Dealing with heart palpitations, fatigue, and weakness: any advice?

For adult women, a standard serum iron range falls between 8 and 30 µmol/L.

I agree. A reading of 12 µmol/L isn't enough to either confirm or rule out sideropenia—essentially, low iron stores. To get the full picture, testing ferritin levels provides a far more reliable metric.

That said, if we're looking strictly at sideropenia without full-blown anemia (low hemoglobin or red blood cell counts), research and hematological consensus suggest this wouldn't significantly impact immune, neurological, psychological, or muscular functions in adults.

In addition to checking your sex hormones as previously advised, it would be wise to have your TSH and fT4 (thyroid levels) tested as well, assuming you haven't already.

*Source: Iron Deficiency Anemia in Adults.

Maria Fisher46 said:For adult women, a standard serum iron range typically falls between 8 and 30 µmol/L.

I agree that an iron reading of 12 µmol/L isn't sufficient to either confirm or rule out sideropenia—essentially, depleted iron stores. To get a clear picture, checking ferritin levels would be a much more reliable metric...

Regardless, the reality remains that if one were dealing strictly with sideropenia without full-blown anemia (low hemoglobin or red blood cell counts), such a condition shouldn't significantly impact immune, neurological, psychological, or muscular functions in adults, at least according to current hematological research and expert consensus.*

It would also be prudent to include TSH and fT4 (thyroid hormones) alongside the hormone panel you were advised to test, as previously suggested.

*Source: I. Aurer: Sideropenic Anemia in Adults.

I’ve already had my thyroid checked twice and everything was fine, but I haven't done the hormone panel yet... which specific ones should I look at? Estrogen and progesterone? The issue is my gynecologist can't see me for another two months—not until after my period—but hormones need to be tested within three to five days of the cycle starting. I really don't want to wait another two months, so I'd prefer to get this done as soon as possible.

Megan Adams53 said:I’m experiencing the exact same thing—my resting heart rate sits right around 84, but the second I move, even just to slice some vegetables, it spikes straight to 163... I feel perpetually exhausted and completely drained, and honestly, this has been dragging on for seven months now; I am losing my mind! I have conducted countless searches and consulted endless specialists, yet no one seems able to pinpoint the cause. I can only pray that it turns out to be low ferritin levels, because if it is, I might finally put an end to this misery.

I am in the exact same boat.
Every single one of my lab results comes back perfectly fine, ranging from my hormone levels to my thyroid function... you name it.
You absolutely must insist on checking your ferritin levels. So many women present with the precise symptoms you described even when their standard panels look normal, particularly when those ferritin values fall somewhere in that frustrating window between 10 and 50. Typically, doctors only start talking about anemia once the numbers drop below ten. In my own case, no physician ever thought to check my ferritin until an acupuncturist suggested I might be deficient; I had to demand the specific test myself, and sure enough, his intuition was correct and the bloodwork confirmed it.

goldenskipper13 said:I feel the same way.
All the levels should be fine, from your hormones to your thyroid... and so on...
Make sure to insist on checking your ferritin levels. So many women experience the exact symptoms you described even when their results fall within the "normal" range—specifically when ferritin sits somewhere between 10 and 50. Typically, doctors only label it anemia once it drops below ten. In my case, no one even considered checking my ferritin until an acupuncturist suggested I might be deficient. I insisted on the blood work, and sure enough, it confirmed exactly what they suspected...

Well, thank you so much! I was honestly feeling quite lost, so I'll head to the clinic first thing Monday morning to get this sorted out and see where we stand...🙂

goldenskipper13 said:Values under ten generally point toward anemia.

Anemia isn't diagnosed based on ferritin levels alone; you look at hemoglobin and red blood cell counts.

Maria Fisher46 said:One doesn't determine anemia BY LOOKING ONLY at ferritin levels; you have to look at hemoglobin and red blood cell counts.

True, though I was implying that the ferritin level is low as well... that was my point.
But we must consider that there are various types of anemia, so simply checking iron levels is absolutely insufficient if one wants to truly assess whether iron stores are replenished and if the anemia itself has been resolved.

I moved this thread here. Since you already started a separate discussion regarding your symptoms, it makes more sense to keep everything consolidated in one place.

Anthony Scott54, I’ve just read through your previous posts from the beginning. I’m struggling to see the connection to progesterone or sex hormones—what specifically led you to suspect low levels there?

If those hormone levels were fluctuating significantly, you would likely notice disruptions in your menstrual cycle first, rather than just pronounced fatigue and palpitations while maintaining regular cycles.

What you need is a cohesive diagnostic plan, ideally guided by a competent internist who can establish a logical clinical roadmap. Jumping from one isolated test to another is rarely effective; it’s just guesswork.

First, you need a thorough, systematic physical exam to check for any abnormalities in your physical status. From there, follow up with routine labs (CBC, electrolytes, basic biochemistry, urinalysis, TSH). Only then should you consider more specialized testing, such as ACTH, cortisol, viral serology, immunological/rheumatological workups, or psychological screening.

It looks like you've completed some testing, but a good internist needs to synthesize all those data points into a single picture to see if anything was missed and perhaps reach a conclusion.

goldenskipper13 said:yes, but the ferritin was low too... that's what I meant.
But there are various types of anemia. Simply checking iron levels isn't enough to determine if iron stores are sufficient or if the underlying cause of the anemia is resolved.

Exactly. It matters if we are dealing with iron-deficiency anemia, but it's a different story if other forms are at play, such as anemia of chronic disease.
😉

I believe I mentioned that point earlier, so we are in agreement regarding the iron.

I should also add that basic anemia screening involves checking hemoglobin and red blood cell counts; TIBC, iron, and ferritin are only used later to pinpoint the specific cause.

Maria Fisher46 said:I have moved this thread here, since you already opened a discussion regarding your symptoms, just to ensure everything remains organized in one place.

Anthony Scott54, I have just read through your previous posts from the beginning, and I am somewhat unclear on how you arrived at the conclusion involving progesterone and sex hormones; specifically, what led you to suspect low levels in those particular areas.

If there were significant fluctuations in those hormones, one would likely notice irregularities in the menstrual cycle first, rather than such pronounced fatigue and palpitations alongside a regular cycle.

You require a coherent diagnostic approach, preferably under a skilled internist who can establish a rational clinical testing algorithm. If you simply move from one isolated test to another, I fear you will achieve very little.

To begin, you should undergo a thorough, systematic physical examination to see if there are any deviations in your physical status. This should be followed by routine laboratory work (CBC, Sed rate, electrolytes, basic biochemistry, urinalysis, TSH), after which further investigations could be considered (ACTH, cortisol, etc.), viral serology, perhaps immunological (rheumatological) screening, psychological testing, and so on.

It appears you have completed some steps already, but I believe a competent internist needs to synthesize all these results into a single cohesive picture to determine if anything has been overlooked, potentially leading to a diagnosis...

Yes, if iron-deficiency anemia is the cause, but certainly not if other forms are at play (such as anemia of chronic disease). 😉

I have noted the same point you mentioned, so we are in agreement regarding the iron levels.

I should also mention that basic anemia screening involves checking hemoglobin and red blood cell counts; TIBC, iron, and ferritin are only used once anemia has actually been established.

I have had my CBC checked multiple times, and everything is fine, except for my iron being low. My thyroid levels are normal, as are my electrolytes—though magnesium and potassium sit right at the bottom limit—and my Vitamin B12 and folic acid are both fine. After those results came back, they suggested I check my sex hormones and cortisol, which I haven't done yet... not to mention I've gone through every possible neurological test (CT and MRI scans), and those were all clear; EEG was fine, too. Thyroid scintigraphy and a biopsy were also okay... I saw a cardiologist, and there are no signs of heart disease, though they did note a rapid pulse, which the doctor suggested might just be due to the low iron... I really don't know what else to test for... I've been cycling through doctors for seven months now and I still feel exactly the same :/

You should go ahead and get ferritin and those other tests you were advised to take. To be honest, I find it quite strange that they skipped ferritin during such a thorough workup. It’s a simple test, yet absolutely vital if you want an actual picture of your iron stores. Judging iron status based solely on serum levels is a mistake; there's too much daily fluctuation and too many outside variables at play for that data to mean much of anything.

If they already suspected your issues stem from an iron deficiency—not anemia, mind you, provided your CBC looks normal—it makes little sense why ferritin wasn't checked or why you haven't started any supplements. 🤷

Nicholas Myers As specified by Anthony Scott54:
You should probably go ahead and request ferritin levels along with those other tests you were advised to take. I have to admit, it seems quite unusual that such a thorough panel would omit ferritin; it is such a straightforward test, yet absolutely essential if you want an accurate picture of your iron stores... Judging iron status based solely on serum levels is hardly reliable, given how much they fluctuate daily and how heavily they depend on various other factors. That single data point really doesn't tell us much...

If they have already suspected that these symptoms stem from an iron deficiency—and I am not referring to anemia, provided the blood work comes back normal—it seems rather peculiar why ferritin wasn't tested. It leaves one wondering why iron supplements haven't been prescribed yet... 🤷

It is frankly staggering that medical professionals could overlook such an obvious oversight... They attempted to dismiss the whole situation by suggesting stress was the primary culprit. As for the hormonal imbalance, that logic doesn't hold much water for me; if my sex hormones were truly out of whack, I would have noticed irregularities in my cycle long ago, yet everything there remains perfectly normal. That leaves only the cortisol levels. Is it truly possible for cortisol alone to trigger these kinds of complications?...

Megan Adams53 said:It’s wild to me that doctors could miss something like that... honestly. They’re trying to pin everything on stress, too. As for the hormones—it makes sense if my cycle was acting up, but it’s totally normal. Just this cortisol thing? Can that actually cause all this...

Hey, I’m new here. Been dealing with dizziness and heart palpitations for about four months now—thyroid seems fine, though. Sometimes I get these waves of heat coming from my chest and I just feel constantly on edge. Please, any advice? This is driving me crazy...
🙂

Angela Ramos8 said:Hi, I'm new here. I've been dealing with dizziness and heart palpitations for about four months now. My thyroid tests came back normal, but sometimes I feel this intense heat rising from my chest and I'm constantly on edge. Please, I need some advice—this is driving me crazy.
🙂

What has your doctor told you so far? Have you seen a specialist yet? Did you get any testing done—just basic stuff like blood pressure, an EKG, or blood work?
Have you noticed if there's a pattern to when it happens, like during specific activities or certain body positions?

I start running into these issues whenever the heat kicks in; my blood pressure tends to drop way too low...

Here’s my experience so far..

I generally struggle with a weak immune system, but what really gets to me is how quickly I wear out during any kind of physical activity. I just feel constantly exhausted, no matter what.

On top of that, my progesterone levels are low, which messes with my cycle and causes much heavier bleeding than usual..
I recently had some blood work done through my doctor. My hemoglobin came back at 116 (normal range is 119-157)
My iron was 7 (normal is 8-12)

And my ferritin was 8 (should be 10-120)

The UIBC and TIBC numbers look normal, though..

I’m assuming they’re going to put me on an iron supplement next..