A normal serum iron level is 60 to 170 , so that 22 is likely not your iron level but probably your hematocrit which is a measure of the percent of your blood that is actually red blood cells. The normal parameters that the doctor stated sound more like that. So 22 is definitely low.
When you are low on iron you will have fewer and smaller red blood cells , because you won’t be able to produce enough hemoglobin, which is the part of a red blood cell that carries oxygen. You can be breathing just fine, but if your blood doesn’t have enough RBCs, (or large enough RBCs, or enough hemoglobin in them), it will not be able to pick up and carry the oxygen from your inhaled air, and transport it to the cells of your body, you will feel tired. You will likely even feel out of breath from minimal activity.
This lack of iron can be caused by not getting enough iron in your diet, or not absorbing what you do take in. That could be caused by lack of certain digestive factors. Having low thyroid function can cause decreased production of hydrochloric acid in the stomach, which in turn lowers your absorption of iron.
It could also be due to losing blood in some manner. Like heavy menstrual flow or bleeding somewhere in the gastro tract. This could even be due to loss of microscopically small amounts. The different blood tests that the doctor does can give him an idea of which process is responsible for your low iron.
I would guess that the difficulty with your sleep is likely due to the fact that, while asleep your breathing is shallow. That’s normally so. But your iron level is so low, and thus your blood’s oxygen carrying capacity is so low, that your body’s tissues cannot tolerate the difference between the poor level of oxygenation they receive while you are awake versus the even worse level of oxygenation they get while you are asleep. I wouldn’t be surprised if when you wake up all those times during the night, that you are probably gasping for air, or at the very least taking several deep breaths before going back to sleep.
I’ve been there myself. I spent much of my adult life slightly anemic, and several years severely anemic. I also spent years trying to take iron supplements, which I never could tolerate well at all, due to my history of gastric problems. It never really helped as much as it should.
When my blood levels finally got bad enough my hematologist ordered iron infusions for me. (He wanted to give me blood, but I wanted to try the IV iron first.) The iron infusions were wonderful !! The difference in how I felt was like a miracle to me, and took only a couple days to be noticeable. (Although the total difference takes weeks, matching the time it take the body to produce a new red blood cell, start to finish.)
The energy difference is remarkable.
But more amazing was the immediate disappearance of the weird anemia symptoms, the crazy skin itching (a not real common symptom) and the ice chewing compulsion which is a very common symptom of anemia. It’s classic, so I’ll bet you do it. Once you’re not anemic anymore, that will just stop, all by itself.
I wish you luck with the new tests. If it’s all due to the low thyroid, you should feel much better once they get your thyroid hormone levels under control and the blood iron levels up to normal. I wish you a speedy recovery.
