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Old 02-27-2007, 06:47 PM   #1
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Susanheb HB User
iron in blood work Q, new here

Hi,
I'm new to the world of anemia and new to this board. I have been reading as much as I can here but I'm having a hard time concentrating and reading so much. lol <sigh> So, I thought I would put my question out here as well just in case.

I had blood work done almost 5 years ago because I had pneumonia at the time. It came back showing that I was anemic. The emerg dr told me to get it checked but I didn't think much of it and I didn't really relish the thought of taking iron pills. I knew about iron pills because I had to take them when I was pregnant and all I knew was that they made me constipated. So, I underestimated the seriousness of anemia.

Fast forward, 5 yrs later, and I am experiencing some really weird symptoms of tailbone pain and constipation. I go to the dr and along with an xray, she sends me for routine blood work. My second visit, she asks me if I knew I was anemic. Ummm okay. I'm steadily decaying by this point. After my third visit, I insisted on seeing someone who knew what they were talking about.

Anyways, to make a stupid long story just a bit shorter...my stupid dr did a CBC as well as a couple other blood tests.
She told me that I was anemic and needed iron BUT the bloodwork doesn't show any test for iron levels!!! So now, here I am, waiting for my colonoscopy/gastroscopy and taking 900 mg of ferrous fumarate and wondering if I'm poisoning myself!!!! I don't trust this dr at all but up here, we really don't have any choice of dr's. (Not private health care in Ontario lol) It's just very hard to find another dr.

I guess I'm concerned about it because I still don't have the energy I had a month ago and the energy peaks and dips at different times. Sometimes I feel good, and then just as suddenly, I feel drained and icky. I'm also experiencing headaches now every day whereas I *never* had headaches in the past. I'm a pretty healthy person and had just started jogging when all this stuff started happening. I hate this fog I'm living in, not to mention the horrible depression that seems to accompany it!

My hemoglobin is 102 ( I guess that would be 10.2) and the hematocrit is .315.
MCH (I don't know what this test is) was low at 26.0 and RDW (don't know this one either) was high at 16.7.

Shouldn't there be an iron test there to determine if it IS indeed iron deficiency anemia that I have?? I have been taking the iron for about 10 days now. Do you think I should insist on having another bloodwork done to check for iron levels? I usually have to tell this dr what to do...
Any help or advice would definitely be welcome.

Thanks so much.
SusanH

 
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Old 02-28-2007, 06:35 AM   #2
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ChristineVA HB UserChristineVA HB UserChristineVA HB User
Re: iron in blood work Q, new here

Quote:
Originally Posted by Susanheb View Post
Hi,
I'm new to the world of anemia and new to this board. I have been reading as much as I can here but I'm having a hard time concentrating and reading so much. lol <sigh> So, I thought I would put my question out here as well just in case.

I had blood work done almost 5 years ago because I had pneumonia at the time. It came back showing that I was anemic. The emerg dr told me to get it checked but I didn't think much of it and I didn't really relish the thought of taking iron pills. I knew about iron pills because I had to take them when I was pregnant and all I knew was that they made me constipated. So, I underestimated the seriousness of anemia.

Fast forward, 5 yrs later, and I am experiencing some really weird symptoms of tailbone pain and constipation. I go to the dr and along with an xray, she sends me for routine blood work. My second visit, she asks me if I knew I was anemic. Ummm okay. I'm steadily decaying by this point. After my third visit, I insisted on seeing someone who knew what they were talking about.

Anyways, to make a stupid long story just a bit shorter...my stupid dr did a CBC as well as a couple other blood tests.
She told me that I was anemic and needed iron BUT the bloodwork doesn't show any test for iron levels!!! So now, here I am, waiting for my colonoscopy/gastroscopy and taking 900 mg of ferrous fumarate and wondering if I'm poisoning myself!!!! I don't trust this dr at all but up here, we really don't have any choice of dr's. (Not private health care in Ontario lol) It's just very hard to find another dr.

I guess I'm concerned about it because I still don't have the energy I had a month ago and the energy peaks and dips at different times. Sometimes I feel good, and then just as suddenly, I feel drained and icky. I'm also experiencing headaches now every day whereas I *never* had headaches in the past. I'm a pretty healthy person and had just started jogging when all this stuff started happening. I hate this fog I'm living in, not to mention the horrible depression that seems to accompany it!

My hemoglobin is 102 ( I guess that would be 10.2) and the hematocrit is .315.
MCH (I don't know what this test is) was low at 26.0 and RDW (don't know this one either) was high at 16.7.

Shouldn't there be an iron test there to determine if it IS indeed iron deficiency anemia that I have?? I have been taking the iron for about 10 days now. Do you think I should insist on having another bloodwork done to check for iron levels? I usually have to tell this dr what to do...
Any help or advice would definitely be welcome.

Thanks so much.
SusanH

Susan,
I agree that you probably should have further tests done to ensure that you are dealing with iron deficiency. Most likely, that is what it is since that's what most women have. It would be more rare for you to have a B-12 or folate deficiency.

Anyway, like you, I was not satisfied with just going off a CBC. One indicator on the CBC of iron deficiency anemia is the MCV value. This measures the size of your red blood cells. In long term iron deficiency, the red blood cells will shrink in size and your measurement will be lower than normal. I think the low end of the scale is 80. Mine was at an 83 I think--still normal. I ended up adding on a ferritin test (which is measurement of your iron stores) and a reticulocyte count. Both of these tests are the definitive tests, these days, for iron deficiency anemia. They can do a serum iron test and iron saturation test, but they are apparently not as reliable as the ferritin. But my iron saturation did match my low ferritin scores.

Why don't you stop taking the iron supplements for a few days and call your doctor and ask, at the minimum, for a ferritin test. You will get an idea from that.

 
Old 02-28-2007, 06:45 PM   #3
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Join Date: Feb 2007
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Susanheb HB User
Re: iron in blood work Q, new here

Thanks Christine,
My MCV is 80.1. I just went to my chiropractor and he's doing more for me than my family doctor ever will. He told me to take the three pills at different times and not all at once. He also suggested taking it with meals because I had been taking them on an empty stomach with OJ but really suffering from dry mouth, thumping heart and headaches still. I'll do that for a couple of days and see if it makes a difference and then start looking for a different doctor. My colonoscopy is on Monday so hopefully I will be getting answers soon.
Thanks again,
SusanH

 
Old 02-27-2008, 07:04 PM   #4
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mariat753 HB User
Re: iron in blood work Q, new here

Hi, Susanheb. I'm a physician assistant in Internal Medicine and actually just had a couple of interesting cases of anemia. Remember, this is NOT medical advice, but I thought maybe I could answer a couple of the questions. RDW is related to the size of your red blood cells, and can be related to different kinds of anemia. Again, MCV can also be indicative of a lot of different anemia. I cannot question your doctor, but a lot of times one does run an iron and what's called an "iron binding capacity" test, and we often test B12 and folate, because they can cause another kind of anemia--but your doctor may have decided that those were not an issue.

 
Old 02-27-2008, 09:11 PM   #5
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Join Date: Oct 2006
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osteoblast HB User
Re: iron in blood work Q, new here

Susan-You do seem to need more labs done. What caught my attention though was that you said you were going to have a colonoscopy next Mon. and you said you are now taking iron. I do not have handy my instructions from the colonoscopy that I had last year-I do recall though that I was not supposed to have iron for a period of time before the procedure. Maybe it was for a week prior-not sure though. Anyway, did you get colonoscopy instructions that said not to take aspirin, iron, etc?

 
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