I wince as the cannula finally punctures my vein, but although it hurts and is an uncomfortable as hell, I am jonesing for the hit I’m about to receive. No, I’m not an IV drug user, although I am starting to get awfully fond of the lovely stuff that’s about to flood through my body: liquid iron.
Before you go thinking that I’m a waify, pale-looking little slip of a vegetarian who looks like she could fly away in the breeze, let me confess I am far from that. I’ve been an enthusiastic carnivore who’s feasted on steaks, burgers and salamis since I was a toddler and I look averagely healthy.
That said, I have struggled with iron deficiency (ID) since I became pregnant with my first child, 18 years ago. It’s normal, I was told. Babies suck your iron as they grow. If you drop too low, take supplements and you’ll be right. After bubs was born, my iron levels had risen reasonably and so I forgot about it, until the next pregnancy nine years later.
Again I was told my ferritin (a marker of iron stores in the body) was low. This time I was given iron tablets, told to make sure I ate red meat with sources of vitamin C, and to avoid caffeine as it could block iron absorption. Like a dutiful pregnant woman, I obeyed and got on with the business of having my baby. After she was born, any concern for my iron levels was lost in the chaos of mothering.
I was tired but told myself sleep was a bonus with a new baby. If I was run down, it was because I was a working, single mum. I figure if I ate my veges and exercised it would all come right eventually.
Except it didn’t. My attitude of ‘every mum is tired – suck it up sunshine, it’s a consequence of having kids’ – began to sound hollow. The level of fatigue and sickness that had infiltrated my life was pretty extreme. Still, I put down my constant lethargy, irritability and tendency to catch every bug going around as a delicate constitution. I also I drank too much alcohol, smoked cigarettes and comfort-ate junk food, so I had probably caused my ill health from own actions, I figured. I just needed to clean up my act and I would feel better.
Stepping up the action
I stopped drinking, smoking and lost 35kg, which also staved off type 2 diabetes. I did yoga. These turnarounds took monumental efforts of will, discipline and surgical intervention (bariatric surgery). I had high expectations of feeling like a strong, healthy 40-something ninja mama who was going kick butt with my newfound vigorous constitution. Instead, I was sicker than ever, to the point where working was almost impossible. I couldn’t concentrate, which is not helpful when you’re a writer. I had no energy and was Miss Cranky Pants: my poor kids – it was like living with Attila the Hun. I would sleep 9 hours at night and needed a two-hour nap to make it through the day. Rudely, my hair started to fall out, which, as a vain, formerly well-maned woman, was brutal.
I tried everything to figure out what the hell was going on. As a health journalist, I probably had too many clues and diagnosed myself with chronic fatigue syndrome, adrenal fatigue, mad PMS, perimenopause, gluten and dairy insensitivity and arthritis, all exacerbated by out-of-control depression and anxiety. Doctors made non-committal noises and told me to reduce my stress. I drove myself and everyone around me mad with my hypochondriacal musings. What the hell was wrong with me? Why did I feel so ill? Was I going to DIE? My life was far from the yummy mummy I hoped to be. Instead, I was a pathetic, worried, sick and whinging husk of a middle-aged woman. And my hair – did I tell you it was my saving grace through every fat day I ever had? – was brittle, grey and sparse. Eeew.
In the background, I knew that iron was still a problem from regular tests my doctor ordered, but I was assured iron tablets would get it back up. After three months, I queried if it had risen, as I wanted to stop taking the constipation-causing tablets. They’d barely made a difference, so out they went.
Instead, I continued with diet, exercise and lifestyle improvements but still, my health continued to decline. I ended up in hospital twice – once with a severe bowel infection and the other time with chest pains. That year was a blur but my memory comes into sharp focus at my doctor’s words: You’re iron-deficient. You’ve hardly got any stores left. It’s a bit concerning. Don’t you feel tired and washed out?
He explained that technically, I wasn’t anaemic but ID could cause all sorts of problems that might explain my deteriorating state, including the alarming breathlessness and chest pains I was getting. He suggested more tablets, but I scoffed and reminded him that they hadn’t worked. After a bit of too-ing and fro-ing, he proposed that I couldn’t absorb oral iron because of my bariatric surgery (not supposed to happen with the procedure I had) and I was better off to get an infusion. After a cautious start with a tiny dose that proved useless, a second infusion saw my level of 11 soar to 327 (normal levels vary from 90-380). I felt FANTASTIC.
What ‘better’ feels like
Let me define that over-used term. Within a few days of an iron infusion, I felt alert. I felt enthusiastic about my days. I had energy to back up the actions I wanted to take. I didn’t collapse on the sofa, so tired and achey after going for a gentle 30-minute walk that I wanted to cry. I wasn’t freezing cold when everyone else wasn’t. I felt like I had re-discovered my role as a parent and professional and no longer constantly felt at the end of my tether over every little thing that went wrong. I felt calm, happy and content. Some people call it healthy. I called it better.
It was short-lived though: three weeks to be exact. My iron levels had dropped down to 70 and another infusion was ordered, with monthly ones scheduled thereon. Some people use up iron more than others, and you’re one of them, said the doctor. Just keep getting the infusions, if they’re working.
And so I did. My health has continued to improve with reliable energy and an immune system which doesn’t get snarky with every virus doing the rounds. My mood is good and my concentration is great. Tasks that used to overwhelm me and necessitated two-hour naps, like writing an article or just vacuuming the house, are now done with ease and even enjoyment.
Yes, the monthly infusions are a pain, taking at least four hours (it must be administered very slowly because of the risk of an allergic reaction) and costs $100 for the nurse’s time to monitor me, although thankfully, the iron itself is fully subsidised by Pharmac. I’m not eligible for the faster iron infusion (takes 15 minutes) as I’m not anaemic enough.
You’ve got to be kidding me, I told my doctor. If I was any sicker I think I’d be almost dead. Yep, he said, anaemia can and does kill people as you simply don’t have enough oxygen in your blood.
Which brings me to the difference between anaemia and iron deficiency. Iron deficiency is when you have decreased iron stores in your body and anaemia is when you don’t enough iron to create red blood cells. Anaemia is considered the end-stage of iron deficiency. You can also be iron-deficient with or without anaemia, and there are several types of anaemia, which can be caused by different things.
Some people seem to be healthy and happy with very low iron levels and other require a lot more to get by.
It’s complicated, for sure, but as I have learnt, just because I wasn’t technically anaemic didn’t mean I didn’t suffer from the symptoms it can cause. Some people seem to be healthy and happy with very low iron levels and other require a lot more to get by, the doc told me: clearly I am one of the latter group.
I’m just glad that I’ve reclaimed my health but now feel concerned that so many women are out there with the same silent problem – iron deficiency that sucks the oxygen from your blood, the energy from your life and the passion from your soul. And the stats support my concerns – the World Health Organization reports iron deficiency is the most common dietary deficiency in the world, especially among women and children.
If you’re concerned that you may be low in iron and want my advice, I say: don’t muck around, see you doctor and get tested. Find out what the numbers mean but don’t be satisfied that higher figures are necessarily okay for you if you don’t feel well. If they’re on the low side, push for oral supplements and get educated about how changes to your diet can help. Make sure you’re monitored regularly – three-monthly tests are standard. If oral iron supplements aren’t making a difference, go back to your doctor and push for further investigations to rule out conditions that may be stopping you absorbing iron, or pinpoint how you may be losing blood. Menstruation is one of the key ways women lose blood and if you’re low in iron to begin with, even normal period flows can cause problems with your iron stores, a nurse told me. Pregnancy and strict vegetarian and vegan diets are also risk factors for lowering iron stores.
If your iron-deficiency is chronic, ask for an infusion and see if this makes a difference.
Copyright Paulette Crowley, 2018.