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Adrienne Dellwo

Anemia & Fibromyalgia: How's Your Iron Level?

By April 13, 2012

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For many people, fibromyalgia involves certain nutritional deficiencies. One that we should all be aware of is low iron, which can lead to a type of anemia.

A study published in 2010 showed a significant difference in serum ferritin (iron) levels between healthy people and those with fibromyalgia. Researchers concluded that low iron created a 6.5-fold increase to the risk of fibromyalgia.

Some of the study participants had iron-deficiency anemia, but some were at the low end of what's considered normal.

I recently got an email from a woman who says treating her anemia greatly reduced her pain, fatigue and other fibromyalgia symptoms. It made me wonder how many of us are living with low iron and don't realize it.

Anemia isn't a problem I've ever worried about. In fact, while looking at my test results, a nurse once asked me if I'd been eating raw meat because my iron level was extremely high. Even during pregnancy, my stores just began to drop a little in the third trimester.

However, that was before fibromyalgia. Now I'm thinking I should ask my doctor to test my iron the next time I go in for blood work.

It's easy to see how anemia would make fibromyalgia worse, at the very least. The symptoms include:

  • Fatigue
  • Cognitive problems
  • Cold hands and feet
  • Headache
  • Pale skin
  • Fast or irregular heartbeat
  • Shortness of breath
  • Chest pain

Looking at that, I can see how anemia could be missed in someone with this illness. The symptoms are also remarkably similar to those associated with low thyroid hormone (which is also common in us.) While it's possible for people with chronic fatigue syndrome to be anemic, anemia is one of the conditions doctors should exclude before diagnosing it. Still, it doesn't hurt to get checked now and then.

To see how anemia is treated, see Treatments for Iron-Deficiency Anemia, by former About.com Women's Health Guide Tracee Cornforth.

Have you ever been diagnosed with iron-deficiency anemia, or had levels that were borderline low? Has upping your iron helped your fibromyalgia symptoms? Leave your comments below!


Photo Digital Vision/Getty Images

April 13, 2012 at 9:44 am
(1) dana says:

Isn’t there also a connection between low iron and restless leg syndrome?

April 13, 2012 at 12:09 pm
(2) Ann says:

I’ve had fibro/cfs for 16 years. My hemoglobin (finger prick) levels were always on the low side of normal during pregnancy, but I had every symptom of iron deficiency anemia. So, with the help of my OB I started supplementing with iron anyway, but b/c apparently their normal was not my normal – I was deficient. After supplementing, my anemia symptoms went away. Now that I am done having babies (5), I have my ferritin levels checked and they are almost none existent. I treat with iron and it improves the anemia symptoms and it does improve the fibro/cfs symptoms as well. Not a cure, but definitely helpful. I am still under treatment, but am hopeful that all symptoms will continue to improve until I get my levels back up.

And yes, my restless legs have GREATLY improved with iron supplementation. Listen to your intuition. Tests that show low normal – could mean that you are indeed deficient. Everyone is different. My body needed iron – ferritin levels showed that. Hemoglobin finger prick did not.

April 13, 2012 at 7:47 pm
(3) Mary has everything says:

I have Fibro, diabetes and now hyperparathyroidism. This Thursday I will be having one of my four parathyroids removed. There is a lot of pain in every bone because my bad parathyroid is telling my body to remove calcium. Also, my vitamin d is in the deficient range. Doctors don’t always check for calcium and vitamin d levels. The symptoms are very similar to Fibro. Anyone else had this problem?

April 13, 2012 at 10:02 pm
(4) Pat says:

Every two years my iron is low and I need an iron infusion. My doctor has never been able to figure out why. I do have fibro, CFS, low thyroid, IC, and more. I can tell when my iron is getting low. My symptoms are slower growing hair and nails, nails breaking and splitting. Low, low energy, getting tired and breathless from simple things such as drying my hair.

April 13, 2012 at 10:35 pm
(5) Gloria says:


Yes — When I had my sleep study a doctor called me later about the “restless legs” problem and suggested that it could be caused by low iron levels.
My hemoglobin levels were on the low side so I took some supplements and ended up with too high ferritin levels. I was also having celiac symptoms and not digesting well, especially the fats. My vitamin D ended up in the deficient range even though I was taking what I thought was a fairly high dose.

AND, I also found out recently that adequate levels of Vitamin A are needed for the ferritin to be brought out of “storage” to be used for the hemoglobin. Vitamin A was another thing that I was not processing because of the celiac problems — as problems with digestion can interfere with the conversion of Betacarotene to Vitamin A.

So yes, I do think that many of us have nutritional deficiencies!

April 14, 2012 at 12:28 am
(6) Lorilyn says:

My doctor told me years ago to eat more red meat that I was a litle anemic. I didn’t do it, because red meat sort of gives me the creeps. I eat more turkey, chicken and cheese for protein. I never thought to put the two things together. Fibro and anemia.
I think I’ll get tested again and see if I’m anemic. In fact, my Endocrinologist asked me last month if I was anemic and I told him, NO. If more Iron will help, well, it’s more iron I’ll take

April 14, 2012 at 1:47 am
(7) Donna D says:

I just had my iron level checked by my rheumatologist after I complained of even greater fatigue-my Feriten level was 9 and the range is 20-288 !! So he started me on IV iron-Infed-1 IV a week for 4 wks.I have had fibromyalgia and CFS since 1999-so most of my docs are used to me saying how tired I am-but this doc really listened,I got him from the Fibromyalgia List and he is the one that diagnosed me in 1999.So he is still doing a great job for me.I’ll let you know how it helps.Donna

April 14, 2012 at 4:43 am
(8) Walter says:

Hi, I constantly suffer a baffling range of symptoms (I do have hypothyroid, sarcoid arthritis, osteoarthritis & fibromyalgia & more) & have been consulting with Rheumatologist for nearly 5 years now with no real definitive diagnosis. I have tried the usual drugs to combat my issues & am now on a course of Sulfasalazine which is making me as nauseous as a sailor on board his first ship.

When my immune system decided to rebel back in december 2007 I was told I have unexplainably high iron levels in my liver! I have a liver ‘anomally’ which causes Non-alcoholic Steato Hepatitis on a regular basis. I also have Lipodermatosclerosis (chronic venous insufficiency) which seems to bring on the hepatitis as my allodynia is acute.
Probably a complicated case to analyse but I am intrigued by your reference to the IRON issue. I am resolved now to never having a true ‘diagnosis’ & just keep walking the guinea pig path.

I look forward to your comments

April 14, 2012 at 7:22 am
(9) amneh says:

ive had symptoms of fibromyalgia all my life, but had my first son 4years ago and lost that much blood i died and came back due to that my iron was low hospital gave me iron tablets, im now not anemic anymore but just i number higher on the scale i have now a 4, 2 year old and a 4 month old the last thing i rember is to take my iron, but i do agree it does help with my symptoms if i take them regurly it doesnt get rid of them but sure does help fatigue, and your mood etc,….

April 14, 2012 at 9:59 am
(10) fibrowendy says:

I also have anemia as well as low Vitamin D levels. I take my vitamins everyday and i still naturally low because I cannot process red meat. While I try alternative ways to supplement my iron and D it is always on the low side.

April 14, 2012 at 11:54 am
(11) Mary has everything says:

Have your doctor check your PTH Intack and calcium levels. Low vitamin D can be a sign of a tumor on one of the parathyroids. There is not way to fix it except surgery.

April 14, 2012 at 10:33 pm
(12) Mary says:

I do not have iron deficiency anemia, but my ferritin level is always a very low 7. Whenever I have tried to take iron supplements, I become hypothyroid even though I do not take my thyroid meds and iron together. I tried taking my thyroid in the morning and the iron at night, and I still had a problem.

Any thoughts, anyone???

April 15, 2012 at 12:13 pm
(13) April says:

I was diagnosed with fibromyalgia about 8 months ago but I am sure I have had it longer because I have had they symptoms for a few years I just didn’t know what was wrong with me, my sister in law talked to me about it, she has had it for about 20 years. So my dr.s done tons of testing and I have been to so many dr.s it made my head spin. After 8 months 5 different docs diagnosed me with FMS. My Iron levels were very low I had to have 8 weeks of Iron transfusions, I do have more energy but my pain was not affected by it at all, it seems like everyday my pain gets a little worse. My hemotologist told me I will need to get a hystorectomy or have Iron transfusions for the rest of my life. I have an appt. set with my obgyn to talk to her about it. But as far as the pain goes I did not notice a difference in pain lvl’s after transfusions.

April 15, 2012 at 12:45 pm
(14) Cynthia Williams DC says:

Many of us with FMS/CFS avoid red meat as it can increase the inflammatory response. The trade off is a loss of dietary iron and possible iron deficiency anemia (IDA) For many reasons, I gave up eating beef and eat very little red meat so IDA is always an issue so I need to take iron supplements .
Another cause of IDA can stem from taking NSAIDS. Taking anti-inflammatories such as aspirin, ibuprofen, or prescriptions like Celebrex can irritate the stomach lining and cause tiny bleeds- just enough to cause IDA. Both causes should be considered.

April 15, 2012 at 1:20 pm
(15) oldmill says:

very interesting. I will definately look into this possability. thank you.

April 15, 2012 at 11:45 pm
(16) Terry says:

Yes, I was diagnosed with anemia during my first pregnancy at 16 yrs old, It am 51 and still have it . They said it would leave after the pregnancy, but it didn’t. I still take irom supplaments every day. If I forget 1 day I can tell a dfference. Was diagnosed with fibro when I was in my early 30s and again 6 years agp. I take Lyrica 2 times per day and Effecor 2 times a day along iwth my other meds. Seems to work most of the time except if I am gtting six……like this week I was diagnosed with a bladder infectinion and phuemonia also, Hasn’t been a good week I must say.

April 16, 2012 at 3:06 am
(17) Vee says:

I was anemic last year (for the second time in my life, that I’m aware of). After a battery of tests to determine the source of blood loss, it was determined that my heavy periods were to blame. I had a length of time prior to this when I went off of BC (which was keeping things under control) because of lack of insurance. I went through several months of prescription iron supplements and now my levels are holding steady. Being back on BC the past year has gotten the cause of my anemia under control again. My doc hoped it would help me feel a little better, just like when we got my vitamin D levels normalized (only slightly low), but neither one made any difference in how I felt.

April 16, 2012 at 9:09 pm
(18) Beverly Letsche says:

My iron actually runs high. Interesting as my mom has chronically low iron, but my dad who had fibro, always had VERY high iron. He actually had to have blood taken on a regular basis to lower his levels.

April 16, 2012 at 9:09 pm
(19) Beverly Letsche says:

My iron actually runs high. Interesting as my mom has chronically low iron, but my dad who had fibro, always had VERY high iron. He actually had to have blood taken on a regular basis to lower his levels.

April 16, 2012 at 11:14 pm
(20) Helen says:

About raising your ferritin level: a close relative had an extremely low ferritin level (7?)that was completely ignored by his GPs for 4 years. Finally an internist who he was seeing for another condition suggested that he take vitamin C with his iron, and start taking iron 3 times a day instead of 2 times. Still, not much of an increase. So, she sent him for B12 shots monthly, and the ferritin went right up in a few months. Keep in mind that his hemoglobin was fine, despite the low ferritin, probably because of algae and wheat grass supplements. Low ferritin is associated with depression and poor memory., and if you have fibro, you would blame that on the fibro, not to mention any pain associated with anemia. Btw, the best thing I ever did for my fibro was get my D3 level up, after making my doc send me for blood work. Took two years to get up with a healthy range, and everything hurts less now.

April 20, 2012 at 3:50 pm
(21) Tamiko says:

This is very timely for me, I just had a bunch of blood tests (with still more in process) and my ferritin result was 5 along with some other tests that came back non-standard I had one dr. saying I have severe iron deficiency anemia and another saying it’s not too bad… Now they are testing for celiac and other things to figure out the cause.

As always Adrienne you have brought a great topic to light. Thank you for the information!

April 20, 2012 at 5:16 pm
(22) claire seymour says:

I have fibro and i am also prone to anemia i have to have blood test all the time. I also have a underactive thyroid and the symptoms are all the same its very odd.

April 21, 2012 at 5:47 am
(23) Liz says:

Sorry – a long post but I have quite a lot of experience with this, so could be useful to someone! Definitely worth checking this out for anyone with CFS or fibro.

A couple of years ago I had an iron crash (blue lips, difficult breathing, etc), though subsequently found I’d had low haemoglobin for some years which my doctor had not mentioned. An iron infusion brought my levels up and I now need an additional infusion every eight months or so. I’m peri-menopausal and it’s been put down to that, though I’m not convinced that’s the full explanation.

I had huge difficulties convincing medics how ill I was because the blood test figures didn’t corroborate my story (how familiar!) – until I saw a haematologist who agreed that CFS and fibro could interact with low iron to exacerbate symptoms. Now I try to fast-track myself straight to the haematology department every time my symptoms increase, so I get a proper hearing.

The infusion cleared my restless leg syndrome, improved tinnitus greatly, reduced muscle pain on exertion and improved fatigue levels (from appalling to severe, but still improvement).

One thing to look out for is that haemaglobin levels may read fine, but low ferritin on its own can also cause symptoms, as can low blood volume. Also, I came across one report about CFS that claimed we already experience a functional iron deficiency even before we have an official one. Sorry, I don’t have a reference for the report but this is what it states:

People with CFS showed 25% lower heart contractility, so they pumped much less blood. Standard blood tests for anemia compare amount of blood cells relative to blood volume. As both are low, blood count tests come back as normal despite people with CFS in reality being functionally very anemic. People with CFS are likely to be 6-13% lower than optimal depending on the severity of CFS. So effectively we should reduce our blood result by a percentage to get a truer reading of our physiological state.

April 21, 2012 at 2:43 pm
(24) Kaz says:

I have been diagnosed with CFS, FM and also pernicious anaemia. I am now having B12 injected every 6 months(initially every week), but it wasn’t till over 2 years of that that I started to see signs of improvement in my CFS etc. I saw a quick improvement in some pernicious anaemia symptoms, but I wonder whether it could take years to reverse the internal damage to the organs. Recently I went 10 months without my B12 injection and reversed very quickly, was almost back in my wheelchair and it felt like full-on B12 dementia was setting in, I will never leave it 10 months again.

I feel I am begining to be able to tell the difference between all these illnesses, but I do wonder how they impact and cause each other. From conversations with doctors, they seem to think they are completely seperate and nothing to do with each other. I do still have CFS, but its so much better now, please get your B12 levels tested and keep with the treatment, it may take years, but it could end up helping you. I am not 100% sure but I think it got me out of my wheelchair, I cannot walk that far yet, but more than I ever thought I would.

April 23, 2012 at 5:46 am
(25) Tracy says:

Thank you all for your posts, it’s good to read all the advice and know you’re not alone! In responce to April’s post- please don’t rush into a hysterectomy. I’ve had CFS & low iron for at least the last 4 years, my gynae told me I needed surgery to sort out my heavy bleeding but I saw an endocrinologist first &after a few months on Progesterone cream and other suppliments to get my hormones right, the bleeding is much better. My Gynae was amazed. Thank you Helen & Liz for your great information, it makes sense. Dispite less bleeding I can’t get my Ferritin up, had injections (which I don’t reccomend!) & they didn’t help at all, considering IV infusions & will get my B12 and Vit A tested now too. I wish you all strength & wisdom in your fight for health

April 24, 2012 at 1:41 pm
(26) Louise says:

To Walter & Beverly….Have you been tested for Haemochromatosis (hemachromatosis) which is a serious iron overload storage disorder and often hereditary. You would need to have your serum transferrin and transferrin saturation tested. These are part of an iron studies panel, a simple blood test. Wishing you both well.

April 26, 2012 at 6:15 am
(27) Fibromyalgia Symptoms says:


I found easier way to know about fatigue disease and symptoms. You give whole information about “Anemia & Fibromyalgia”. And this information is more important for us.

Thank You so much for this information…….

Fibromyalgia Symptoms

June 29, 2012 at 2:25 pm
(28) Devera Sanders says:

I have low Iron but every time I try to take an iron supplement I have side effects that are not worth the risk of taking it. I try to get as much as Incan through my food but don’t know if ots enough. I should have my levels checked again.

July 2, 2012 at 3:04 am
(29) So confused says:

I have a ferritin level of 3. My saturation is extremely low too. Unfortunately IV Iron makes my inflammation all over so much worse. I have been tested for Lupus and Lyme. Does anyone else have this problem? Also does anyone have any suggestions as to why infections are so much worse during the months my ferritin goes up from the infusion? I thought I would feel so much better now I feel even worse than when I was anemic because I can’t fight off bacterial or vital infections? They are constant

So confused!

July 3, 2012 at 10:32 am
(30) Jill says:

I too have low iron levels. Iron supplements are too constipating. I have found good results with Red Beet Root to keep my levels up. Looking forward to my next blood test to see how they are holding up!

July 17, 2012 at 2:57 pm
(31) Maternity Wear Online says:

Thanks for providing this information to the web.

August 23, 2012 at 9:50 am
(32) andrea says:

My RLS becomes unbearable when my iron levels are too low. I have to get iron infusions every 6 months.

October 5, 2012 at 11:00 pm
(33) elissa says:

im anemic i have exzema and allergies

October 29, 2012 at 10:43 pm
(34) Edie Summers says:

Hi Dana,

Yes, there is a connection between iron-deficient anemia and restless legs.

July 23, 2013 at 7:45 pm
(35) Reerob says:

Yep. I’ve had fibromyalgia for 16 years and have low feretin levels (but hematocrit and hemoglobin are ok) = iron deficient. I’m pre-menopausal and have very mild cycles, so it’s not from blood loss. Taking the iron supplement 1-2x per week HELPS A LOT with energy.

November 19, 2013 at 9:40 pm
(36) vicky says:

I have FMS for 8 years. For 6 months I have had to have iron infusions and one blood transfusion. I also was recently diagnosed with pernicious anemia it is B-12 requires weekly B- 12 injections. I found your sight very interesting.
Thanks Vicky

December 3, 2013 at 6:25 pm
(37) Melanie says:

I have fibromyalgia for the past 3 years. My last blood test came back with low iron levels (6). I’ve been feeling very bad since June, I tough it was due to my fibro. Now I have to wait to see the doctor to know what he wants me to do. Any advise or comments?


December 11, 2013 at 8:30 am
(38) krista says:

I have been taking a high dose iron supplement for the past 3months and my fibro symptoms have improved massively. Worth being checked.

December 30, 2013 at 9:39 am
(39) Marina says:

Hi, I was diagnosed of having fibromyalgia about 2 yrs ago, but I have been suffering with Anemia since I got my periods.. I dont know how to corelate iron deficiency & fibromyalgia?? I think stress is a major factor in the worsening of the condition (lack of sleep, in-correct position, being rigid as in tightening the muscles as a result of stress, etc. ) I tried all medications, with only temporary relief.. What I got from the doctor is that i need to exercise gradually to train my muscles; which maybe right? I wonder if Low ferritin & low Vit. D levels have a relation to chronic fatigue?? If anyone could answer that for me please.
Thank you.

January 13, 2014 at 1:13 pm
(40) Sydni says:

I will be 46 this year. Dr’s have told me my whole life I was borderline anemic and I had a heart murmur I should out grow. When I was young I was in a bad car accident with my Mom. She has many problems no dr. could solve and went to a chiropractor ( our neighbor) as a last resort. He fixed her. Later I starting blacking out, dizzy, numbness, always had headaches and my periods were hell. I also went to the chiropractor. He helped me enormously with most of my symptoms. As I got older though, I kept saying, watch I’ll die of a stroke or something because I always attribute my pain, headaches, dizziness, restless legs, numbness, to my back. I have acquired new symptoms as well. What I have come to understand as Irritable bowel syndrome, had depression, hair falling out/ thinning, shortness of breath, insomnia and /or inability to stay asleep, forgetfulness, fatigue. I would wake up thinking about taking a nap later. My pain has increased and moved around. I was feeling things weren’t normal anymore.

I started researching and found FM. I found that I do have the pain points and most of the symptoms. I went to the dr. and he agreed it was a possibility but did blood work to test for vitamin deficiency. My Iron and D levels were non existent and my thyroid was just 3 points above low. I am now on 325 of iron and 5000 IU’s of D daily. He said to come back in a few months to test and see the results I do feel better since taking these, but my hair is thinning ( just not as fast) and I can still get restless legs. A lot of my symptoms get worse with stress. The more stress the worse they are. the tension in my upper back and shoulders climbs right up the back of my head. But what is scaring me the most is my Memory is getting horrible. Is there something that can help the mind?

January 16, 2014 at 9:20 am
(41) Bren says:

THANK YOU for your symptom list. I have these symptoms…SOB, chest pressure, fatigue, cold all over and dizziness. I get worn out shopping for groceries. They diagnosed iron anemia & after 16 days of supplements I feel just a bit better. The symptoms seem to be a little less pronounced. I was told by an NP and a nurse (at two separate offices) that no way would low iron make me SOB or have chest pressure. I felt so validated when I found this that I HAD to reply. I have had Lupus since 6/04 and was diagnosed with Fibromyalgia and borderline low Vitamin D 4/13. Iron anemia was diagnosed 12/13. I had been feeling off since 3/13 & feel it was the iron issue. It took me longer to pay attention to some of the symptoms because being cold (Raynaud’s) and fatigue are issues I have with Lupus & Fibro.

March 14, 2014 at 1:24 pm
(42) melissa flynn says:

i have just been to the hospital and they have just said to my iron level are 7 and i need to do something about it or it will go lower and i would need iron infusion because i am constanly tired and i feel like i have no engery at all in the day time. i was just seeing what every one eles uses to boost there iron levels as i may be at risk ?

March 28, 2014 at 8:56 am
(43) Hilary says:

I have fibro and have always been prone to anaemia. I had blood tests done last week since I’m always worried about liver function with all the pain meds I take. My doctor’s office called me to come in urgently to review my test results. Turns out my iron is at 3 when it should be at 80! While I’m relieved that I’m not dying or something…..3?!?!?! How does it even get that low? I’m wondering if Lyrica has something to do with it as I just started on it last month and quit after less than a week because of all the other ridiculous side effects that I couldn’t take. If anyone has any information about Lyrica and iron levels it would be greatly appreciated.

April 8, 2014 at 8:46 pm
(44) patty says:

I was told i had fibro for years from many different doctors. Had a sleep study because of severe debilitating migraines for 20 years…..got diagnosed with insomnia and PLMD-periodic limb movement disorder. Researched it….found out I could have low serum ferritin levels, doc didn’t want to order test, I insisted, I was anemic with extremely low serum ferritin. Iron infusions…..shortness of breath, pain in legs, sleep issues, went away. Two weeks out from infusions, symptoms are returning. Ugh….don’t give up finding your answers.

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April 15, 2014 at 1:06 pm
(46) Lori says:

Yes, I have upped my iron to 65 mg’s a day and have greatly reduced my pain along with muscle relaxers to help me sleep.

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