Tag: anemia

If you had iron deficiency anemia in the past, or other deficiencies, I suggest regular blood work.

I have been feeling worse in the past months than in the summer / fall. I attributed this to the Canadian winter – cold, dark after 4pm, almost no sunlight even during daylight time. And I’m sure the weather and the darkness plays a big role. I have been taking vitamin D regularly and also I use fortified soy milk in my cooking and lattes. I also take Optifer, since my ferritin was low about a year ago.

About a year ago, my ferritin was 21 µg/L, which is below the 30 µg/L threshold. My family doctor also mentioned that more recent evidence suggests that to actually feel well, ferritin should be at least around 50 µg/L, not just barely within range. She told me to start taking Optifer every other day. I have been doing that consistently for the past year, so I assumed the issue would be resolved and didn’t bother to repeat any blood work.

I was certain that the weather was the only factor contributing to worsening mood at this point, especially since I already take Optifer, vitamin D, and soy milk is fortified with B vitamins.

My psychiatrist recently suggested that I do blood work, just in case. It came back showing low ferritin again, as well as low vitamin D and B12 right at the lowest threshold value. My ferritin was 29 µg/L, and the lab note stated that <30 µg/L is consistent with iron deficiency, so after a full year of taking iron supplements, it barely increased and is still well below the level associated with actually feeling well. My vitamin D was 73 nmol/L, while the normal range is 75–250 nmol/L, so it is below range. My B12 was 241 pmol/L; the reference ranges are >220 pmol/L as normal (deficiency unlikely), 150–220 pmol/L as borderline (deficiency possible), and <150 pmol/L as low (consistent with deficiency), so even though mine is technically in the normal range, it is very close to borderline. My psychiatrist mentioned that ideally B12 should be in the 400s to actually feel well, not just barely above the cutoff. I wish I would have done the blood work sooner instead of assuming everything was fine.

I have an ongoing issue with ferritin, vitamin D, and B12 being low, these deficiencies has happened in the past. I assumed though that the supplements I was taking were enough.

I ended up getting an iron infusion. I am also now making sure to take Optifer early morning on an empty stomach, so that it would be at least an hour before food, for better absorption. I was also told that taking it every other day instead of daily is more efficient for absorption. I increased my vitamin D and B12 dosage and will do blood work again in a month.

So my suggestion is that if you have experienced deficiencies in the past, do regular blood work. Don’t assume that the deficiencies have resolved. My psychiatrist said she believes that I may have poor absorption due to Celiac disease. I don’t eat gluten, but celiac disease can still cause poor absorption even on a gluten-free diet.

The symptoms of these deficiencies often overlap and are easily mistaken for general seasonal changes or stress. Iron deficiency, or low ferritin, typically causes a deep, persistent fatigue, cognitive fog, and an inability to stay warm. It is also a primary cause of restless leg syndrome, an uncontrollable urge to move your legs, usually in the evening. Vitamin D deficiency is closely linked to significant shifts in mood, muscle aches, and a general feeling of physical heaviness. Meanwhile, low B12 can lead to neurological symptoms like tingling or “pins and needles” in your hands and feet, increased irritability, and even subtle memory lapses.

If you have had deficiencies several times in the past, it’s possible that you also have poor absorption and that deficiencies may persist despite supplementation, which means you actually need to monitor them regularly instead of assuming they’re fixed.