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Do I have iron deficiency if I have fatigue?

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Practicing since : 2002
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Hello, i have a normal iron value (15 umol/l) and my ferritin is 53 ug/l. Now i have an light increased TIBC (70.3 umol/l). For 2 years i have fatigue and sleep problems and recognize symptoms of Iron deficiency. The whole day i am tired.

Could it be that i do have iron deficiency even if my ferritin and iron value is normal, i do have Crohn and have haemorrhoids and lose some little blood every day.

The hospital i visit tells me that my TIBC is light increased, the use the range 43-64 umol/l. Is it a good idea to use iron pills to get the iron value some higher? The fatigue make me grazy and i hope this will give an solution for my problem.

I am from holland, so excuse for my bad english. Many thanks!
Posted Tue, 17 Apr 2012 in Blood Disorders
Answered by Dr. Robert Galamaga 2 hours later
Hello and thanks for the query.

Your question is a very good one and I will try to give you some helpful information and recommendations as far as what to do next. You are correct in assuming that your doctors have concluded that your bloodwork does not show a true laboratory iron deficiency. The ferritin level is a good measure of iron store in the body. Your value of course is within normal limits. With the total iron binding capacity being slightly elevated this again does not show a true evidence of iron deficiency. Your iron level again also is within normal limits.

The question is if you have a true iron deficiency. Again the laboratory values do not support this. You are having symptoms which are suspicious for fatigue induced iron deficiency. Again at the same time we need to explore other possible causes of fatigue.

I'm on the other causes of fatigue we must not miss the fire right. I hope your physicians have explore that or at least have discussed that with you. Again that can be checked with a simple blood test.

As far as recommendations for you I think it is not unreasonable to consider and iron supplementation. What I would do is try to take an iron supplement which is quite safe and will be quite effective for you.

I recommend you start out by taking ironed once daily for the next seven days and then increase it to twice daily for the next 4 to 6 weeks before you revaluate for a response. Iron tablets are available as iron sulfate and can be purchased at a pharmacy. A typical tablet is about 325 mg.

There are a couple of side effects of iron supplementation which you should be aware of. The first thing is that it might cause a small degree of constipation. In addition it may cause the stool to become somewhat thick and pasty. Finally it can sometimes cause a change in the color of the store where the stool becomes black in color. Again these are side effects and not anything XXXXXXX

I thank you again for submitting your question. I hope you have found my answer to be both helpful and informative. If you have additional concerns regarding this I would be happy to address them.


Dr. Robert.
Above answer was peer-reviewed by
Follow-up: Do I have iron deficiency if I have fatigue? 17 hours later

thanks for your informative answer, it make me happy and i understand what's my situation. I have only one question, if i take the 300mg tablet Iron per day for 6 weeks, there is no chance that i wil get an iron overload with my values within the normal limits? I heard people saying that you can get an iron overload when you take too much of Iron.

Thanks for your help and keep going on with your good help!

Answered by Dr. Robert Galamaga 6 hours later
Hello again and thanks for your followup and feedback.

300 mg per day of oral iron will not generate a situation where you have iron overload. This is not something you have to worry about at all. It would generally involve taking huge doses of iron or receiving many blood transfusions before a concern regarding iron overload would be an issue.

I encourage you to continue the once daily dose and consider stepping up to twice daily for a few weeks to see how you feel and then go back to once daily. A continual assessment of your overall health by your physician should also be done on at least a 6-month basis.

Again I thank you for the query and hope we have provided an adequate answer again. If there are other concerns, I am available to address them.


Dr. Galamaga
Above answer was peer-reviewed by
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