Can low ferritin levels cause palpitations?

Question

Hello doctor,

I have been experiencing fatigue and palpitations for about six months. I consulted with a cardiologist, who assured me that my palpitations were benign.

My blood test results were normal, with a hemoglobin level of 15.6 g/L, but my ferritin was 25 µg/L, which I understand is on the lower side. My GP does not believe I need iron supplements.

Could you please advise if my ferritin levels could be causing my symptoms?
Should I consider taking iron supplements?

Kindly assist.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Yes, your serum ferritin is low, as the normal range is between 50 and 300 µg/L. However, since your hemoglobin is normal, it is important not to rely solely on serum ferritin levels.

It would be best to repeat your hemoglobin and serum ferritin tests, along with serum TIBC (total iron binding capacity) testing, serum transferrin saturation assays, and a peripheral smear examination. If these tests indicate an iron deficiency anemia, then iron supplements may be recommended.

Additionally, checking your vitamin B12 and free ionized calcium levels is essential. If any of these are low, they should be corrected accordingly. Conditions such as hyperthyroidism, fibromyalgia, and HIV (human immunodeficiency virus) can also contribute to similar symptoms. These should be considered based on your physical examination.

Please consult your physician for a thorough examination, and they will determine if any further work-up is needed. If no specific cause is found, it may be stress-related chronic fatigue syndrome, for which Amitriptyline can be prescribed.

I hope this helps clarify your concerns.

Thank you.