Hi, I’m a 39F in Canada currently being investigated for a bleeding disorder (possible von Willebrand type 2).
I’ve been dealing with heavy menstrual bleeding and recently noticed a significant drop in my ferritin despite having IV iron a few months ago.
Ferritin trend:
Nov 2025 (post IV iron): 192 µg/L
Mar 18, 2026: 95 µg/L
Mar 26, 2026 (post-period): 80 µg/L
→ Drop of 112 µg/L in ~4 months
Other labs:
Hemoglobin: 124 → 117 g/L in 7 days
Transferrin saturation: 15%
Serum iron: 10 µmol/L
Symptoms: fatigue, low energy
Question:
Even though 80 µg/L is technically still “normal,” is this kind of rapid decline after IV iron considered clinically concerning?
Does this usually indicate that iron loss is exceeding replacement, and would it typically justify more aggressive management (like repeat IV iron or urgent follow-up)?
Not looking for a diagnosis, just trying to understand how this pattern is viewed medically.
Thanks so much.