Hey All, 

I met a pretty sharp Dr. a few weeks ago. He mentioned that it's very common for AA/AU patients to have low ferritin (iron stores).

In simple terms, Ferritin is a protein in our cells where the body stores excess iron it doesn't need now, for use later, say when you're not getting enough in your diet. Essentially, it's a backup iron store/buffer for when we're low on iron. When that happens, the body starts drawing down from from those stores, but starts with what it considers to be non-essential cells...like hair follicles. 

Like most things related to our AA/AU, they don't really know why it happens but they suspect that some form of inflammation prevents us from absorbing iron properly through our GI, and starts to get depleted quickly.

He explained that for healthy hair to grow, Ferritin needs to be above 70ug/L. At 50ug/L hair stops growing, and at around 40ug/L hair becomes very thin, weak and falls out.

He asked me to collect the results of my annual blood tests from my GP as well as any other tests I had thought this past year since my AA/AU started and see him again.

When we reviewed the results together we noticed that for the past 5 years when I was healthy my Ferritin range was between 125-150 ug/L, then last year when all this started it spiked to 190 which is considered an inflammatory marker, but then it started dropping into the 90's...57...51..and the latest result from Oct was 48 ! He put me on Ferrous Fumerate 300mg 2x/day and will need to test Ferritin monthly until it's back up. He said if it doesn't increase or at least stabilize, it's due to an absorption/inflammatory issue in the GI, and we'd need to move on to injections to bypass the GI altogether. I'm really hoping that between getting the Ferritin sorted out and starting Xeljanz that things will improve and go back to normal. I miss my life..a lot. 

This got me thinking about some of the people that haven't responded to Xeljanz, or that have had a poor response and whether it might have to do with low Ferritin levels. I mean, even if you're on Xeljanz and the auto-immune part of it is controlled, if ferritin is low the hair just won't grow.

Hope this helps someone. This forum and the people in it have been a great resource, so just wanted to contribute what I can.

All the best,

TC