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Iron Infusion in Third Trimester
Hi B & Daniel,
I am currently 33 weeks pregnant, and my provider recommended 125 mg iron infusions every week for five weeks, and I wanted to get your input on it.
I initially got my bloodwork at the end of July which pointed towards low iron levels. My lab results were:
Ferritin: 18 ng/dL
RBC: 3.80 / uL
Hb: 10.8 g/dL
Hematocrit: 33.9%
MCHC: 31.9 g/dL
MCH: 28.4 pg
RDW 13.7%
Platelets 183 uL
MPV: 10.4 fL
I tried for one month to increase my iron intake through my diet (more red meat, more eggs, eating vitamin C rich foods with iron rich foods & avoiding dairy, consistently taking my prenatal which has 45 mg of iron but I would sometimes take only 2/3 the dose so 30 mg)
My ferritin levels & CBC were retested last week, and my ferritin levels went up by 4 18 ng/dL (so 22 now). My Hb remained the same. The other markers increased or decreased slightly:
RBC: 3.77 (decreased)
Hematocrit: 32.9% (decreased)
MCH: 28.6 pg (increased)
MCHC: 32.8 g/dL (increased)
RDW: 14.6% (increased)
Platelets: 158 (decreased)
MPV: 10.5 fL (increased)
The first test in July was taken while fasting in the morning (since it was done alongside my glucose tolerance test), and the second test was taken last week in the afternoon (while not fasting). I did not my prenatal before both tests.
I don’t feel any strong symptoms of anemia. I do have some mild fatigue (but significantly better than my first trimester) and the occasional lightheadedness which are considered normal I think given that I’m in my third trimester. I have Charlie’s horses sometimes, but taking magnesium has helped almost eliminate it. My feet have been feeling colder than they were earlier in pregnancy, but I’ve been tryingto be diligent about eating two Brazil nuts daily for Selenium & consuming sufficient eggs, dairy, kelp granules, and seafood for iodine. No craving for ice and non food related items.
Thanks
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3 Replies
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For reference, my ferritin levels at 8 weeks were 80 ng/mL
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Hey @healthyliving99
First of all, exciting news! Congratulations!
Since your pregnant you have to share your nutrients with your new family member. It is quite normal for ferritin (the storage form of iron) to drop during the third trimester in regular pregnancies. For a good interpertation of lab values it’s important to know the reference ranges provided by the lab that examined your blood.
That we don’t have them, doesn’t mean we can’t give you some answers, but if you like to have a deeper dive on what is happens with these lab values during pregnancy you can look in table 2 of this research paper.
Since you are sharing your iron, it is common for pregnant women to see a drop in hemoglobin, iron and ferritin. If you’re already experiencing anemia in the beginning of the pregnancy it is important to get your iron markers up and have good quality en quantity of red blood cells. It are the red blood cells that transport oxygen and make metabolism possible.
Choosing to work with injecting iron is the fastest way to get iron up. Maybe you are worried about the fact that your Hb remained the same in the third trimester, but it is quite common for Hb, iron and feritin to drop in the third trimester. Your Hb remaining the same is actually good news. You’ve even managed to get your ferritin up.
I do challenge you to dive a little deeper into investigating why your iron was low in the first place?
- Was iron in your food? (for example: are you on a plant based diet?)
- Is iron being well absorbed?
- We need strong stomach acid production and enzymes to cut out the iron from foods. These enzymes in the stomach need vitamin C to do their job
- A lingering simmering infection can cause the body to choose to sequester iron away from the bloodstream since bacteria and viruses both need iron to reproduce
- Was your copper measured (this is usually not examined in traditional medicine)? Copper deficiency can mimic iron deficiency.
- Do you have heavy blood loss during your cycle and did you start with low(-ish) iron before pregnancy?
If you would like to learn more about what could cause iron deficiency, check out this video as well.
Another thing to consider is the form of iron in your supplements. We have a video explaining what to look for in your supplements. Bernadette explains it well in this video
The change in numbers is quite good considering the pregnancy and considering you were dealing with an iron deficiency. Symptoms however are leading: we aren’t treating numbers, but symptoms. If you feel better, you’re on the right track!I hope this answers your questions!
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Thanks for your response.
I was not iron deficient pre-pregnancy and neither was I in my first trimester. My providers redid blood work at 27 weeks, which is when I was diagnosed with mild anemia.
I can attach the screenshot of the labwork and the reference ranges they provide, but the reference ranges are for normal situations and not for pregnancy specifically.
I have been consuming iron rich foods, like red meat, eggs, nuts, lentils, and some leafy greens. I’ve been trying to consume them with vitamin C rich foods, which is why I think my ferritin levels did go up in the past month. I am concerned about my Hb and platelets being on the lower end, and not increasing.
I do not think I have a stomach acid problem because my stools have been quite regular and usually type 3/4. They are occasionally softer or harder but I’d suspect my organs being squished has something to do with that and progesterone.
My copper was not measured. I did not have iron deficiency or heavy periods before pregnancy.
I’m not sure if I have a simmering infection. I had a mild cause of the flu/covid (not sure which one because I didn’t get tested) three weeks ago (week 30 of pregnancy), and I got a cold sore on my chin two days ago (week 33). My WBC levels that were tested in the last week of August (week 32) seemed a bit higher and so did my neutrophils. I know WBC increase during pregnancy and remain high until delivery, so I’m not sure if it’s indicative of anything. Would love to hear your thoughts on it
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