u/Superb-Hurry-2259

Hi everyone, long story short: I am 33 year old woman with a family history of heart disease/heart attack (both sides of my family). I was referred to a cardiologist as part of a work up for some exercise intolerance symptoms which are most likely being caused by a clinical iron deficiency.

I was able to get in with the cardiologist last week and my APO B lab is 111 and my LPA is 251. Not great! I'm looking for advice on how to approach this as I work with my cardiologist. On one hand, I am happy to know this information now. On the other, it feels scary. I am 100% on board with whatever my cardiologist recommends.

I also told my immediate family members they should get tested because they never have been. My grandma was diagnosed with AFib last year and has had lifelong elevated cholesterol and I'm really worried about her even more now.

Thank you! ♥️

Hi everyone! I'm dealing with iron deficiency without anemia again. I'm posting here to ask if anyone has experienced something similar to my situation. My doctor has consulted a hematologist so we are waiting to hear from them. Has anyone else still had low ferritin levels even with controlled heavy menses and no clear autoimmune or GI indicators for malabsorption? I've also always had normal thyroid labs my whole life. I am not vegetarian/vegan and eat a normal diet with moderate red meat consumption.

Context: In 2021, I started birth control due to heavy menses. All of my female health work ups have been normal, but the heavy menses was gradual over time. I went from a light to moderate flow to eventually changing a super tampon every 2.5-3 hours with blood clots around the size of a quarter and sometimes a little larger. My flow had never been that heavy before, but my OBGYN didn't seem concerned. I only went to the doctor in 2021 because I was helping a friend move a heavy box up some stairs and almost passed out.

At that time, my ferritin was 6.6, iron 45, and saturation 9%. In 2024, I was still feeling fatigued, and visited the doctor. After three years of being on birth control, my ferritin was 14, iron 64, saturation 13%. In October 2025, I went for my routine physical and also brought up some gnawing in my stomach and heart-burn on an empty stomach, and discomfort relieved by eating. He said it was most likely GERD/gastritis. This time, my ferritin was 46, iron 71, saturation 17%. In my labs, I tested negative for h. pylori (breath test) and celiac.

I switched birth controls to the mini pill at the advice of my provider due to my high weight in November 2025. The heavy periods have returned with this (and my new doc said this is probably behind the recent drop in ferritin, which makes sense). I started making better choices in my diet around then and began to move more (more walking, gentle rides on a stationary bike). Then in April 2026, I started Zepbound, and it really helped with my joint and muscle pain and I've lost 15 pounds. I've returned to the gym and experienced the exercise intolerance I had in 2021, which prompted me to check in with a doctor. Ferritin is back to 20, iron 76, saturation 18%. Negative for parietal cell and intrinsic factor blocking. My doctor said he would like to see my ferritin at a minimum of 100.

I'm curious as to what could be behind this (aside from the switch to mini pill) as I also experienced iron deficiency when menses was controlled. Has anyone else experienced something similar? The iron deficiency is the only thing abnormal in my labs. My PTT is 37 and my fibrinogen was slightly elevated at 465, but that was it. I would really like to get back to being active (I played rugby in college and was doing boxing/muay thai up until the pandemic in 2020), but for the last couple years, I have really just felt not great. I have made good progress with my diet and other health markers (cholesterol now in ideal range!), and fitness is the next thing I want to get back to. Thanks for reading!