A few questions??? Dr is advising iron supplements

Hello! New here.  I recently had a physical done with lab work.  I informed my doctor of beta thal minor (my sister and brother also have it) and she ordered an iron panel.  From the results she's advising 325mg of iron because my iron stores (ferritin) are low.  Any thoughts regarding this?  I'm not sure how to fully read the results.  And is there an iron supplement that doesn't cause constipation?  I also had a thyroid test done and it came back normal.  I read about vitamin D testing here, but I'm not sure if I should still get that done.  The multivitamin I take already includes 3000us of vitamin D3 and 1000 of folic acid.  But most days I'm so tired of being tired, I'm sure there's something more my body needs.  I appreciate any advice.  Thank you :-)

Here's are my iron panel results:

Iron Bind.Cap.(TIBC)    334      
UIBC                      178      
Iron, Serum      156      
Iron Saturation       47      
Ferritin, Serum        8      
Vitamin B12       804      
Folate (Folic Acid), Serum      15.6      
WBC      7.3      
RBC      4.81      
Hemoglobin      9.7      
Hematocrit      32.9      
MCV       68      
MCH      20.2      
MCHC      29.5      
RDW      17.8      
Platelets      293      
Neutrophils      71      
Lymphs      22      
Monocytes      5      
Eos      1      
Basos      1   
   
Immature Cells            
Neutrophils (Absolute)      5.2      
Lymphs (Absolute)      1.6      
Monocytes(Absolute)      0.4      
Eos (Absolute)      0.1      
Baso (Absolute)      0.0      
Immature Granulocytes      0      
Immature Grans (Abs)      0.0      

NRBC            
Hematology Comments:            
Reticulocyte Count      0.8      

lemondrop,

The only value outside of normal concerning iron is the ferritin. The serum iron is normal, as is the TIBC. TIBC is elevated when iron deficiency (IDA) is present. RBC is low in IDA and yours is on the high end of normal. RDW typically presents at >18 in IDA. Your level is more typical for thal minor. We regularly see reports of thal minors with low serum ferritin and no other indication of IDA. Ferritin is the worst measure and is why the iron panel is done in the first place. The other values do not confirm IDA.

As far as supplementing, 325 mg is a very high dose (I know doctors often prescribe these high amounts, but on what basis?), considering the daily need is no more than 10-20 mg, which is easily obtained through a healthy diet. If you feel that you must take iron, I have been told that this type of iron is easier on the stomach.  http://smile.amazon.com/Spatone-Pur-absorb-28ct-20ml-packets-contents/dp/B005FA7U3K/ref=sr_1_1?ie=UTF8&qid=1437490423&sr=8-1&keywords=iron+water+supplement

My advice is get the D tested. 3000 IU may seem like a high dose but it is not. My own experience is that I need 5000-10,000 IU daily year round to maintain a D level in normal range, >30-35.

Thank you Andy.  I asked about the high dosage and I was told because of stored iron- low ferritin levels.  It wasn't enough and could be the cause of being so tired.  From previous labs I've had with a hematologist, I don't ever recall ferritin going higher than a 9 and that was while taking 20mgs of iron.  My multivitamin has 22mg of ferrous carbonyl and I can I stay with that.  Is there any other way to raise ferritin levels?  Also anything I can do to feel less tired?  I'm going in a few days to get vit D tested. Thanks!

Ferritin has no value to the body in terms of iron needs. What it does is sequester iron so your body can't use it, so the level has far less significance than doctors like to think. As long as your serum iron is good, the TIBC is normal and nothing points to iron deficiency, like a low RBC level, there is no reason to be concerned about it. If your Hb does rise from taking iron, it does show deficiency was present. In the end, that is the ultimate test for iron deficiency, as all the other tests can be taken together and IDA can be suspected, but there is no definitive test for IDA, so often, a one month test of iron supplements will be tried to see if the Hb rises. If it doesn't it can be assumed there is no IDA. If you haven't seen a rise in Hb from the supplement you already take, you can be fairly certain that your Hb is as high as iron is able to raise it. With thal minor, L-methylfolate may be more useful for raising Hb. Wheatgrass tablets can be considered, as well.

That's really interesting.  I had no idea. So much to learn.

Unfortunately most of our doctors just want to bring our ferritin up as the hemoglobin also they want to store iron I don't understand why. Since I read the problems with iron and felt on my skin I get really concerned about using iron .