So my teenage daughter has complained of being tired for years. We have had tons of bloodwork done, and the only thing that comes back abnormal is her iron levels are low. That obviously could be the culprit. So how do you get levels up? She has been taking supplements. Hasn't made much difference.

How low? Why is her iron low? Heavy bleeding? Diet? Typically you have to address the reason why.

But, regarding supplementation, there are different formulations that claim better absorption. But typically best to have iron supplements with vitamin C, as it assists in absorption or something.

I know we have always added a little black strap molasses to our kid's oatmeal for iron supplementation.

what kind of supplements? some are more absorptive than others

aznaggiegirl07 said:

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what kind of supplements? some are more absorptive than others

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A brand called Ferrosolve.

https://www.amazon.com/NBI-Ferrosolve-Supplement-Vegetarian-Capsules/dp/B0058AC6WM

Is she a vegetarian or does she do a lot of endurance type exercise?

Leggo My Elko said:

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Is she a vegetarian or does she do a lot of endurance type exercise?

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Not a vegetarian. Plays basketball, volleyball and tennis, but she's not over the top in the amount of time she trains.

Look for a ferrous sulfate supplement…

Plant based iron is not going to be as bioavailable.

My wife had similar symptoms for many years. Part of it is she had a thyroid issue that could be corrected. With drugs. Then later she had to have a uterine cyst almost as big as a softball removed, but that required a hysterectomy unfortunately. That resolved her iron deficiency issues and other menses symptoms and her levels are more normal now. Not sure those are the issues so much as saying look into potential causes of the symptom instead of just trying to counteract it.

What iron was low? Serum? TIBC? Ferritin? Etc

Without knowing any details (labs, what she does, takes anything else, etc),
Typically elemental iron ~40-65mg taken every other day (helps absorption),

Avoid taking with dairy, calcium, coffee, tea, multivitamin, etc -- Google lists

Prob should take with vit C and on an empty stomach

OasisMan said:

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What iron was low? Serum? TIBC? Ferritin? Etc

Without knowing any details (labs, what she does, takes anything else, etc),
Typically elemental iron ~40-65mg taken every other day (helps absorption),

Avoid taking with dairy, calcium, coffee, tea, multivitamin, etc -- Google lists

Prob should take with vit C and on an empty stomach

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Taking supps, esp iron, on an empty stomach may cause GI issues

Wife has the same issue she takes a supplement called slow FE that you can get at H-E-B.

Checking on those results. Also really low on testosterone.

Ok, now I'm confused. Doctor said she was low on iron. Did blood work last April. Ferritin level was at 28 (range of 15-77). Testosterone was at 6 ng/dl (range of 12-71). Low T was surprising given she is pretty muscular and strong. Tested again a few months later. Ferritin was at 49. Testosterone at 13.

Low testosterone can make you really tired, too. Ask any perimenopausal woman.

However, that's usually associated with declining testosterone (as well as other hormones) as we age. So, if you do any research on your own, that's likely going to be the context of the information you find.

Testosterone does fluctuate during the various stages of the menstrual cycle, so if you don't have that piece of info, the numbers won't make complete sense. If it were me, I'd want to know my full range over my cycle.

The higher her testosterone gets during one phase of the cycle, the worse symptoms may be if it drops really low (it's the drastic change that we notice).

Based on my personal experience (47 year old female), a level of 6 would be extremely low, and expected in someone who is in menopause/has stopped ovulating. A level of 13 would be more normal in someone my age (still ovulating, but things are starting to shut down).

Testosterone levels in women are typically highest in the late teens and early 20s.

Testosterone is really important for women, and not just as a "sex hormone". It's important for bone density and mood/cognitive function.

Just as a side note, it may be difficult to find a doctor who even thinks this is a problem. It's only been the last couple of years that the medical field has started taking hormone therapy for older women seriously again. And most doctors are still stuck on the old way of thinking (ie, hormones cause cancer - which is not true). The buzz right now is there is no "FDA approved" treatment for low testosterone in women. Well, that's just because they haven't bothered to approve a treatment in the right dose (there are FDA approved treatments for men).

You might be able to find an OB/GYN who specializes in this, or an endocrinologist who specializes in fertility. You also might get help from a knowledgeable female urologist.

My best advice is to take this as seriously as if a doctor told you your son has low testosterone, and find a doctor who does the same.

aznaggiegirl07 said:

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OasisMan said:

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What iron was low? Serum? TIBC? Ferritin? Etc

Without knowing any details (labs, what she does, takes anything else, etc),
Typically elemental iron ~40-65mg taken every other day (helps absorption),

Avoid taking with dairy, calcium, coffee, tea, multivitamin, etc -- Google lists

Prob should take with vit C and on an empty stomach

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Taking supps, esp iron, on an empty stomach may cause GI issues

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possibly, but it also may not

iron is best absorbed on an empty stomach


however, her ferritin has responded to supplementation, so it does not sound like iron absorption is her issue

Please pardon me if this is an oversimplification, but can your daughter consume more red meat? Other high-in-iron foods? The iron contained therein, in my understanding, is more bioavailable than supplementation.

Does her doc recommend an iron infusion?

You may ask her doc for a referral to a. Oncologist / hematologist (hematologists are sometimes hard to find, so a cancer doc is usually the next best alternative)? When I had low iron levels, I feel that my oncologist took me more seriously and was able to order the tests to rule out a chronic vs. temporary issue. Turns out it was short-lived due to extreme weight loss.

AggieBarstool said:

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Please pardon me if this is an oversimplification, but can your daughter consume more red meat? Other high-in-iron foods? The iron contained therein, in my understanding, is more bioavailable than supplementation.

Does her doc recommend an iron infusion?

You may ask her doc for a referral to a. Oncologist / hematologist (hematologists are sometimes hard to find, so a cancer doc is usually the next best alternative)? When I had low iron levels, I feel that my oncologist took me more seriously and was able to order the tests to rule out a chronic vs. temporary issue. Turns out it was short-lived due to extreme weight loss.

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Getting her iron levels tested again in 2 weeks. Will report back. I have my doubts that iron is the problem here, but we'll see.