I was raised to believe that doctors know it all and that we should trust them implicitly when it comes to our health care. However, over the years, I've learned that it's so important that we take control of our own health care and work as a team with the doctors. They are only human and make mistakes. This past week I relearned this lesson and thought I'd share my experience with you.

The past couple of months I've been even more exhausted than usual, dizzy and irritable. I knew something was wrong but didn't know what. Finally, I complained enough to my primary care physician that she suggested it might be my iron levels and that I get a blood test. So, two weeks ago, I went in for blood tests and they tested me for a number of things including Lyme, Celiac, the usual CBC, cholesterol, etc. I called a week later for my results and was told that everything was "normal" by the nurse.

In the past I would've let it go at that and just figured this was how life was going to be for me - exhausted without a clue. However, I decided that although this doctor's office was pretty good I wanted to see these results for myself. I requested they mail me a copy. I received it in the mail last Friday and a quick scan of the results did show that everything was in the normal range. However, upon closer examination, I saw that the ferritin (iron) result was 17 with the normal range being 10-154. That seemed a rather low normal to me and I did some poking around on the Internet. Several sites recommend that anyone with a result below 50 take an iron supplement. I should note that my total iron is perfect but this ferritin level also indicates anemia.

I called my doctor's office today and the doctor agreed that I really needed to start taking an iron supplement and that we'd retest my levels in six weeks. Now, if I hadn't requested my lab results I'd never have known that my ferritin was this low and would've continued to suffer. Obviously, the doctor thought that the levels were normal and wouldn't have recommended any changes. I'm not saying that this is going to cure me of chronic fatigue syndrome or anything but, hopefully, it will get me closer to normal than I have been lately.

So, my moral of the story here, is always ask for copies of your labs, ask questions and don't trust others to keep you in your best health. Doctors are only people, they make mistakes and it doesn't help that they see a zillion patients in a day and have people from pharmaceutical companies dropping in at all times.
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As an addendum I found this journal article which makes me feel very optimistic that my fatigue may get decreased!

BMJ 2003;326:1124 (24 May), doi:10.1136/bmj.326.7399.1124

Primary care

Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial

F Verdon, general practitioner¹, B Burnand, senior lecturer², C-L Fallab Stubi, pharmacist³, C Bonard, general practitioner¹, M Graff, general practitioner¹, A Michaud, general practitioner¹, T Bischoff, general practitioner¹, M de Vevey, general practitioner¹, J-P Studer, general practitioner¹, L Herzig, general practitioner¹, C Chapuis, general practitioner¹, J Tissot, general practitioner¹, A Pécoud, professor³, B Favrat, consultant of internal medicine³

¹ General Practice Unit, University of Lausanne, rue du Bugnon 44, 1011 Lausanne, Switzerland, ² Health Care Evaluation Unit, Institute of Social and Preventive Medicine, University of Lausanne, ³ Medical Outpatient Clinic, University of Lausanne

Correspondence to: B Favrat bernard.favrat@hospvd.ch

Objective To determine the subjective response to iron therapy in non-anaemic women with unexplained fatigue.

Design Double blind randomised placebo controlled trial.

Setting Academic primary care centre and eight general practices in western Switzerland.

Participants 144 women aged 18 to 55, assigned to either oral ferrous sulphate (80 mg/day of elemental iron daily; n=75) or placebo (n=69) for four weeks.

Main outcome measures Level of fatigue, measured by a 10 point visual analogue scale.

Results 136 (94%) women completed the study. Most had a low serum ferritin concentration; 20 µg/l in 69 (51%) women. Mean age, haemoglobin concentration, serum ferritin concentration, level of fatigue, depression, and anxiety were similar in both groups at baseline. Both groups were also similar for compliance and dropout rates. The level of fatigue after one month decreased by -1.82/6.37 points (29%) in the iron group compared with -0.85/6.46 points (13%) in the placebo group (difference 0.95 points, 95% confidence interval 0.32 to 1.62; P=0.004). Subgroups analysis showed that only women with ferritin concentrations 50 µg/l improved with oral supplementation.

Conclusion Non-anaemic women with unexplained fatigue may benefit from iron supplementation. The effect may be restricted to women with low or borderline serum ferritin concentrations.