What can cause ferritin levels to drop very quickly?

I have problems holding on to iron. It's a common trait in my extended family. My TIBC (Total Iron Binding Capacity) is always either low in range or below range, and I wonder if this is relevant to my problem, because low TIBC is normally found when iron levels are high.

I supplement iron pretty much all the time, but I have never managed to find just the right dosage to keep my levels stable - they either rise or they fall, sometimes quite dramatically.

A couple of years ago I overdid the iron supplementing, and had an over the range ferritin. So I stopped supplementing altogether for four months. The results before and after those four months of no iron are at the bottom of this post.

I am concerned that my ferritin dropped by approx 90 ug/L in just four months. It seems like a rather dramatic drop to me, but then I don't know people I can compare with who have the same problems as me and who also get tested. (I pay for my own tests.)

As far as ferritin goes I aim to keep it to mid-range or slightly higher - say 85 - 110 with the range given in the table. If my ferritin is kept mid-range everything else in my results below is always below mid-range, often well below.



Edit : Grammar

 

@Arnie Pye this whole ferritin issue is frustrating. I had low ferritin levels for over 20 years. I did not understand why and had to supplement with iron. It dropped to low levels quickly if I didn't supplement.

The weird thing is that when I started menopause it went up to 98 on it's own! I was shocked at my lab results when they came back. I never had heavy periods so it doesn't make sense to me.
Here are some results of my Iron metabolism tests from 2002 (when I had low ferritin). I don't know if it points to anything.

Total Serum Transport Iron:
23.6 (7.0-29.0)

TIBC:
48.0 (44.0-77.0)

Unbound Iron Binding Capacity (UIBC)
24.4 (24.0-67.0)

In my report it states "the storage capacity of iron in circulation is almost insufficient. A further decrease in UIBC would lead to free iron in circulation which is known to lead to oxidative stress itself". Protein supplementation was recommended.
It states the Hemoglobin carries about 69% of the total body iron, ferritin makes up for 15%, and transferrin only 0.1%.

Do you take digestive enzymes? Perhaps you have malabsorption problems?

 

I was the same. My levels went from 27 to just under 100 after meno. According to my doctor that usually happens post meno.

 

My sister struggles w it, she has blood specialist ( hematologist maybe) and they have her in b12shots and iron. Something to do with her b12 keeps her iron low. She is mostly ok now, but has to be monitor and on b12 shots for live.

 

I passed menopause many years ago, and yet I still have to supplement iron.

I do have problems with my gut, and it is probably a factor in my losing iron so quickly, although I don't think it explains everything. I struggle with anything acidic - digestive enzymes, vitamin C, caprylic acid (I tried it for candida), betaine HCL. I have severe pain in the area of my left kidney and my splenic flexure (the point where the colon turns a sharp corner into the descending colon on the left) which is unexplained. I take pain killers for it every day - Naproxen and Tramadol - and because of the Naproxen I take ranitidine to protect my gut from erosion. This has only been true for about 2 - 3 years. Before I was on pain killers I still had the same problems. Whenever I take anything acidic the unexplained pain gets much, much worse.

I almost certainly do have malabsorption problems. I developed severe indigestion in my teens and it never went away. I was diagnosed with a duodenal ulcer in my 20s. I have discovered in recent years that untreated hypothyroidism cuts acid production, and indigestion is more likely to be caused by having too little stomach acid rather than too much. I've been tested for SIBO (a hydrogen breath test) and it was negative.

But although these seem to explain my problems they don't explain my ferritin and iron issues completely. I don't know why my TIBC is low, and my female relatives don't have the same health problems that I do, and in fact are generally much healthier than me. But they still have repeated problems with hanging on to iron.

I wish it did for me.

My vitamin B12 is high. I don't inject, I supplement methylcobalamin and adenosylcobalamin to keep my levels high. But I've only been supplementing B12 in the last few years. But I've had issues my whole life with iron. My balance is poor, and I have found by experiment that keeping my B12 levels high with supplementation helps a bit.

 

I cannot see any problems with this if it has shifted to a very normal level. The results for May look fine. If something like this is reverting to normal than I do not see why it matters? And four months is ages for this sort of thing to change.

 

I was concerned because I have read that the body usually has a lot of difficulty getting rid of excess iron, and yet mine got rid of a high level in a fairly short time, so I'm wondering how that happens. If I don't supplement at all then my ferritin and serum iron drop to bottom of range or even below, and my haemoglobin ends up under range.

 

My sister has Hashimoto and can't hang on to iron either. She takes iron supplements.

 

If your levels drop if you do not supplement then presumably you are losing iron on a regular basis. That is quite normal because we all lose some iron in the gut every day. If you lose enough to drop your iron then that obviously explains why the ferritin can go down. I don't really see a problem here to be honest. it all seems to fit as expected.

 

Hmm if you b12 is high and iron low how is your folate?

 

@Arnie Pye I think the main question is are you anemic, yes or no?
If your hemoglobin is normal, then there is nothing to worry about. Eat well, and if you have heavy periods or if you are vegetarian you may benefit from iron tablets as you would need to eat a lot of meat to catch up.

As of why your feritin levels could change drastically, it may simply be lab related (i am no lab tech) or dietary related. As long as you can maintain your hemoglobin (considering a stable hematocrit) then you’re good.

 

It's just above middle of the reference range, which is fine.

 

I'm past menopause so I should have plenty of iron without supplementing. I'm a meat eater, including liver, so I should have plenty of iron without supplementing. I'm not aware of me losing blood from the GI tract. I'm not anaemic, but past experience tells me that I would develop it very quickly if I stopped taking iron supplements. I just wish I understood why I lose so much iron and ferritin all the time and have to keep it topped up with supplementing all year round, and why my TIBC is always low in range or under the range.

 

We all lose iron through the gut without being the slightest bit aware of it. If it is enough to make you significantly anaemic, then investigation is called for, but not if levels are normal.

 

are there other important human processes that compete for the iron ?
ie if iron supplies are low, haemoglobin might be adequate, but other things depleted.

i've read that some bacteria compete for our iron stores ...