?Anemic

I'm a 32 year old female and lately I'm experiencing increased fatigue. I am losing more hair that usual, I have horizontal ridges in my thumb nails, and I'm increasingly moody. I dont' think my stress level has increased and depression has been ruled out.

My doctor has run a few blood tests, but everything looks good.  He's put me on a multivitamin and Iron.  After a month, I've noticed no change.  

Is this anemia, or something more?

[J.M. Keyes, MD]

The cause of fatigue is often difficult to pinpoint. Your symptoms can be due to a variety of things.  Fatigue can be due to anemia, hypothyroidism (low thyroid), pregnancy, new medications, sleep apnea, anxiety/depression, infections (eg mono), environmental exposures (eg carbon monoxide) among other things.  What testing is done usually depends on history and your physical exam.
Hypothyroidism can also cause hair loss as well as nail changes, so I would make sure that your doctor checked this in the blood tests you had.
The goal with fatigue is often to rule out iron deficiency and serious causes for the symptoms, although I know it is often frustrating for patients not to get a definitive answer.  
Be sure to make sure pregnancy is ruled out, and double check that your MD checked your thyroid.  If your symptoms are getting worse, or you are getting new symptoms, be sure to bring it up wih your doctor again.
Find out if your iron levels were actually low on your blood work, because if not and you are not getting any benefit from an iron supplement after a few months, there isn't any point in continuing it.

Hope you are feeling better.

JMK MD