I thought I was tired because I was busy.
It was an easy explanation. Work, life, not quite enough sleep, probably too much coffee – nothing particularly unusual. I was still functioning and getting everything done. I just felt tired far more often than I thought I should.
Then I had bloodwork done.
My ferritin was low and near single digits.
I knew vaguely that ferritin had something to do with iron, but that was about the extent of my knowledge. What I didn’t know was that ferritin is essentially a marker of the iron your body has stored away. You can have low iron stores even before you develop iron-deficiency anemia.
Suddenly, the tiredness was worth looking at a little differently.
What does low ferritin actually mean?
Ferritin is a protein that stores iron, and a ferritin blood test gives your healthcare provider an indication of your body’s iron reserves.
Iron matters because we need it to make haemoglobin, which helps red blood cells carry oxygen around the body. When iron stores become depleted, fatigue can be one of the symptoms.
There can be others: headaches, weakness, dizziness, feeling short of breath, heart palpitations, difficulty concentrating, and reduced exercise tolerance are among the symptoms associated with iron deficiency.
The tricky part is that none of these symptoms scream iron. They also happen to sound a lot like being busy, stressed, overtired, or generally run down.
That’s partly why guessing isn’t particularly useful in these situations – but bloodwork is.
What should you ask your doctor to check?
If you’re persistently tired, tell your doctor what you’re actually experiencing rather than simply asking for an iron infusion.
If iron deficiency is a possibility, they may order a complete blood count as well as iron studies. Ferritin is worth knowing about because it reflects stored iron.
It’s also worth asking your doctor to explain your results rather than trying to interpret one number yourself. Ferritin ranges and what constitutes deficiency aren’t quite as simple as finding yourself inside or outside the reference range on a lab report. Your symptoms, medical history and other blood results matter too.
And if your ferritin is low, ask the next question: why?
Heavy periods are one possible reason women become iron deficient. Pregnancy and increased iron requirements can play a role. Diet, gastrointestinal blood loss and conditions that interfere with iron absorption can also contribute.
Replacing iron is important. Understanding why you’re losing or not absorbing enough of it is important too.
Why an iron infusion?
There are different ways to treat iron deficiency, and an infusion isn’t automatically the first or best choice for everyone.
Oral iron is commonly used. An iron infusion may be recommended when tablets aren’t tolerated, aren’t being absorbed adequately, haven’t been effective enough, or when there is a clinical reason iron needs to be replaced more quickly.
In my case, an infusion was the recommended next step.
And while that might sound dramatic, it really wasn’t.
What is an iron infusion actually like?
This is the part I wish someone had explained to me beforehand.
An iron infusion is simply iron given through an IV into a vein. You arrive, an IV is inserted, and the iron is administered while you’re sitting there.
How long it takes depends on the particular iron preparation, dose and clinic protocol. You’re monitored during the infusion and usually for a period afterwards because, as with any intravenous medication, reactions can occur.
Mostly, there is a lot of sitting.
Bring something to read. Charge your phone. Wear something that makes it easy to access your arm. And if anything around the IV feels painful, burns, or starts to swell, tell the person looking after you immediately. Iron leaking outside the vein can stain the skin, so that’s not something to tolerate.
I also didn’t walk out feeling instantly transformed. That’s probably one of the most useful things to know beforehand.
What happens after an iron infusion?
An iron infusion isn’t an intravenous espresso.
The infusion puts iron back into your body, but your body still has to use it. If iron deficiency has been contributing to your fatigue, improvement may happen gradually rather than the moment the IV comes out.
Some people experience temporary side effects after an infusion, such as headache, nausea, dizziness or muscle and joint aches. Your clinic should tell you what to expect based on the particular iron preparation you’re receiving.
Your healthcare provider will also advise you about follow-up bloodwork. This matters because the point isn’t simply to feel as though it worked. It’s to see whether your iron stores and, where relevant, haemoglobin have responded appropriately.
For me, that changed the way I thought about the whole thing. The infusion wasn’t the end of the story; it was one part of figuring out why I felt the way I did and correcting something that had actually been measured.
When should you seek medical advice?
Fatigue is incredibly common, and having a tired week doesn’t mean you need a battery of blood tests.
But persistent or unexplained fatigue is worth mentioning to your healthcare provider, particularly if it’s a noticeable change for you or is accompanied by symptoms such as shortness of breath, dizziness, weakness, palpitations or headaches.
If you have very heavy periods, that’s also worth discussing rather than simply accepting them as something you have to put up with. Heavy menstrual bleeding is a common reason women can become iron deficient.
And if you’ve already had an iron infusion, follow the aftercare instructions you’ve been given. Seek prompt medical advice if you develop symptoms that concern you, and urgent medical attention for signs of a serious allergic reaction such as difficulty breathing or swelling of the face, lips, tongue or throat.
One thing I wish more women knew
What stayed with me after this whole experience wasn’t the IV, it was how easily I had explained away feeling tired.
Women are very good at accommodating a gradual change in how we feel. We compensate. We go to bed earlier, have another coffee, drop something from the calendar and keep moving.
Sometimes we really are just tired.
But if tired has become your normal, it’s worth being curious about it.
You don’t need to diagnose yourself. You certainly don’t need to decide that you need an iron infusion because somebody else had one.
But you can start much more simply.
Tell your doctor how you’ve been feeling. Ask whether bloodwork is appropriate. If they’re checking for iron deficiency, ask about your ferritin and what the result means for you. If it is low, ask why, and what your treatment options are.
My ferritin was low. An iron infusion was the right next step for me.
The most useful thing I can pass on isn’t that everyone should have one.
It’s that I stopped assuming tired was just something I had to get better at managing.
Sometimes it’s worth getting checked.
This article shares personal experience and general health information and isn’t a substitute for individual medical advice. Speak with your healthcare provider about symptoms, testing and treatment appropriate for you.
