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Low ferritin and anemic

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Hi all,


This is my first post, but I have spent lots of time reading the boards since I did my first Whole30 3 years ago.  I have continued to eat pretty clean, but will do a few Whole30's throughout the year to tune up.  


Lately I haven't been feeling well and went to the doctor to do some blood work.  It came back that I have very low ferritin (4) and am also anemic.  Doctor wants me to take iron supplements 2 times a day for 6 weeks...but I want to start a fresh Whole30 this weekend and I am worried about finding one that is compliant.  Also, I'm very surprised my ferritin level is that low with the amount of leafy greens I eat - this girl loves kale!  DH has alpha-gal (mammal meat allergy), so we don't do a ton of red meat because every night is not a "cook two meals" type night, lol, so that may be a contributing factor.  


Any BTDT with finding a compliant iron supplement or advice to naturally raise these levels and stay on track?  Should I worry that these levels are a sign of a bigger issue that I haven't thought of?  I am a runner and have felt a little sluggish lately but have been able to stay in the 25+ mile a week range for the last several months.   

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Doctor's orders trump Whole30, so while finding an iron supplement with as few 'extra' ingredients is a good idea, you should ensure that you follow those orders and take the supplement. I've found Feramax150 to be an easily digestible and very effective iron supplement.

If your levels are that low, it would be very hard to get them up again with just food. Take the supplements. You can still do and be successful at a Whole30 and my guess is you'll feel a LOT better in the six weeks.

I do know that non-heme (plant) iron is best absorbed with Vitamin C, but really heme (animal) iron is the most bio available.

Coffee, tea, dairy and whole grains decrease the absorption of iron. Obviously on a Whole 30, dairy and grains won't be a problem, but if you want to try cutting out tea and coffee during your 30, eating citrus with your iron rich plant foods, increasing your animal protein and taking the supplements, you'll be rocking out a good iron score by the time you get retested in 6 weeks.

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1 in 5 Australian women under 50 are iron deficient (20%!).


I tend towards anemic as my body both uses a lot of iron and also don't absorb/convert a lot of nutrients very well (MTHFR).


I eat more red meat than things like chicken, to keep my intake a little higher.


I eat a lot of citrus (all my mayo is made with lemon or lime juice) to help absorption (you can also add it to guacamole and salads, throw some slices into water for infused water). A Vitamin C supplement may be best to help you absorb the iron, for medical needs there are slightly stronger forms of Vitamin C than most of the normal supplements. Mine comes in a powder form, not a tablet (better absorption) and it has some zinc added to it. If you get a Vitamin C powder, once you mix it with water it will start to oxidise, so it's best to drink it fairly quickly rather than pre-make it.


Liver is also a serious iron booster (so much so that it can be dangerous to over eat if you're overly high in iron).

I like chicken livers (beef livers are surprising lower in iron than chicken), goose liver is better if you can find it, it has about triple the iron levels of chicken liver (it's usually only in pate here and that is sadly usually not compliant).

Since your DH doesn't have mammal meat, liver might be a good lifestyle option for you (non-mammals are *much* lower in iron), as you can make a bulk amount of pate, freeze it into small serves and then have it along with your shared meal (dip with veggie sticks, blend into a soup or just eat it with a spoon).


I have to keep up my B12, zinc, magnesium and Vitamin D3 too.


For best iron absorption, avoid taking supplements or foods high in iron, along with things high in calcium (or dairy, although that's easy on Whole30, no dairy!).

Calcium sort of binds to it and prevents the best absorption. If you have to take both supplements, take one before bed and the other in the middle of the day (or other far-apart gap).


Some people have reactions to iron supplements, so if yours makes you feel funny (particularly constipation), talk to your doctor and pharmacist. It's rarely dangerous, but some people do better with different forms (same goodness, no side effects), constipation from them usually means you can't absorb that form. Most of the supplement forms I don't absorb very well, but a new one has been a big success (mine is Metagenics Hemagenics Iron Advanced with 5-MTHF - but I have MTHFR).

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How's your thyroid? Thyroid levels and ferritin can be related. I had a friend that had a tsh of under 2 (which is what doctors focus on, but it's not an actual thyroid hormone) but her free t3 and free t4 (active and inactive thyroid hormones) were quite low. Her ferritin hadn't budged in months despite constant supplements. She eventually did 2 iron IVs last month and feels much better. She's also now able to tolerate an increased thyroid hormone supplement. Before the IV, she couldn't.

Perhaps that has nothing to do with you, but it's worth checking your labs. See if your doc checked your free t3 and free t4. Most only test tsh...

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Thank you all so much for the replies - so much great information! I will go to our vitamin shop today to look for those iron supplements you recommended! I am concerned about keeping things *ahem* moving, so I appreciate those considerations too. I feel like I have some direction when I go to the store - thank you!

Karen, so timely that you asked about thyroid because I feel like that is at play too, but the overall number came back "normal" at 1.8. I was just reading last night about getting T3 and T4 tested separately and I need to do that. My mother had her thyroid removed and as I went through checklists of hypothyroid symptoms, I was checking most the boxes! Maybe similar symptoms to ferritin and anemia, but maybe another layer.

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