@ellen0989 Welcome to Mayo Clinic Connect!

You have had some great responses here, and here is what Mayo Clinic has to say about it all: https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034

Back in the late 90s, I developed severe anemia. Went through endoscopy, colonoscopy and many tests. They determined it was my large fibroid tumors and extremely heavy periods caused by them, as the reason. I took oral iron supplements, and was put on Lupron shots prior to a hysterectomy January 1999. While that stopped the heavy periods and fibroids, it did not cure my anemia! In fact, the doctor told me to drive carefully, if I got in an accident I would probably bleed out before help could arrive!

What I will say is that underlying medical conditions could be a factor, it's trying to nail everything down. You may have a genetic component that does not allow you to absorb iron. Have they done a ferritin test, Total Iron Binding Capacity [TIBC]? From Wikipedia: https://en.wikipedia.org/wiki/Total_iron-binding_capacity. I have this test done routinely due to my end stage kidney disease, and being on dialysis. I take a chelated iron capsule each night, which is easily tolerated by my system, and eat a healthy diet.

I'll be curious to hear what they find out.
Ginger