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Old 12-11-2007, 06:30 PM   #1
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Reticulocyte Counts...

I posted a few days ago about my very low ferritin levels and anemia. I followed up with a different internist today (he was very nice and thorough and explained things very completely). He mentioned that my reticulocyte count, though on the very low end of "normal" is really too low because of the anemia (it's a measure of new RBC production in the bone marrow). This is likely because I have no iron (ferritin was 1, 3 weeks ago, hopefully a *bit* higher today!) to make RBC's.

Does anyone know how long it will take my bone marrow to respond to the iron supplements? How high should my reticulocyte index go to in a "normal" response to anemia? (He said "normal" ranges are 0.5-1.5%, mine was 0.5%, but he felt this was really low, considering my level of anemia--there's an index they do based on hematocrit levels and that is really more like 0.3%--too low.)

He also recommended that I try really hard to take 3 iron pills a day. Blech. But I'll try.

 
Old 12-12-2007, 03:47 PM   #2
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Re: Reticulocyte Counts...

Steph74--I think that it is 35-40 days to respond to iron supplements but I think that was the Hgb. Once that goes up you should begin to store iron.

I can tell you that when I was borderline anemic my retic count (same thing) was at the high end at the top range. This number should respond right away within days from iron therapy. A simple blood test would tell you. Anemia can be caused by a bone marrow problem, bleeding, or RBC destruction. I would do what the doc said and take the iron and it does take 3X. If that is too hard ask for something else that is easier. FLFLOWERGIRL

 
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Old 12-13-2007, 07:27 AM   #3
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Re: Reticulocyte Counts...

I got my repeat blood results today. After 3 weeks of iron supplementation by ferritin level is still 1. The doctor wants me to wrok up to 6 iron pills a day. I see a GI doctor on Monday. I'm wondering if it's possible that this is an absorption problem--seemingly unrelated, I got results from my cholesterol work back and my total cholesterol was 97. The HDL was in the good range and I know my diet is exactly what you're supposed to eat for low cholesterol, so I'm not worried about it at all, I just wish I knew what was causing this iron deficiency.

In good news, my hemoglobin did creep up a little, but the ferritin of 1 is really worrying the doctor, that and my poor reticulocyte response. I'll have my levels checked in another 3-4 weeks.

Shouldn't my ferritin level be responding at least a *little*?

 
Old 12-13-2007, 07:53 AM   #4
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Re: Reticulocyte Counts...

Actually, your ferritin is not going to respond until your anemia is corrected.

Ferritin shows your stored iron. Anemia is the end/final stage of iron deficiency. So, for years you deplete, deplete, deplete and you finally end up anemic.

Every bit of that supplement you are taking is being used to get your red blood cells bigger and more. Your ferritin will only increase when you have "extra" iron. Then your body will put it into storage. Right now, as long as you're anemic your ferritin will not rise.

I think your doctor is being a bit too optimistic to see your ferritin rise in only 3 weeks. That might be true if you didn't have anemia.

I do think it is a very good sign that your other numbers looked better.

 
Old 12-13-2007, 08:04 AM   #5
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Re: Reticulocyte Counts...

Steph--Thank goodness that you see your GI doc on Monday because 6 pills is a lot to take considering the fillers and added ingredients. That alone not to mention the iron can cause great problems for you. You said that you are already having a problem taking 3 a day.

I think that the the ferritin is not responding because you don't have enough iron. Mine went up 1 point in the beginning within a few days. But I was taking Ferris Sulfate 3X daily = 195 mgs of elemental iron, that killed me!

I was then prescribed Poly-Iron 150's 2X daily = 300mgs iron by my GI doc. You should ask your doc on Mon. for a script iron that will give you more iron with hopefully less symptoms. You have to remember that you are on a low dose iron at 2 a day and you only absorb something like 10% or less daily, very little. I think that your 6 equal to be about the same as my 2X daily. Until I took this amount my Hgb kept dropping.

I would think that if it were an absorption problem that you would also be deficient in other things like B-12 and folate. Did you have these vitamins checked? Keep us posted and good luck on Monday with your visit. FLFLOWERGIRL

 
Old 12-13-2007, 08:12 AM   #6
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Re: Reticulocyte Counts...

I wanted to add that when seeing my Hematologist in the beginning, although he ran ferritin tests each time he was never concerned about that number. I asked why and he said, that he knew I didn't have any because it takes sooo long. He acted like I was crazy each time I asked about that number. I had stat blood test with this doc and received the ferritin results the next day, so I would call the office and he felt compelled to call me back to explain that I would not have any ferritin and this is normal at this stage. Although, within days of F/S I did go up 1 point in ferritin and the same lab was used. FLFLOWERGIRL

Last edited by FLFLOWERGIRL; 12-13-2007 at 10:21 AM.

 
Old 12-13-2007, 08:26 AM   #7
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Re: Reticulocyte Counts...

Thanks for the information. Hopefully over the next few months my ferritin will start to increase. The SlowFE I'm taking is 50 mg iron (I think it's 165 mg Ferrous Sulfate)--so 6/day will be 300 mg. I think seeing the GI doctor will be helpful, too.

A totally separate question--can taking iron itself make you extremely dizzy? I took two this morning, trying to up the amount gradually, and I'm so dizzy it's crazy. I have not had big problems with dizziness with the anemia, mostly shortness of breath. It's really hard to concentrate (I'm at work) because I'm so dizzy. I hope this goes away soon.

 
Old 12-13-2007, 10:26 AM   #8
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Re: Reticulocyte Counts...

Steph-- It's hard to say. I never got dizzy from the supplements that I know of. I did get dizzy with the anemia and still get dizzy when fatigued with low ferritin only. Perhaps you are having a reaction. The only way to know is discontinue the increase, go back to the original dose and see if it goes away. FLFLOWERGIRL

 
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