Can Azithromycin lower iron and ferritin levels in blood?

Question

Hello doctor,

I would like to ask you something just to be sure. This month I used Azithromycin 500 mg for three days due to my vaginal problems. I used probiotics as well, with time gaps between antibiotics and probiotics, of course. When I stopped with antibiotics, I have continued my probiotics (Floraliv), which contains Vitamin B (B1, B2, B3, B5, B6, and B12), Bifidobacterium, Lactobacillus acidophilus, and Lactobacillus paracasei. After 10 days, during a checkup with my gynecologist, she took my blood for the first time (she did not take it before my use of antibiotics) and found out I have everything just fine, except for iron levels and ferritin levels, which are lower than normal. I was quite weak for a few months, even before I started using antibiotics. My question is, could somehow Azithromycin cause lower iron and ferritin, or is it due to something else? I sometimes have a heavy menstrual flow, but this month it was alright. Thank you very much and have a nice day.

Answer 1

Hello,

Welcome to icliniq.com.

Azithromycin is not associated with any lower hemoglobin levels. It might be due to some other reason. You need to start on some iron supplements. Sometimes, in spite of taking an iron-rich diet, its absorption is lowered due to faulty diet habits like taking iron-rich food with calcium-rich food, leading to lower hemoglobin levels. Along with starting iron supplements, you have to check on your diet too. Have more iron-rich food, cook your food in an iron vessel, etc. Increase intake of vitamin C-rich foods and fruits in your diet that are likely to increase iron absorption. If you experience heavy menstrual flow, you need proper evaluation for that too, as it is the most common cause of iron deficiency anemia in women. Take care and all the best.