
- coredog64 4y agoThat’s good news. Oral iron gives me an upset stomach unless I have lots of recent carbs.
- redtexture 4y agoDisolving tablets and consuming in liquid form is an alternative.
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- bilsbie 4y agoCould this cause dizziness standing up?
- fasteo 4y agoCheck this out [1] [1] https://my.clevelandclinic.org/health/diseases/9385-low-blood-pressure-orthostatic-hypotension https://my.clevelandclinic.org/health/diseases/9385-low-bloo...
- fiatjaf 4y agoThat's B12 deficiency.
- bilsbie 4y agoI take b12 but maybe I’m still not getting enough?
- fiatjaf 4y agoHow much are you taking? 5000~10000mcg per day may not be too much, also there are no side effects or overdose risks. I think you should do a blood test and ensure you're at least over 500 pg/ml.
- petercooper 4y agoIt's certainly worth checking B12 levels properly. It's quite hard to be B12 deficient and a common reason to be so is due to being unable to absorb it properly in the digestive system (I think this is quite common with celiac disease, for example). That's why injections are a common approach. I went with sublingual administration instead and it worked very well.
- cfcf14 4y agoFor individuals with certain auto-immune diseases (like rheumatoid arthritis), the medication they're on can also interfere with b12 absorption - such as methotrexate. This is a possible consequence of what you mention regarding absorption digestively. Injections are a solution but are not always accessible in every country - in the UK they are extremely hesitant to permit b12 injections, for whatever reason.
- ravenstine 4y agoIron is also needed in the electron transport chain as a component of cytochrome C oxidase. If fewer iron molecules are being prioritized for creating this enzyme, then less oxygen will be reduced at a time. The rest of the Krebs cycle can be in an optimal state but the cycle can only go as fast as the electron transport chain will allow it. I imagine that given a deficiency, the human body will prioritize iron formation in the blood over creating new cytochrome C oxidase since transporting oxygen to cells is more important than running the Krebs cycle at full speed. I have no idea if this is really what's going on, and it's interesting that this is not mentioned in the linked articles. The reduction of oxygen is really the final step for oxygen before it becomes a part of metabolic water, and throwing off the timing of binding oxygen atoms with protons will slow everything down.
- adrian_b 4y agoYour hypothesis is plausible, but as you have said, whether it is true or not depends on the order in which the availability of iron for each of its many functions in the body becomes affected when iron is scarce. Cytochrome C oxidase needs not only iron, but also copper. So any symptoms caused by an iron deficiency to it, presumably a decrease in the capacity for aerobic effort, should also appear in the case of a copper deficiency.
- phkahler 4y ago>> Your hypothesis is plausible, but as you have said, whether it is true or not depends on the order in which the availability of iron for each of its many functions in the body becomes affected when iron is scarce. I just assume that every logical/plausible concept is at play and evolution does its best to balance everything. Rarely is anything absolute.
- samstave 4y ago>>...prioritize iron formation in the blood over creating new _-_-cytochrome-_-_ C oxidase since transporting oxygen to cells is more important than running the Krebs cycle at full speed. https://en.wikipedia.org/wiki/Cytochrome https://en.wikipedia.org/wiki/Cytochrome Whats really interesting to me is the above statement related to a longtime conspiracy-curriosity about the 'Russian kid from Mars' ala an 'Indigo Child' and when back in the ~1990s or some time when he was interviewed, he was ~10 years old and he said that "Humans came from Mars, and after we got to earth, is when we started to age - because Earth is oxigen based, and breathing oxygen is what makes you age." And this crazy piece talks about the iron found in the martian atmosphere: http://www.nuclearplanet.com/Martian%20Iron.html http://www.nuclearplanet.com/Martian%20Iron.html >>The atmosphere of Mars is 95.7% carbon dioxide (CO2), which is available everywhere at the surface and which can readily be compressed. The Martian carbon dioxide can be, simultaneously, a source of carbon monoxide (CO) and a source of oxygen (O2) through the thermal decomposition reaction: >>*2 CO2 → 2 CO + O2 (20.2)* >>Reaction Eq. (20.2) requires a temperature of about 1100C. Note that the iron reduction reaction Eq. (20.1) can take place at about 700C, but a higher temperature, such as 900C, would be desirable. --- What happens if a Nuke goes off in the Martian atmosphere?
- Lammy 4y agoSupplement anecdote: I really like Floradix because it doesn’t make me puke like the over-the-counter Ferrous Sulfate tablets always do: https://www.floradixusa.com/products/floradix-iron-herbs-liquid-herbal-supplement https://www.floradixusa.com/products/floradix-iron-herbs-liq...
- hkt 4y agoSupplemental supplement anecdote: I also really like Floradix for its gentler GI effects. I was anaemic (from a long term health condition) and well, now I'm not. Daily seems fine, too. I also use an app to check my haemoglobin levels. It is weird that an app can do this, but I've calibrated it against less frequent in-hospital blood tests and it checks out. See: https://sanguina.com/anemocheck-mobile/ https://sanguina.com/anemocheck-mobile/
- tornato7 4y agoAnother anecdote: I am using ferrous bisglycinate instead of ferrous gluconate (Floradix) - it is even easier to take and absorbs well. I find it ridiculous that doctors still prescribe ferrous sulfate when these exist.
- Herodotus38 4y agoIron deficiency can also cause restless leg syndrome even without anemia, it's sometimes overlooked. Better to take iron than something that messes with your dopamine receptors. Also recent research has shown evidence that taking iron every other day is better than taking it daily. https://pubmed.ncbi.nlm.nih.gov/31413088/ https://pubmed.ncbi.nlm.nih.gov/31413088/
- PKop 4y agoArguably we have a problem of too much iron, especially supplemented in cereals and such, producing free-radicals that damage cells: https://raypeat.com/articles/articles/iron-dangers.shtml https://raypeat.com/articles/articles/iron-dangers.shtml Ray Peat advice for men is to donate blood periodically to remove excess iron from our body.
- Brybry 4y agoI'm unfamiliar with Ray Peat. Is there a reason Ray Peat advice should be treated differently than say, Mehmet Oz advice? Or Linus Pauling advice? I couldn't seem to find much of anything published by him that was peer-reviewed.
- yellowapple 4y agoThis is the first I'm hearing of polycythemia vera having anything to do with iron deficiency, but considering the overlap of symptoms (and the fact that the former involves making way too many blood cells) it makes a lot of sense.
- ElSinchi 4y agoAnnoying huge Twitter threads. Just. Write. An. Effin. Blog. Post. Long form reading on Twitter is very cumbersome
- aaaaaaaaata 4y agoHow do I one-click retweet my favorite two lines of a blog post and get all my friends to do the same?! /s
- Nowado 4y agoYou're laughing, but there are popular plugins for doing exactly that.
- vo2maxer 4y agoMD here. This particular Twitter account maintained by Dr. Tony Breu is an outstanding repository of clinical information with a large physician following. His clinical threads which he has helpfully grouped (MedTweetorials) for easier access are a miscellany of medical information with even some surprises for old timers like me. The information he includes in his threads includes some interesting links specific to the particular tweet in the the sequence. He conveys the information in a way doctors can appreciate and learn from but also accessible to non physicians. He also runs a podcast. I mean, criticize Twitter threads if you must, but you’re missing how useful this format is in a platform such as Twitter. Throughout the COVID-19 pandemic, some of the most insightful and current information has been delivered this way by top virologists, epidemiologist, and many frontline clinicians learning and sharing the best diagnostic and treatment options known as of the time of the Tweet. I believe in many cases, this rapid real time sharing led to saving lives.
- DharmaPolice 4y agoWhat's stopping someone writing a blog and then sharing it via Twitter?
- vo2maxer 4y ago
- Coolerbythelake 4y agoSo things that can look like anemia can be other things! Case in point, my wife was misdiagnosed for months with Anemia. What she really has is several tick Bourne diseases. For 5 months her doctors kept giving her blood transfusions as he hemoglobin reading was around 4-5 and it should be 12-13 for a normal person. Can't tell u how many specialists and emg room visits. Finally found a female md that listened to her and gave the approval to do a comprehensive tick panel. Sure enough rocky mountain spotted fever, erlicheaosis, recurring Lyme fever and regular old Lyme. The blood they were giving her was basically like throwing gas on a fire. Almost was ready to make funeral arrangements. Let me say tick diseases are going bonkers and a lot of people don't know they have it. Plus a lot of doctors won't believe or authorize tests. Advocate for yourself or you might die! Not kidding !
- ClumsyPilot 4y ago> Plus a lot of doctors won't believe or authorize tests. Advocate for yourself or you might die! Not kidding ! Experienced this myself. So mant doctors behave like JavaScript developer and I am another webpage
- pojzon 4y agoAt least in Eastern Europe thats because they dont really have the time needed to help the patient. Its a business and you have 10m to do all paper work, check patient and prescript something. Its horrible. Doesnt help that private doctors are super expensive, dont care about you and dont believe you. Health became just another accommodity only super rich can pay for.
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- runjake 4y agoIs there any decent way to supplement iron? I’ve never seen any pills in regular stores.
- bpye 4y agoAs I mentioned elsewhere, you can get supplements but at least in BC you need to speak to a pharmacist to get them, though no prescription is required.
- astura 4y agoDepends on your jurisdiction, I guess. In the US they are widely available OTC any drugstore, discount store, or supermarket. https://www.cvs.com/shop/vitamins/minerals/iron https://www.cvs.com/shop/vitamins/minerals/iron
- DantesKite 4y agoFascinating. You can have an iron deficiency, even if your hemoglobin levels are normal, because iron does more than just carry oxygen in red blood cells: It's a cofactor for many enzymes. I'm curious if there's a third variable at play here; something preventing the iron from being accessible (since our bodies normally break down ferritin to access the iron), especially when hemoglobin levels are otherwise normal. I suspect there might be.
- jdadj 4y agoAside from blood loss and Polycythemia Vera, what else can cause serum ferritin levels to decrease over time without anemia?
- DoreenMichele 4y agoI wonder what role underrecognized parasitic infections play here. My specialist once told me that parasites scavenge iron.
- schwartzworld 4y agoI didn't see Restless Leg Syndrome mentioned, but it's pretty heavily tied to iron deficiency. Both my kids were acting tired during the day and showing symptoms at night. Can't feel rested if you're moving all night long. Iron allowed them to actually sleep. https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is-rls/causes.html#:~:text=The%20single%20most%20consistent%20finding,not%20eliminated%2C%20the%20RLS%20symptoms https://www.hopkinsmedicine.org/neurology_neurosurgery/cente....
- cameronh90 4y agoI eat ice, which people often say is due to iron deficiency, but so far no test has suggested iron deficiency. I did have folate anemia, but fixing that didn't cure my desire to eat ice.