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Iron question

I've got a question about iron levels. L has been having a lot of trouble with memory and concentration in school (she has ADHD, but this seems more than usual), and I asked her pediatrician for vitamin levels, especially since she's been on omeprazole for a few years and it cause various problems. Anyway, everything came back normal except ferritin. The nurse (who wouldn't give me numbers :p) said it was "a couple points low, but nothing to work about," so of course I'm worried. The thing is, she has a CBC at every liver check up and her hemoglobin and hematocrit are always high normal. I asked the nurse and she said yes, those were high normal. So...how in the world can she have high normal hemoglobin, etc, and have low ferritin? I guess I thought they went together. I tried to do some online research but I just ended up going in circles. Also, is ferritin "a couple of points low" really something I shouldn't worry about?
San Diego
Probably nothing to worry about. If her hematocrit and especially her hemoglobin are normal then she is not anemic. The low ferritin means that her spare iron stores are a little low, and is proably not severe enough to cause memory or concentration problems. But like anything else it is good to keep an eye on it to spot any ongoing trends or severe shortages developing.

You could try vitamins fortified with iron or some iron pills if you want, although some people report that iron pills irritate their gut.

my little penguin

Staff member
So Ds had low ferritin
Cbc normal on the lower end but still normal hemoglobin etc...

Gi explained ferritin is the pantry of food (her extra)
The body is taking more out to keep her hemoglobins etc at a normal level
It nobody is grocery shopping to replace what’s taken out
Eventually you will be anemic
For ds we did Chelated iron pills
It takes 6-12 months to build up ferritin stores even slightly
Unfortunately Ds did not tolerate iron supplements (tried them all flintstones ,infant drops , other pills ) he ended up with diarrhea (he normally has constipation )

so after 6 months he increased. His levels above normal a little bit
Gi just said they would watch and keep checking ferritin if it dropped again below normal as well as hemoglobin etc then iron infusions

thankfully when Ds switched to Stelara the low ferritin went away and he is very normal now

so you could try pills or you could watch and wait


Well-known member
Did they check B12? A deficiency in B12 could lead to concentration and memory issues. Make sure they tested methylmalonic acid as B12 level can test at a sufficient level but it is really the methylmalinic acid number you want.

Vitamin D deficiency also has some brain issues but not as much as B12.
Thanks, everyone. Yes, her vitamin b12 levels were normal according to the nurse. I don't think they tested MMA. I'm still in the process of getting the actual results, so I can see what the lab's low and high values are and where L's stuff falls.


Staff member
My daughter had iron deficiency anemia - her hemoglobin & hematocrit were slightly low but not terrible. But her Ferritin was very low - hers fell to 3. We did iron supplements for a short period of time but they caused constipation and belly pain and nausea, and since her Ferritin was very low, we did iron infusions.
This was a year before her Crohn's diagnosis. Since her diagnosis, she hasn't needed iron infusions though she's definitely had low Ferritin several times.
Some heme iron rich foods are pretty much all meat products. Eggs, shell fish, shrimp and liver.

Non heme iron is in vegetables but not as easily absorbed which may be a problem given the medication. Molasses, spinach, beans, lentils have better than average non heme iron.

Cooking in cast iron might help

Iron is absorbed better if vitamin C rich foods are also eaten with it.

While I didn't get on with any of the iron tablets, I tolerated liquid iron (Sodium Feredetate) - which I was told is normally only given to pregnant women and children.
There is a newer type of iron supplement you could ask about. It is called feramax in Canada. Didn't bother my daughter at all! She has tried many over the years. It is bound to a polysaccharide and for some reason that is why it doesn't distress the gut.
Hi, all,
Late update, but when I did finally get the numbers, L's ferritin was 16, so actually not out of range according to their posted normal range, but certainly on the very low end of normal. Her serum iron was 140, which was notably high. Odd, but okay. (And her B12 was almost 700.) We explored a number of reasons for her concentration issues with no results, but in the last six weeks L started having abdominal pain and loose stools and weight loss, and lo and behold, her fecal cal is mildly elevated (113, which is above the healthy cutoff for PSC-IBD; her previous fecal cal was 22). So I wonder if the school issues have been influenced by low level inflammation simmering. I'm still waiting to hear back from her GI regarding a plan of action.
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