ADVERTISEMENT

Q. Is it safe to take iron supplements for fatigue or can it become toxic?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 16, 2017

Hello doctor,

I began presenting last fall with some chronic fatigue. The initial blood work showed low iron saturation without anemia. I have attached reports of the same. There were other endocrine-related findings as well. In the course of various endocrine-related treatments and corresponding blood work, I began iron supplementation in the form of ferrous sulfate 143 mg daily. I began this before the blood work was done. So, you can see that that the levels have increased. Subsequent testing, a month later, showed a decline despite continuing treatment. Most recently, you can see that the levels are back up. Note that the ferritin levels began a bit low around 27 ng/mL and had increased to 30 ng/mL.

I have received a wide range of conflicting advice about whether low iron levels in the absence of anemia can cause fatigue. I have also received a range of conflicting advice about whether to continue iron supplementation. One doctor told me to continue taking the iron until the ferritin is up around 50 or so. Another said that would be unnecessary and to discontinue it and wait for three months to re-measure the blood work. It is all quite puzzling. Please help me to understand iron's role, if any, in fatigue in the absence of anemia. And help me to then understand the rationale for treatment or lack thereof. And finally, please give me some sense of when iron toxicity emerges in terms of blood work measurements and at what frequency one needs to check the iron levels during any supplementation.

ADVERTISEMENT
#

Hello,

Welcome to icliniq.com.

  • In my opinion, iron supplementation can be stopped because serum iron, TIBC (total iron binding capacity) and hemoglobin levels are within the range.
  • Fatigue can occur in hypothyroidism, or due to anxiety, lack of sleep, exhaustion, stress or lack of exercise.
  • Repeat CBC (complete blood count) after few weeks and upload the results.
  • The following investigations, if done, will reveal the exact cause of your fatigue:
  1. Thyroid profile.
  2. Serum Potassium, Calcium and Sodium levels.
  3. Liver and kidney profile.
  4. Nerve conduction velocity.
  5. Electromyography.
  6. FSH and LH levels.

You can consult an endocrinologist or a neurologist based on your reports, but iron medication need not be continued as per my opinion.

For more information consult a hematologist online --> https://icliniq.com./ask-a-doctor-online/hematologist

Hello doctor,

Thank you for your answer. My endocrinologist and primary care physician both want me to continue taking the iron and resample the blood in three months. The idea is to raise the ferritin to about 50, so that I will have more iron reserves. I realize that this conflicts with your advice, but I want to understand this from a hematologist. Is continuing the iron safe? When does iron become toxic? Is toxicity going to occur right away or is it more of a long-term possibility? Is a 3-month waiting period sufficient for blood testing if I do continue the iron? They want me to take 143 mg ferrous sulfate per day during this time. These doctors seem very convinced that this is safe. Please help me feel the same way.

#

Hello,

Welcome back to icliniq.com.

Our body uses up the iron reserve whenever required, especially when the iron intake is low.

  • Serum ferritin level reflects the iron store. Your serum ferritin is not low. So, I advised you to stop taking the iron medication intake.
  • But, as such iron tablets are safe. It will not lead to toxicity if you take iron because iron gets accumulated in organs like liver, heart, thyroid etc when the serum ferritin is above 1000. So, iron toxicity issues occur in thalassemia patient commonly.
  • If your doctors are sure, you can continue it as they advise. It will definitely not harm you. You can check the serum ferritin again after iron 3 months.

For more information consult a hematologist online --> https://icliniq.com./ask-a-doctor-online/hematologist


Was this answer helpful?

 | 

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!



Related Questions:
I noticed white strings in my stool. I hope it is not parasites. Please help.

Hello doctor, My wife is 28 years old, and her weight is 49 kg. She is on Thyronorm 75 for past one year. We did some blood tests a year back as per our gynecologist's advice in view of positive ANA two years back which came normal in the same year....   Read full

Please suggest a cure for my skin rashes based on the report.

Hello doctor, My wife is 28 years old, and her weight is 49 kg. She is on Thyronorm 75 for past one year. We did some blood tests a year back as per our gynecologist's advice in view of positive ANA two years back which came normal in the same year....   Read full

What changes have to be done to control BP?

Hello doctor, My wife is 28 years old, and her weight is 49 kg. She is on Thyronorm 75 for past one year. We did some blood tests a year back as per our gynecologist's advice in view of positive ANA two years back which came normal in the same year....   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


Tomato Fever - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Tomato fever is an unidentified and fast-spreading type of viral infection seen in young children. Scroll down to know m...  Read more»
Histrionic Personality Disorder - Causes, Signs, Symptoms, Diagnosis and Treatment
Histrionic personality disorder causes variations in the thinking ability of a person. Read this article to know more.  Read more»
Nighttime Skin Routine for Clear Skin
A skin that gets all the attention during the day requires a chance to repair, rejuvenate and replenish from day damage ...  Read more»

Ask your health query to a doctor online?

Ask a Hematologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.