The nurses swarmed around me as my vision began to go dark.

“I’m going to pass out,” I choked out as they lowered my bed flat and one strapped a blood pressure cuff around my arm.

“Get me a liter of saline!” the charge nurse called out. He turned back to me with a calming smile. “Are you feeling shortness of breath?”

“I’m going to pass out—” was all I could say as my hands went clammy, heat and cold both coursing through my veins as consciousness started to slip.

“Do you have the rescue meds ready?” Another nurse asked the charge nurse.

“She doesn’t need them,” he said, confident.

It turns out the charge nurse was right. They pushed saline and my blood pressure — which had an extraordinary and precipitous drop — started to slowly return to normal.

Over the next half hour I was the most popular patient in the infusion clinic, all of the nurses rotating around to check on me as I slowly recovered.

“Ready to try again?” my lead nurse asked me with a grim smile.

Was I ready to risk another steep drop of my blood pressure and intense sensations from my body rejecting the IV?

“Hell yeah,” I said. There was zero chance that I was leaving that infusion room without my dose of IV iron.

The infusion started, and my life changed.

this is life with low iron

In 2023 I did the 26-mile hike to Machu Picchu with a ferritin level of under 20.

I do not recommend this, especially as ferritin represents your iron stores in your body and is partially responsible for oxygenation to important organs like, I don’t know, your brain!

The maximum altitude on the hike was 13,800 feet at Dead Woman’s Pass, an insane place with deep folklore that actually inspired a story in my detective short story anthology, The Nomad Detective.

During the hike, I almost passed out multiple times and my now-husband Kyle had to carry my backpack during the hours-long climb to the pass. I chewed coca leaf (basically unrefined cocaine) and that was the only thing that got me through.

In fact, stimulants in vibey drink form have been my crutch for years. Coffee, matcha, freddo espresso (Greece), Turkish coffee and tea (Turkey, obv), Blue Bottle NOLAs (first in Korea, now my obsession here in SF) have been the only way I can hit the goals I set for myself and be a functioning human. I’ve even quit caffeinated tea and coffee for 6-12 month stints at a time to see if getting off of them would help raise my iron stores or cut my dependency, but it turns out when your iron is low life is hard!

This month, the American Society of Hematology raised the bar for what counts as iron deficiency. The new cutoff is a ferritin of 30 ng/mL or lower for most adults, and 50 or lower for higher-risk groups like mine. At my lowest, my ferritin was 8!

If you feel brain fog, exhaustion, or “coat hanger pain” (pain of the shoulders and neck) it’s worth it to ask your doctor for a ferritin test to see if you’re low — EVEN if the rest of your bloodwork looks normal (mine does). Ferritin isn’t part of a standard blood draw, so you have to ask for it by name.

I literally had to fight my doctor in LA in 2021 to get me one and he straight up did not order it for me the first two times I asked. When I finally got the test results back my nutritionist told me “I’m sorry the medical system has failed you” because it was so low.

Low ferritin feels like your life force is struggling uphill to bring color to your cheeks and light to your eyes. Low ferritin means it’s a struggle to get out of bed or up a flight of stairs. Low ferritin is living with weights on.

Getting my ferritin from 8-25 over the last five years has been a challenging journey, but at every stage of improvement, I’ve felt better, happier, and more full of life. Things unlocked at every stage: I could tolerate caffeine better, I had less mysterious anxiety that seemed to come from nowhere, I could workout longer and harder.

And now, my ferritin is at a normal level.

life in full color

I had a feeling that an iron infusion would change my life, and I don’t think it’s too early to say that it has.

Immediately after the infusion, colors started looking different.

Colors.

The walls of the infusion clinic were warmer, softer, hues seemed deeper. Maybe it was a brush with death? No, because when Kyle and I got dinner at a great Burmese restaurant nearby, the colors there seemed more lush.

But the biggest change? Energy. I feel replenished. Almost as if the full night of sleep I have been chasing for years finally arrived.

It’s hard to not type this and start crying because since I put my autoimmune condition in remission a few years ago, I couldn’t have imagined how much better even from then I could continue to feel.

I’ve changed everything: I quit drinking, I’ve switched to a majority-plant-based diet, I’ve cut my caffeine way back, and I’ve worked with doctors to solve deficiencies in vitamin D and now ferritin.

I feel like a new person, and that’s from years of being persistent and doggedly chasing down doctors and telling them “I need this. Can you help me get this?”

Even AI has been incredibly helpful for picking apart my lab results and preparing me to ask my doctors better questions. If I’d had AI back when I was putting my rheumatoid arthritis into remission, I probably would have gotten there faster.

Regardless, I’m filled with gratitude. I have energy now??? I wake up feeling alert and excited about the day??? I used to have to manufacture all of that with highly caffeinated beverages, and now I feel like I’m walking into this next phase of life wide awake.

…all in time to finish my novel

I’m working with my talented editor Kyle Cords (who also happens to be my husband!) on finishing Let Me Be Your Ghost. Kyle’s story sense is unmatched (there’s a reason he worked for high-profile showrunners during his time in Hollywood as a TV writer) and we’ve been having lots of great story conversations as I prepare to do the final rewrite on the book.

Rewrites are always a highwire act of trying to please readers while keeping the book constructed in a form that will deliver the best story, and I’m excited to finish up this journey.

And thank you to everyone who has pre-ordered the book — I’ve been so honored to see the 1, 10, and 50-book pre-orders roll in, and if you haven’t already seen all of the gifts I have for you for your pre-orders, check them out below!

🎁 pre-order the book and get your gift

Wishing you all creativity and good health,

-Amy

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💡 Sutoscience by Amy Suto

💡 i was exhausted for years. it was my iron.