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Old 08-06-2008, 05:11 PM   #1
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Chronic Low Iron?

If I had been told all of my life (as far back as I can recall, and I am 37 now) that I am "slightly anemic" why do you think that would be? I tested more than slightly a couple of months ago, and had to go through some major testing. I went on iron 325 mg. a day and it brought my hemoglobin level nearly to normal fairly quickly. However, my ferritin is still only at 7.

I have had my "insides" checked, meaning just had an endoscopy and colonoscopy. No internal bleeding found. I have mostly mild to moderate periods.

Why would someone be chronically low on iron in this situation?

P.S. when I just had my colonoscopy done, they had me on oxygen for the procedure-a first. I wish I had some of that for at home! I have a hard time breathing sometimes.

 
Old 08-07-2008, 09:18 AM   #2
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Re: Chronic Low Iron?

TiredOTired--It could be your diet if it was when you were younger (or having babies), and have periods in general. You have to take in more iron than is being lost. When this doesn't happen, there is a ~slowly accumulated loss~ eventually resulting in lowered ferritin. This leads to anemia. Anemia can even happen only at the time when you have a period and resolve on it's own. If you tend to run low on iron you are at greater risk for a low ferritin.

It is good that you had the testing for internal bleeding done. Did they do any Malabsorption tests on you or take a biopsy? Unfortunately, they usually do not check the small bowel and there is a small chance 5% (I think) that something can be going on in that department too. If it doesn't get resolved in a normal time frame you might want to ask your GI doc about this. There is a test for that too, different one's actually.

Have you had your Thyroid checked? Do you take PPI's like Nexium? Over long term these things can also lead to malabsorption of iron. Also, did you have your B-12 and Folate checked sometimes these can be overlooked? When it is not due to blood loss you should look at malabsorption syndromes, there are several. Good luck to you.

PS--I forgot to say that you are not on enough iron. When anemic you should take at least 200mgs of iron daily. I know you are no longer anemic. But you still have a low ferritin. My doc kept me on 300mgs of iron (Iam still on 150 daily) for most of the year to fill my stores. Just to get to normal on the Hgb is not enough, you should be higher. You are only getting 65 mgs of elemental iron in your supplement, not enough.
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Last edited by FLFLOWERGIRL; 08-07-2008 at 01:06 PM.

 
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Old 08-07-2008, 09:48 AM   #3
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Re: Chronic Low Iron?

what about the possiblity of thalassemia? ive had slightly low iron my whole life but thalassemia runs in my family now i also have low iron but you can that by ferritin

Last edited by neffie663; 08-07-2008 at 09:49 AM.

 
Old 08-08-2008, 10:22 AM   #4
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Re: Chronic Low Iron?

I am unsure if you read correctly. I am on 325 mg. per day-still. Even though my hemoglobin has gone from a 9 to an 11, I will be on it for 3-6 months. Also, I asked my dr. about Thalassemia, particularly since I am of the heritage it affects-tests show negative.
Negative for B-12 probs. I had biopsies taken to rule out a couple of things. I know that since I have a hiatal hernia and severe GERD that being on a PPI has probably reduced my stomach acid, thereby making things worse.
I just want to know why even while taking iron and having a nearly normal hemoglobin level, my ferritin being low, I CAN'T BREATH.
I pant just from walking from my car to the door to work. I pant going DOWN one flight of stairs.
My blood oxygen level must have been low for my dr. to give me oxygen during my colonoscopy.
How does someone know whether or not to go to the hospital?
How does one know whether or not their dr. is taking you as seriously as you would like?
How does one know whether or not you need iron via IV?
How does one know whether or not you need a blood transfusion?

Long story long, I don't think I should be nearly blacking out if I am on 325 mg. a day, and my hemoglobin is nearly a normal range.

I don't think I should be having a hard time breathing.

I don't think I should have calf pains that GO THROUGH MY 50 FENTANYL PAIN PATCH and require additional pain measures.

I am tired of being tired. I am tired of feeling like a fish that was taken out of the bowl of water.
If you remember that commercial where the fish are in the bowl and the water level keeps getting lower-I can relate.
If you have ever gone swimming and dived kind of deeply under the water, and you are kicking and swimming up to the surface, but you are nearly there and your air is gone- and you are starting to just slightly panic--THAT is how I feel almost all day almost everyday.
Thanks for your replies.

 
Old 08-08-2008, 10:54 AM   #5
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Re: Chronic Low Iron?

Tired,

Sorry to hear about your problems. Do you have any other medical conditions, such as asthma, cardio problems, diabetes, etc.?
What I am thinking of is that your breathing problems could be completely unrelated to anemia. I know how terrible not being able to breathe is. To me, that is worse than almost any pain. I also know what shortness of breath does to ůur energy levels, when not enough oxygen is getting to the organs and tissues. How long have you had the SOB?

FG

 
Old 08-08-2008, 12:18 PM   #6
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Re: Chronic Low Iron?

Quote:
Originally Posted by flowergirl2day View Post
Tired,

Sorry to hear about your problems. Do you have any other medical conditions, such as asthma, cardio problems, diabetes, etc.?
What I am thinking of is that your breathing problems could be completely unrelated to anemia. I know how terrible not being able to breathe is. To me, that is worse than almost any pain. I also know what shortness of breath does to óur energy levels, when not enough oxygen is getting to the organs and tissues. How long have you had the SOB?

FG
Thanks for your reply.
To my knowledge, the only other reason for the breathing problems are having a deviated septum and being a naturally shallow breather. I also thought that it might be due to stress as when I am upset, as it sits in my chest. I also am on Fentanyl 50, which can affect breathing, but unlikely that it is an issue as I am used to being on it and have been for many months. (Years, actually.)

The SOB has been an on and off thing-meaning I have good days and bad days. I would say that I have been oxygen deprived for years. I just used to think that since I was such a shallow breather, that was why. I didn't know much about anemia, even though I knew I had it. (If I take a deep breath, I get dizzy.)

My dr. has told me to simply go to the ER as I might need a blood transfusion. I know good and damn well once I get there and wait 3 hours to be seen, they will test me and realize that my hemoglobin is not low enough to do so. I have an 11.1 last they checked. Although my ferritin is only a 7.

I have now been short of breath where it is affecting me severely for at minimum a couple of months. I don't exercise anymore. I try to keep movement to a minimum as even walking about my office makes me dizzy.

I know this isn't healthy. I know that it isn't normal. I just don't know what else to test for, and or if I should just wait and see if taking iron via pill will build up my stores enough to make this stop.

My son is now taking over some of the household duties as I simply can't.
Thoughts?

Last edited by TiredOTired; 08-08-2008 at 12:25 PM.

 
Old 08-08-2008, 01:45 PM   #7
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Re: Chronic Low Iron?

Adding to previous: just spoke with (possibly? incompetant) dr.'s office and found out a bit more:
my iron absorption test was also low.

They keep telling me to go to the ER. Like what are they going to do there? Make me wait 5 hours to tell me that I should keep taking my iron pills? Or to schedule an appt. with my dr.?
Jesus.

Then, spoke with my mom, who happened to inform me that, oh, by the way-I know what you are going through as I have been passing out for years. Also that her blood pressure is LOW. 86/60-something.

I also have low BP, but not THAT low. She said she never was told she was anemic. And just "dealt with it."

She now is being told to eat PICKLES to give her added sodium to help raise her BP. I think she is worse off than she is, but isn't a complainer, and only the squeeky wheel gets the grease now-a-days.

K, so she says to just give it more time, with regards to me. Any thoughts?

 
Old 08-08-2008, 02:35 PM   #8
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Re: Chronic Low Iron?

Hmmm....thoughts.

Well, I tend to agree with the others in that I don't think your hemoglobin values (and ferritin) are going to be the sole reason for your shortness of breath.

When I was at my worst, my hemoglobin was at 11.2 and my ferritin was at 5. I did have episodes of shortness of breath and tachycardia, but it was not constant as you have described. Only if I did some strenuous exertion. BUT....for many years (even while not anemic), I do get episodes of what I call "air hunger" or not being able to take a deep breath (these episodes seem unrelated to any type of physical activity). I have, through trial and error, figured out that they are related to my GERD. When it flares up or I've been eating the wrong foods (even when taking the PPIs) one of my first clues is that I will have episodes that last for weeks of not being able to take a satisfying breath. It was comforting to know that many GERD folks suffer from this and it turns out that when the espophagus is very irritated, it stimulates the cardiac and bronchial nerves that run through that area.

So, I'm thinking this could be your GERD?

As for why your ferritin won't raise on all the iron you are taking--well, I'm not sure. I don't think you are the first person in the world who had trouble absorbing this stuff. Maybe ferrous sulfate is just not the best for you. Have you tried any other types. I know this is the supplement that doctors first recommend but it's not always the best.

I agree that if you went to the hospital, they would not transfuse you. I wouldn't go to the ER either. Not worth it. With your hemoglobin levels being close to normal, you probably wouldn't even be able to get a doctor to give you infusions, but some hematologists will with a ferritin in your range.

I don't know why you are blacking out--some people have episodes of this for no reason (although there is a name for this). I really do believe that it is unrelated to your iron status.

 
Old 08-08-2008, 08:57 PM   #9
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Re: Chronic Low Iron?

okay, I will disagree.... the fatigue could certainly be related to your low ferritin... I have had sob as one of my main symptoms...maybe your hbg is dropping ...did you recently have a heavy period...

I would go get a cardo check to be safe

 
Old 08-08-2008, 10:13 PM   #10
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Re: Chronic Low Iron?

Quote:
I also am on Fentanyl 50, which can affect breathing, but unlikely that it is an issue as I am used to being on it and have been for many months. (Years, actually
Taking a drug for years does not guarantee there won't be any problems down the road. Adverse reactions or side effects can occur at any time, months or years after starting the medication. Think about it: in clinical trials and studies, the drugs are tested for a relatively short period of time on a SELECT group of patients, who have usually just one medical condition (not a severe form of it, either) and meet many other criteria. To me, any results thus obtained are not a guarantee of the drug's safety, and the claims that they had been tested on a sample of a general population and found safe are ridiculous.

The true test comes after the drugs' release for use by the general public in clinical practice. This means people of all ages, with various genetic makeup and personal characteristics, and from varied ethnic backgrounds, many of whom have co-existing diseases, taking the same drug. It is not surprising that many adverse effects of the new drug are discovered during this period. Unfortunately, these adverse reactions go mostly unreported.

Similarily, some people develop drug tolerance after many years of using it. It stops working for them. Some drug's long-term effects on people are not known, because they have never been tested on people. (I take one like that).

Quote:
The SOB has been an on and off thing-meaning I have good days and bad days. I would say that I have been oxygen deprived for years.
I like Christina's suggestion of GERD. This condition often causes shortness of breath. Unfortunately, there are so many others that do the same! You would be surprised to hear what some possible causes of SOB are. I know I was. I researched this topic thoroughly, because not being able to breathe became a big problem for me. I too have had to quit physical activity. I feel great if I make it up the stairs without becoming completely breathless.
I still don't know the cause of my problem, and probably never will. There are just too many likely possibilities. After I had the pulmonary function tests, it was asumed I had asthma. I only took asthma meds briefly and felt no change in my breathing. I also have several other health issues, all of which can cause SOB. A few of my meds can cause it as well.
I hope you'll find a solution and will find something to help you with your breathing.

take care,
flowergirl

 
Old 08-09-2008, 07:25 PM   #11
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Re: Chronic Low Iron?

TiredOTired--I did read your prior post correctly. From my experience I saw 10 doctors due to my illness with multi symptoms because the anemia brought me down so low. Several of my doctors told me that one iron daily is not near enough. People come on this board with the same numbers as you and take 3X the amount of iron that you are on. I took 2X 150 mgs daily myself. You will not overload with such deficiency anytime soon. If you are able to tolerate it, I would suggest at least trying more iron to see if your stores respond. Feeling well with a low ferritin is a very individual experience. We cannot tell you at what level you will feel better but somewhere in the area of 20-30 you should at least begin to show positive progress. A 7 ferritin means you no longer have ANY iron in your stores (bone marrow) for use. That is very low.

I was given oxygen at the time of my colonoscopy. I think that it is standard procedure.

I also believe that ferritin can have many symptoms that are different for everyone just as the anemia symptoms are. A lot of changes go on inside our body and each of us have anemia or lowered stores to a different degree of severity. I would suggest seeing a doctor of internal medicine that can look at the whole picture for you and help you with these symptoms. You should rule out other possible reasons for your symptoms. Many things can begin to overlap, doesn't necessarily mean they are a result of the ferritin. The good thing is that you CAN raise your levels and see what is left over. Then tackle those symptoms that are left over. You might be surprised at what you get rid of as your body heals. Of course I am only a patient and you should consult your PCP to find out what is appropriate for your circumstances. FLFLOWERGIRL

 
Old 08-11-2008, 03:33 PM   #12
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Re: Chronic Low Iron?

Adding some replies/facts:

I didn't end up going to the ER, as I just really didn't want to. Also, I have found that when I am at home, and not at work, I feel better.

I also have anxiety symptoms, and I believe some of the tightness in my chest is due to that.

I also know that when I am having a bad day at work (physically), most of my coworkers do not know what I am dealing with, and still treat me the same-which means they expect a lot of me. I am sure this is adding to the problem.

However, I wondered if one of you knew what the test was that my dr. was talking about when he said that my iron absorption test came back as low as well. What does that mean when you don't absorb iron as well?

With the following, is it still simply iron deficiency anemia?:
low hgb---lowest I knew of was in the 9-range (although in the past, I never asked numbers). It is now back up to 11.
low ferritin. It is now up to 7, didn't ever have it tested when my hgb was lowest, but I am sure it was lower then too.
I was told my red blood cells are low in count and small in size.
I don't know the name of the test or the result number with regards to the low absorption of iron--anyone?

I have other health problems that have overlapping symptoms, and I also believe that my dr. is annoyed with me asking for additional tests. I think he simply wants me to "take my iron and shut up."

I have lower bp, high bad cholesterol-in the 200s, can't recall, but decent good cholesterol-so dr. didn't want me to start cholesterol meds yet, dizziness particularly upon standing from sitting or laying down, calf pain-sometimes severe. I am short of breath from simple tasks, oh, and almost forgot to say that when I was out in the extreme heat-prior to knowing I was very anemic and sick, I started to have symptoms of heat stroke. I ended up having to stop and catch my breath, went inside, got totally dizzy and passed out. I was asleep for hours. I was hydrated but felt as one feels when they are left out in the desert without water. (P.S. this happened in the Phoenix pre-summer heat-but I had an umbrella over my head, and water to my lips nearly the whole time!)

This sound like iron deficiency anemia?

I think my dr. simply wants to "wait and see" with regards to my health. I don't have a problem with knowing that it takes time for iron stores to be brought up, and for oxygen to be back in blood. I just want to know if there is anything else to concern myself with. In my opinion, having problems absorbing iron is something to investigate--no?
Also, why are red blood cells small?
Thanks for your replies.

 
Old 08-12-2008, 03:11 PM   #13
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Re: Chronic Low Iron?

Quote:
Originally Posted by TiredOTired View Post
Adding some replies/facts:


However, I wondered if one of you knew what the test was that my dr. was talking about when he said that my iron absorption test came back as low as well. What does that mean when you don't absorb iron as well?
TOT,

There is no test that exists which tells how well you absorb iron. I think your doctor was either commenting on your %iron saturation or your ferritin and then trying to put this into simplistic terms for you (which he didn't need to do). Oh, if they could only so easily tell if a person absorbs iron or not. They cannot tell this. So, the doctor has looked at your labs and has determined that you don't have much iron stored anywhere.

Quote:
With the following, is it still simply iron deficiency anemia?:
low hgb---lowest I knew of was in the 9-range (although in the past, I never asked numbers). It is now back up to 11.
low ferritin. It is now up to 7, didn't ever have it tested when my hgb was lowest, but I am sure it was lower then too.
I was told my red blood cells are low in count and small in size.
I don't know the name of the test or the result number with regards to the low absorption of iron--anyone?
Yes, this still looks like iron deficiency anemia. Especially with the low count of RBCs and the size of them. Very diagnostic of IDA.


Quote:
I have lower bp, high bad cholesterol-in the 200s, can't recall, but decent good cholesterol-so dr. didn't want me to start cholesterol meds yet, dizziness particularly upon standing from sitting or laying down, calf pain-sometimes severe. I am short of breath from simple tasks, oh, and almost forgot to say that when I was out in the extreme heat-prior to knowing I was very anemic and sick, I started to have symptoms of heat stroke. I ended up having to stop and catch my breath, went inside, got totally dizzy and passed out. I was asleep for hours. I was hydrated but felt as one feels when they are left out in the desert without water. (P.S. this happened in the Phoenix pre-summer heat-but I had an umbrella over my head, and water to my lips nearly the whole time!)

This sound like iron deficiency anemia?
Quite honestly, most of your stuff does not really fit IDA. Sure, your fatigue does and some shortness of breath. You don't usually see "passing out" in anemia until someone is around 8-9 hemoglobin and even then it doesn't happen much. As for the heat intolerance, no that is also not IDA. Have you ever been evaluated for POTS (postural orthostatic hypotension)? Many of its symptoms overlap with anemia, panic disorder, etc.

Quote:
I think my dr. simply wants to "wait and see" with regards to my health. I don't have a problem with knowing that it takes time for iron stores to be brought up, and for oxygen to be back in blood. I just want to know if there is anything else to concern myself with. In my opinion, having problems absorbing iron is something to investigate--no?
Also, why are red blood cells small?
Thanks for your replies
Your case doesn't sound like straightforward anemia. It does sound like something else is going on. But, until you 100% fix the anemia, you are never going to see what symptoms are "leftover" to investigate. And the red blood cells are small because you are iron deficient.

 
Old 08-12-2008, 03:12 PM   #14
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Re: Chronic Low Iron?

Quote:
Originally Posted by TiredOTired View Post
I didn't end up going to the ER, as I just really didn't want to. Also, I have found that when I am at home, and not at work, I feel better.
I meant to add in my last post: The above statement is CLASSIC anxiety.

 
Old 08-12-2008, 05:21 PM   #15
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Re: Chronic Low Iron?

Thanks for your replies. It gave some good info. I do know that I am dealing with some mega-serious GERD. It has been somethin awful this week.

I think I am feeling a bit better since starting my iron. At least I was breathing easier this week. Perhaps I will just give it time.

I definitely have anxiety. No question about that! I just know that there is a difference between the way I feel with anxiety and the way I feel with anemia with regards to breathing and one is different than the other.

Anyway, got to run, will add more later. Thanks again.

 
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