Dear all,
I’m really desperate and I would appreciate any advice or insight.
I am a 39-year-old woman, without children, and I have been struggling with anemia for as long as I can remember. About three months ago I visited a dermatologist due to noticeable hair thinning. She advised me to restart iron supplementation containing ferrous sulfate (329.7 mg) and 500 mg vitamin C.
For context, my baseline blood results before restarting supplementation were:
* Ferritin: 28
* Iron: 12
* TIBC: 49
One month after starting the supplementation, my ferritin increased from 28 to 56. However, in the following months it has been steadily dropping again, and my latest result is 29.5 — almost back to where I started.
My iron studies trend looks like this:
* February: Ferritin 56, TIBC 47, Iron 20
* March: Ferritin 39, TIBC 47, Iron 15
* April: Ferritin 29.5, TIBC 42, Iron 10
I also have quite heavy menstrual bleeding. Two months ago I had a polyp removal procedure, and my first period after that was the heaviest I have ever experienced. The most recent period, however, was noticeably lighter than usual, and I am currently on day 12 of my cycle.
For additional context, about a year ago I had a colonoscopy which was completely normal. All related tests (FOB few times, fecal calprotectin few times, celiac serology, etc.) were also normal. I also had a gastroscopy which showed gastritis and GERD, and I was on PPI therapy for three months. Since then I have not had any further symptoms or follow-up investigations.
I also had CRP checked today and it is 1.3, which is within the normal range.
For the last month, I have been taking iron supplementation every other day instead of daily.
Additional metabolic/lifestyle context:
* HOMA-IR (2 months ago): 1.8
* In the last 2 months I lost about 4 kg
* I also increased my training/exercise intensity during this period
I am really confused why my ferritin keeps dropping despite supplementation, and I would be grateful for any ideas, similar experiences, or possible explanations.
Thank you in advance.