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My wife had menorrhagia (extremely heavy periods that lasted a week) and extreme lethargy. And restless legs. Not only did her doctor not get her bloods checked, he didn't care about the heavy periods and said (about heavy periods), "go on the pill, and see a shrink" (because presumably he thought she was a hypochondriac or depressed, because she came back several times to see if he could do anything about it). He finally got her iron and B12 checked, and since they were both on the lowest end of the "Ok" range, he didn't do anything further.

It took 2 doctor changes and a lot of goggling to realise that her menorrhagia had a cause, but that she's need scans to prove she might have uterine fibroids. It took 2 procedures to correct them. Once all that was done and she got iron + B12 injections, and got her life back.

On a forum she talked to other women who were left to deal with fibroids for up to a decade because their doctors would just sigh and say, "Yes, women's problems. This is normal. Go on the pill". Unfortunately the fibroids grow so large that there is sometimes no option but a full hysterectomy. This is a common story.

I completely agree, you need to do your own due diligence these days.

> He finally got her iron and B12 checked, and since they were both on the lowest end of the "Ok" range, he didn't do anything further.

This type of mistake infuriates me to no end because there’s no reason it should happen. I was recently looking at blood tests from years back to figure out my usual resting glucose levels (just got a GCM) and stumbled on my testosterone results.

I was in the green, so my doctor (and nurse practitioner) didn’t notice a problem but I had the testosterone levels of a 50 or 60 year old in my late 20s. Since the acceptable range wasn’t adjusted for age by the Quest report, the range is ridiculously huge.

It's worth noting that in some cases it might be cheaper to outright purchase a CPAP machine online than to get a diagnosis via a sleep study.

I got a sleep study about a decade ago, having to go in first for diagnosis and then to evaluate the right settings. Even with insurance it cost about $2000 after all was said and done due to limited coverage and out of pocket fees. THen add the ongoing $35/month copay for renting the CPAP machine (they did not offer to sell it) and limited fee for having someone deliver it, which was a scam of an 'in-home medical visit' to set it up by handing me a box and saying where to plug in the hoses.

Meanwhile, the same machine sold for $400 online, wouldn't have required me to spend overnights in a lab or go through doctor visits every couple months for continued 'check-ups' where they read the card data to make sure I'm still using the machine to justify insurance coverage of everything beyond the $35/month fee. With automatic settings (now standard on machines, perhaps not at the time) or simply using materials online to do a few nights trial and error to figure out correct settings.

I felt like I (and my insurance carrier) was getting scammed at every point along the line. But the doctors claimed these were the hoops I had to go through to get tested and treated.

Hopefully it's a lot better today, but.. I doubt it. The CPAP did work when I finally got it, though.

H.Pylori is well known to impact iron absorption and serum iron/ferritin levels. Most of the world carries this unknowingly (esp. since childhood), and it has all sorts of silent consequences ranging from fatigue (due to iron impact, etc) to GI issues to stomach cancers.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513126/

[2] https://pubmed.ncbi.nlm.nih.gov/11218379/

I just wanted to mention how I cope with occasional restless leg syndrome. I find that a wall sit for two minutes right before trying to fall asleep works every time. I have to do it long enough and push hard enough to make my legs really burn from the exertion. The more unpleasant it is, the better it works. Afterwards, I immediately get in bed and try to go to sleep (it doesn’t work unless I do it right before attempting to fall asleep). Usually by the time my heart rate returns to normal, I’m asleep.

I'm looking into this as of now. For your situation though, from what I've read about iron supplements. A week is too short of a time for anything. So your situation was placebo; in my opinion.

I was sleeping 8.5-10h per day and still feeling extremely tired. Also had a lot of mental problems to the point I was thinking of going to a therapist (I thought it was work related).

My doctor sent me to do sleep apnea tests and blood work, but turns out I was vitamin B12 and B9 anemic AND seems like I have mild sleep apnea as well (I have more tests booked). But taking vitamin supplements cured most of my symptoms in less than a week. I had horrible headaches for the first couple of days of supplements though.

Isn't iron one of those things you don't want to overdo due to dangerous side effects?

You raise an interesting situation here though because I've also had restless leg forever and my iron tests came back normal. Still, I'm not sure how safe it is to take iron supplements under "normal" conditions.

EDIT: this is just one source, but it doesn't sound like a great idea to be taking iron supplements with normal iron levels, at least not on your own: https://ods.od.nih.gov/factsheets/Iron-Consumer/#h11

Did I suggest otherwise? I said I ended up seeing four doctors before one suggested what worked for me. YMMV. Consult a physician, etc., etc.

I need to have my iron levels checked semi regularly. I would imagine any doc suggesting iron supplements would suggest the same.

tbh. I generally I don't understand why some people are so insistant to point out "how dangerous supplements are".

For most nutrients there is quite a large area between what the body needs and when it starts to become a problem.

And while you can over a long time accumulate by not only only consume more then you need but also more then your body can disperse it's not really an issue either. Doing semi regular tests in case of knowing you have some nutrition issues is pretty common and stuff like fasting once a year can help you body to flush out accumulations.

And again for a lot of supplement choices people will often not run into this issue at all anyway.

I have seen a lot of people which live quality increased by taking supplements (including non water soluble ones) but yet have to see a single case of overdosing on supplements in my environment.

I have occasional restless leg (once every two weeks or so) and low energy. How would one know if one has iron deficiency despite blood work being normal? Is it just a case of popping iron pills and seeing if you feel better?

Doesn't hurt to try does it? A bit of extra iron is harmless.

That was partly my question. Looking online, iron is definitely something that you don't want to have too much of.

My question is, basically, is having a non-anemic iron deficiency something that can be easily remedied by having low-dose over the counter vitamins, or is it something that requires a higher dose (to make up the difference in what you're missing) and so requires a doctor. And yet it sounds like this is difficult to diagnose.

Over the counter iron supplements are totally safe to take for the period indicated on them. They contain as much iron as a medium piece of chicken liver.

Most of the over the counter ones I see online are 65 mg iron, which is nearly twice the iron in a whole half kilo of chicken liver.

The medical sites say a safe value is no more than 45 mg per day.

There are also low iron pills (or "gentle iron") that are 28 mg.

So not only are many over the counter pills potentially over the safe levels, but it still doesn't even really answer the question, which is whether the low-dose pills that are under the RDA effective in countering an iron deficiency.

Anyway. I think I'll ask my doctor at a once-every-several-years checkup.

Do you live in America? Supplements tend to be much stronger there. Here in Germany at the local pharmacy you will mostly find in the 10mg-30mg range. I've bought and drank them before to no ill effect, which is why I even started this entire chain.

Same for here in the UK. My iron suppliments are 30mg, which seems pretty usual here.

It can indeed hurt[1], and getting medical advice from the Internet can be... fraught.

[1] https://www.ncbi.nlm.nih.gov/books/NBK557376/#:~:text=The%20....

What's "normal"? Your results are never just "normal", there is a range that is considered normal. If you're at the low end of normal, that could actually be just "low". Those teams can be a bit too wide.

How is your B12? If you're a vegan or vegetarian and aren't taking those supplements then I would start taking them. It's always safe to take extra B12.

Unless your iron is at the upper end of the band it should be safe to take a low dose. But it won't do anything if you're not really deficient.

I find that sitting at a desk all day makes me tired. I just push past it and go for a run. Always works, and it guarantees me a good night's sleep.

Just remembered, if you walk a lot, like over 25k steps a day, or do a lot of exercise (squats?) that can also cause restless legs.

Also, your diet? Most people are getting more than enough carbs these days, but are you on some weird diet?

Similar for me, I thought I would start feeling better after my CPAP. Still had terrible sleep. Still experimenting with solutions (issues started after Covid vax, so I’m experimenting with long Covid protocols and have noticed much better sleep in the last month although I’m not getting my hopes up just yet)

If you don't mind sharing, what are some of these long-covid protocols that you're trying?

Do you have any additional resources you recommend on this topic? I've experienced life long restless legs alongside issues with sleep quality, daytime tiredness and low energy levels so this seems like an interesting avenue to explore.

I don’t, just my personal experience. A few years ago I started getting exhausted to the point I was napping every day and getting 10-12 hours asleep and still felt tired. I’ve never been overweight, don’t have any structural occlusions in my airways, though I do snore (so says my wife).

I did all of the normal things and got regular exercise. I finally went to a specialist, and got an at home sleep study which found moderate apnea (on the low side of moderate). I spent several months using a CPAP and bought a sleep tracking watch. Nothing improved and I was still tired. The pulmonologist suggested one of my medications affected REM. I was able to stop taking it without any significant issue and my REM improved, but I was still tired. I asked them for an in lab study and did that and it found the same as the home study.

I had convinced myself I had narcolepsy or some similar neurological issue.

My wife’s friend coincidentally mentioned he had sleep issues and they had found a sleep doctor they liked. He was the first to ask about restless legs and have any blood work done. He confirmed that I have apnea, but thought trying an iron supplement might help based on recent studies and my iron levels.

The iron helped almost immediately. Within a week I didn’t need to take a nap, which I had done daily for at least two years. I still use the CPAP because apnea can cause heart issues long term, but don’t “feel” like it does anything in the short term.

Usually, the most common thing is the most likely, but when it’s not, it can be really hard to find someone who both believes you and can do something about it. When I was exhausted all of the time, finding that person was even more challenging.

So interesting! Thanks for sharing. Do you still take iron every day, or is this the kind of thing one does for a period of time until the body is rebalanced?

Serum iron is a pretty useless test. What was your ferritin?

In August it was 66ng/mL prior to taking any supplement. So above the reference low, but below the adjustment for RLS.

Unfortunately, I just had it tested last week but had given power red a few weeks prior and came in below even the normal range (20ng/mL).