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[kittywells]

Hello all, after being diagnosed with full menopause at 43 I began HRT this spring, first on the FemSeven sequi patch. I had a lot of trouble with the patches staying on, and was feeling some hot flushes still, so switched two months ago to a regime of Sandrena 1.0 mg gel and Utrogestan 100mg for days 15-26 of my cycle. I've been experiencing some strange things for the past six-eight weeks. Chiefly, I've been very breathless, and feel exhausted and low energy all the time. I also seem less mentally sharp than normal - very foggy and unable to cope with work tasks. I am also pale, sore throat and trouble sleeping. I've had to take time off work as I couldn't cope - have also been quite low, anxious and depressed, though I am not usually like this.

I am wondering if anyone here knows of a link between anemia and this HRT regime, or more generally with the menopause. I eat a balanced diet, and am active and otherwise healthy. I had a blood test about a month ago and it showed my ferritin (20) and hematocrit (0.363) were both low, though not apparently low enough for my doctor to mention or treat it - he said my bloods were 'fine.' I only took another look when it seemed like my symptoms matched with anemia. Does anyone else have any experience of this? Many thanks.

[CLKD]

When I was expecting a period I would be breathless which would ease once the bleed began.  It was like my body was bloated and I couldn't draw a full breath if that makes sense  so it may be hormonal.

At age 43 you could have taken HRT to protect heart and bones.  You could of course buy iron tablets from a Pharmacist to see if they actually help, most Pharmacists have a private room for discussion.  They may make you constipated though  . 

[Annie0710]

20 is low and it really narks me when drs say it's fine.  I'd like to see them function on levels they class as fine.  Mine was 46 and I asked if I could buy some ferritin (stronger ones) and they said yes, ideally it should be around 80!

[Sue52]

Hello Kittywells,

I have recently had a number of blood tests and have been diagnosed with vitamin D deficiency. My ferritin levels were in the lower end of the ‘normal range' at 39 ug/l.
Almost 4 weeks ago I started a course of vitamin D (a seven week mega dose as prescribed by my GP). I also checked with my GP if it would be ok to take Floradix to boost my iron and B vitamins. He was happy for me to do so.

Several weeks later the ‘brain fog' has lifted. I am not sure if it's the vit D or the Floradix or both, but my ability to think clearly is much improved.

Your symptoms do sound very much like anemia and your ferritin levels are very low.
Could you speak again with your GP or with another GP at the practice? Or, as CLKD suggests with a pharmacist?

Wishing you good health,
Sue52 xx

[Maryjane]

My ferritin was 6 😳 last test 16 so far from ideal.

Yes it is exhausting being so low , plus it could also be Vit d , B12 as low iron very often has “ friends” who like to be low also 🙄.

[racjen]

Anaemia can also be caused by testosterone deficiency, which can happen as a result of the menopause. I only discovered this after my testosterone deficiency had been diagnosed - had had unexplained anaemia and fatigue like you describe for several years before that. It might be worth getting your testosterone level checked.

[kittywells]

Ah, thank you all so much for your kind and helpful responses. I saw a friendly herbalist/naturopath who looked at the printout of my bloodwork I'd asked for and immediately set me up with some good, easily absorbed iron supplements which she'll said I need to take for a couple of months before I can switch to something to maintain iron levels like Floradix. She was appalled that they had told me my blood results were 'fine'. Amazingly, I've checked back with the practice and they reiterated that these results were normal so wouldn't be picked up. (she said b12 was fine, butI'll look again at Vitamin D.

About testosterone, I had noticed that my libido has pretty much flatlined for much of this year, so perhaps that's an indication that Testosterone could be the culprit? I know zero about this, but I'll chase this up - am booking in to see the only sensible doctor at my practice, who had ordered more bloodwork last week, so hopefully testosterone will be on there? Is it on the 'full bloodwork' racjen, or do they have to measure it another way?

[racjen]

Not sure I'm afraid, when I had my testosterone measured it was asked for specifically along with estradiol. I saw a private specialist who then gave me a letter for my GP requesting the blood tests.

[kittywells]

Ah, well good to know, thanks for this. I'm going to see the doctor today with the hope of seeing the gyno consultant and possibly switching back to the patches. They weren't ideal, but as I've been having this problem for exactly the period of time I've been on Sandrena/Urtogestan it seems to suggest that is the problem. I'll ask about my testosterone too.

[Hurdity]

Hi there kittywells

Have come late to this thread - hope you got on OK at the doctors. Just to say it is very unlikely that your breathlessness and anaemia has anything to do with the change in HRT but glad you are taking a course of supplements anyway to remedy your iron deficiency. Floradix is great stuff (the liquid natural herbal tonic) and is what I use from time to time since I still have a bleed and am getting on in years for this! I started taking it in my first pregnancy when I became anaemic and didn't want to take the tablets I was given and I find the tonic to be very gentle on the system.

I hadn't come across the idea about testosterone and anaemia before but did have a look up a few studies on this especially in the elderly and there seems to be the odd study showing an association but not necessarily causal - ie low T does not necessarily cause anaemia and there are other causes of anaemia besides low T (which is obvious!). As always - important to make sure your diet is not deficient in iron - and those over 65 approx need to pay particular attention to this and all aspects of diet due to possilbe reduction in absorption as we age, I think?

I think you need to take the HRT type both that works best for you in terms of general menopausal symptoms, and that you find most convenient.

Let us know how you got on?

Hurdity x