u/Ajax34762

https://ashpublications.org/hematology/article/2023/1/617/506479/Sex-lies-and-iron-deficiency-a-call-to-change

Abstract

Iron deficiency is a very common and treatable disorder. Of all the tests available to diagnose iron deficiency, the serum ferritin is the most able to discriminate iron deficiency from other disorders. However, the reference range for ferritin in many laboratories will lead to underdiagnosis of iron deficiency in women. Studies have shown that 30%-50% of healthy women will have no marrow iron stores, so basing ferritin cutoffs on the lowest 2.5% of sampled ferritins is not appropriate. In addition, several lines of evidence suggest the body physiologic ferritin “cutoff” is 50  ng/mL. Work is needed to establish more realistic ferritin ranges to avoid underdiagnosing a readily treatable disorder.

I discovered after many blood tests, measuring such things as testosterone, vitamin D and ferritin, that even if my levels fall within the reference range, I can still experience symptoms of a deficiency.

I was continuously gaslighted by negligent doctors that my symptoms are nothing more than health anxiety as my levels are within the reference range and I shouldnt experience symptoms at these levels. This was a lie as many blood marker reference ranges dont factor in deficiency symptoms as a cut off for what level is below the reference range and there is also bioindividuality between different people. Example. You can feel fine and have no symptoms with a ferritin level of 35(reference range is usually 30-300), while I experience extreme fatigue and palpitations with a level of 47. Its the same for vitamin D3. My levels have to be at least 36ng to not experience symptoms, while the bottom of the reference range is usually 20ng.

So if you have symptoms and whatever you are measuring falls within a reference range, it doesn't mean you are not deficient or suboptimal. It can take a while having many followup blood tests and taking note of your symptoms at the same time, to figure out what levels are optimal for you or to establish a minimum level baseline.

I have chronic gastritis(negative H Pylori) that doesnt want to heal, no matter what I do. Its been over 2.5 years. I assume its due to my low ferritin that is impairing healing.

Can B12 levels indicate severity of gastritis as usually gastric inflammation suppresses ability to absorb B12. My B12 levels have remained unchanged since before and after developing gastritis. Can this mean the gastritis isnt too severe?

What role do gut flora have in regulating immune function and by what mechanism?

How accurate is serology to diagnose H pylori, past or present infection?

Mine came back negative twice.

I have chronic gastritis or duodenitis that doesnt want to heal after 2.5 years. It all started after a single alcohol binge session on an empty stomach. I also have poor bile flow for 2.5 years, so I assume a lack of alkaline bile caused it.

I have had chronic sleep issues(insufficient and broken sleep) since Jan/2024. It all started suddenly after a prolonged fast. Other symptoms were pale loose stools, weight loss and malabsorption of fat soluble vitamins.

I tried various sleep remedies. Melatonin made me tired but not sleepy. Antihistamines worked but sleep quality just wasnt there.

In the mean time was trying various ways to improve bile flow and eventually came across ox bile and taurine, which succesfully treated my bile flow issues. My insomnia resolved soon after that

I dont understand the exact physiological mechanism at play(insomnia isnt listed as a symptom of poor bile flow), but for some reason poor bile flow was disrupting my sleep.

If you have sleep issues and poor bile flow, this could potentially be the cause of your sleep issues.

Doctors for whatever reason do not like to address low ferritin, especially low ferritin without anemia.

If you report symptoms such as anxiety, restless legs, some are quick to blame your symptoms on your mental health, without evidence and say its nothing more than anxiety and dismiss low ferritin.

So focus on your other low ferritin symptoms if you have any and exagerate them if necessary to your doctor. The goal is for your doctor to take your low ferritin seriously, not simply dismiss your symptoms.

Anyone has low ferritin too?

Gastritis can impair iron absorption, but can low ferritin cause delayed healing of gastritis?

I have a bile flow issue that impacts absorption of fat soluble vitamins like D.

Despite this, I have still managed to increase my D levels with high dose oral D3 supplementation up to 10,000 IU per day from 12ng to 45ng. Took almost 9 months.

I still have some lingering low D symptoms such as joint pain despite good D levels.

I once tried sun bathing and noticed that my joint pain disappeared after a single day with full body sun bathing at the beach. I assume the sun must give extra benefits than what oral D3 supplementation can give.

So I purchased the Sperti vitamin D lamp to try to replicate what sun bathing gives me and can benefit during the winter months

I have used the Sperti D lamp for 3 weeks now as directed. Only now do I feel my joint pain resolving, so it appears the UV dosage you get from the lamp is far more gentle than the sun. I also didnt experience any redness or burning.

My plan is to cease oral D3 completely and just rely on the sun lamp and I will measure my D levels at a later date to see if they change.

I have both chronically low ferritin and bile flow issues. Recently discovered that low ferritin can cause biliary issues.

https://journals.lww.com/kesg/fulltext/2022/28010/a_study_on_association_of_iron_deficiency_and_gall.6.aspx

Dealing with chronically low ferritin levels without anemia, doctors have been absolutely useless for me. They have either simply gaslighted me and dismissed my symptoms as nothing more than psychologically driven anxiety as my ferritin levels are within "normal" range or told me to take iron supplements. Both of these failed to address my low ferritin issues.

I finally had to take upon myself to learn as much as there is with regards to low ferritin and I discovered it is a much more complex subject than the baseline knowledge many people who work as doctors unfortunately have.

"Low ferritin can cause fatigue and other symptoms even when haemoglobin levels are normal. Iron deficiency does not always present as anaemia, and symptoms may reflect depleted iron stores rather than red blood cell levels"

https://australianprescriber.tg.org.au/articles/non-anaemic-iron-deficiency.html#article

https://www.tewantinmedicalcentre.com.au/low-ferritin-but-normal-haemoglobin

There is no such thing as a one size fits all, universal cut off level like 30ug/L to determine low ferritin like many doctors imcorrectly believe. Ferritin levels are highly individual and they differ from person to person what is optimal for them and also one's overall health status matters too. Serum ferritin is an acute phase reactant and levels can go up during chronic inflammation . So an individual with chronic inflammation can have a serum ferritin level of 90ug/L and still functionally have low ferritin levels.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8002799/

"There are foods that block the absorption of iron. Have your child eat these foods when not eating iron-rich foods. Below are lists of foods to help treat your child’s anemia.

Some foods can block the body from absorbing iron. Many of these foods are still important to eat. Try to eat foods high in calcium (*) and these other foods at least an hour before or after your child eats foods with iron."

• milk, cheese, yogurt*
• soy, tofu*
• chocolate
• ice cream
• grapes
• popcorn
• sardines, canned salmon*
• pomegranate
• coffee, tea
• blueberries, raspberries, blackberries

https://www.nationwidechildrens.org/conditions/anemia-iron-deficiency

"Non-heme iron supplementation at higher doses can induce hepcidin response, serving as a feedback inhibitor to iron absorption [55]. For example, in women with low ferritin, hepcidin response led to reduced iron absorption by 35–45% on the second day of administration of oral iron. 

"Heme iron’s efficient absorption mechanism, minimal interference from dietary inhibitors, and reduced gastrointestinal side effects make it an ideal candidate for addressing the limitations of traditional non-heme iron supplements. Incorporating heme iron into dietary strategies not only enhances overall iron uptake but also offers a safer alternative for populations vulnerable to the adverse effects of non-heme iron"

https://pmc.ncbi.nlm.nih.gov/articles/PMC12252460/

Certain supplements can help assist with iron oral therapy and it isnt simply vitamin C. Taurine also has been shown to increase the effectiveness of oral iron therapy as well as lactoferrin.

"Oral taurine appears to increase the effectiveness of oral iron in the treatment of IDA, and has no significant side-effects."

https://pubmed.ncbi.nlm.nih.gov/12431243/

"A total of 160 studies were identified, of which 10 were included in qualitative synthesis and 8 in meta-analysis. Overall, LF supplementation showed an additional effect on serum ferritin compared with iron alone....modestly increased serum ferritin"

https://academic.oup.com/nutritionreviews/advance-article-abstract/doi/10.1093/nutrit/nuaf296/8436301?redirectedFrom=fulltext

I dont think I have ever heard of doctors discuss issues of bile synthesis. They assume the only issue it can be is cholestasis.

I have tried everything to stimulate bile flow like digestive bitters to no success.

Only had success with ox bile and also supplementing with taurine.

Taurine is a building block of bile. It combines with bile acids to make bile salts that comprise the majority of bile.

Taking taurine and also ox bile basically resolved my pale loose stools.

I have never come across a more useless medical speciality profession like GI docs.

The term medical specialist is also such a misnomer as they are anything but specialists in the gastrointestinal system and disease. Besides politicians, I dont think there is any profession where one can essentially BS there way through and sell you an absolute farce and its tolerated and acceptable. Like a scam.

These are my and some other people's experiences I have come across.

- "SIBO?, did you read that on google?"

- "It's IBS, you should consider seeing a psychologist"

- " We didn't find anything on your scope, so I suggest doing a repeat in a few months"

- "If you're constipated just add more fiber to your diet"

- "Butyrate?, what's that?"

- " Histamine intolerence is pseudoscience"

- " Tudca?"

- "Sorry I am a doctor, not a nutritionist, so dont ask me about supplements for the gut"

-Literally anthing- "Here take this PPI".

- "Reflux is caused by too much acid"

-" You dont need a gallbladder"

-" The appendix doesnt do anything"

If taurine is a non-essential amino acid that the body can synthesize itself why is that I experience benefits when supplementing with it?

I have a weird issue in which it appears my liver isnt synthesizing sufficient levels of bile acids and its negatively impacting my digestion and causing symptoms such as pale loose stools and malabsorption of fat soluble vitamins. My issue came on suddenly 3 years ago after binge drinking alcohol on empty stomach and doing fasting.

- Liver enzymes, always good.

- Liver ultrasound and MRI, good.

- No pain or discomfort when consuming fatty foods.

- Fasting aggravates my issue though.

- Taking digestive bitters does nothing.

- Taking taurine, ox bile or tudca completely resolves my symptoms. When I stop taking any of the above my symptoms return in a few days.

Anyone experience anything like this?

It typically manifests as pale/yellow stools and malaborption of fats and fat soluble vitamins.

I have chrnically low ferritin. One of my main symptoms are fatigue and even going up a flight of stairs can leave me feeling exhausted.

I notice when I get a cold, I have far more energy despite being unwell, less fatigue.

Anyone experience something like this?

How is it treated?

I have what I assume is poor bile flow which is causing symptoms such as pale loose stools, deficiency in fat soluble vitamins.

I have tried digestive bitters which dont do anything. I have relief with amino acids(building blocks of bile acids) and ox bile.

Does low serum bile acids mean the liver isnt synthesizing adequate bile acids?

Conjugated bilirubin is normal.

Elevated bilirubin can be a sign of potential cholestasis. I have symptoms of cholestasis like pale stools but normal bilirubin levels. One marker that has become slightly elevated is cholesterol. My understanding is that cholesterol is excreted from the body via bile . Can this elevated cholesterol potentially indicate cholestasis as bile flow is being restricted causing cholesterol levels to backup and accumulate?

I had a liver ultrasound that didnt detect any stones or sludge.

Taking ox bile completely cures my pale stools.