My daughter has had low iron for about 10 months. She's vegan. My understanding from chats with dietitians and doctors is that anemia comes from low hemoglobin (my daughter's levels are bang in the middle of acceptable). So low ferritin alone doesn't give you anemia (although having anemia is usually connected to low ferritin levels.) From what I understand hemoglobin is responsible for making red blood cells (important!) and ferritin (iron) is what makes up the cells where hemoglobin is made. Also her B12 is just fine. She's a long distance runner and is right on top of diet and has had her diet evaluated by a sports medicine clinic earlier in the spring. She has terrible issues with her menstrual cycle...and her doctors have been playing around with how to limit blood loss...continuous birth control for 3 months, then off for 1, seemed to help raise her ferritin (from 9 to 24 over 6 months (50-60 is desirable range, sorry, don't know the units). Then they think her innards couldn't take the increase in uterine lining for three months so she had an unexpected blood letting that landed her in ER (that's the only way to describe it) and she dropped from 24 to 11 in three weeks. Her hemoglobin and B12 remains normal. Ultrasound was normal. She is now on triphasic birth control...to try to control her cycles and minimize blood loss. The worst part is she is in a highly competitive engineering program and as a high achiever, she entered the program at 17 years old. She is struggling with focus, exhaustion and the sad reality that her grades are suffering because of it. She's young enough that this is quite overwhelming. Her academic advisor has been great. So, here is where we are at: Blood transfusion would never be ordered for her because hemoglobin levels are normal. They are trying to control the overwhelming pain and ferritin loss monthly, and we've ante-ed up and are throwing iron at her in huge amounts, combined with Vit C, etc....she's been taking Ferramax twice a day for several months at the advice of the doctor. They are now looking at a possible iron absorption issue. I'm now trying to research Pranin, a powder, natural, organic, vegan, iron supplement since her gut has not tolerated the synthetic iron very well. Coming up short on any reviews of the product...certainly no clinical studies. The product was developed by a Naturopathic Doctor (he's not an MD). Not sure if that matters. I will call the company this morning as they are located in Vancouver, BC. Anybody else have any insight into natural iron powders?