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Old 01-17-2013, 06:01 AM   #1
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Unhappy Low Low Low

I had gastric bypass in 2004 and a revision/hernia repair in 2010. I have battled anemia since my initial bypass.

However my primary ordered labs and just recently got them back within the last few weeks. She called concerned bc my ferritin was a "4" and she stated that it should at least be "45". She also indicated that my hematocrit and hemoglobin were both low as well.

Throughout even pregnancies, my numbers have never been this low.

She has thrown a few things around like an iron transfusion to sending me to a hematologist. However instead she started me on ion pills 3x a day, and to come back into her office in 2 weeks ( which will be Tuesday )...and get my "finger *****ed" and recheck things in the office.

Since then I have seen my gynecologist for my annual exam. I forwarded the labs to her. We ruled out heavy menstration as a source of the blood loss, but she gave me a lab slip and said that I should get a stool sample checked. She talked and talked about how I should not just take tons more iron to get the numbers up.....bc all that is doing is masking the initial problem vs treating the cause of everything. She's thinking we should start ruling out the GI and then go to bone marrow?
She gave me the lab slip and wants me to continue my treatment with my primary so it's all under one roof ....but to push to have the testing done. I could get the stool sample testing done and have the results sent to my primary by my appointment Tuesday so that's one more thing ruled out possibly.

What do you all think?
Has anyone else had the low iron mixed with low red blood cells? She indicated that the count is low but also the size of the red blood cells are on the smaller side as well...........


My symptoms include fatigue constantly, freezing feet all the time, headaches, bruise a lot, dizziness when getting up or down a lot...I can't even drive more than a 20 min distance by myself bc ill get so sleepy and fall asleep or have to pull over.

I'm only 36.

 
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Old 01-17-2013, 06:48 AM   #2
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Re: Low Low Low

I think that people that have gastric bypass seem to have an issue absorbing iron because food intake is limited and that could very well be the cause. I think that it's awesome you have Dr's on your side willing to go the mile and rule out any other problem. Then again I am no Dr. so this is just my opinion but it's something to think about and mention. Nutritional deficiencies are common with gastric bypass. It's normal for low counts and cells to be abnormal, smaller, bigger, weird shaped. Our body doesn't produce new ones but once every 3 months so that in itself will take a bit to correct just due to the fact that your running low on everything you need for that to happen. That really isn't abnormal with anemia.

All of your symptoms seem to fall in place with anemia as well but I want to throw in that maybe you should have your B12 checked too, something that seems to go hand in hand with anemia and you don't want to be running low on it either. Take your iron like prescribed and drink with a nice big glass or orange juice, it helps it to absorb better. Our bodies can only take so much iron at once. I would guess you should start noticing a difference in a few weeks depending on how well your absorbing, it's a long road.

Welcome to the icky anemia club. Sorry we had to meet like this! Best wishes!

P.S. I'm only 34....anemia is not age restricted. It sucks, but I am thankful that you have Dr's working with you not against you.

Wanted to add they are right about masking the problem anemia is just a symptom, but it is a symptom of gastric bypass too. Don't be to worried, I personally would say it's nutritional and to start there.

Last edited by Heatherx5; 01-17-2013 at 06:53 AM.

 
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Old 01-17-2013, 06:55 AM   #3
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Re: Low Low Low

Yeah I've had gastric for many many years now and it's never been like this. My primary is a gastric patient herself so for her to be worried about the blood loss, makes me worry too.

I just don't want to be blown off as go you're gastric that's why, when a ton of gastric people don't suffer this way and I haven't felt this bad ever.

B12 and vit D are good .

 
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Old 01-17-2013, 06:57 AM   #4
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Re: Low Low Low

Quote:
Originally Posted by Officerswife View Post
Yeah I've had gastric for many many years now and it's never been like this. My primary is a gastric patient herself so for her to be worried about the blood loss, makes me worry too.

I just don't want to be blown off as go you're gastric that's why, when a ton of gastric people don't suffer this way and I haven't felt this bad ever.

B12 and vit D are good .
You can develop anemia years after gastric bypass. I'm definitely not trying to blow you off at all. Just pointing out some obvious stuff I have learned over the last year. I'm glad your Dr's aren't either.

Last edited by Heatherx5; 01-17-2013 at 07:00 AM.

 
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Old 01-17-2013, 07:03 AM   #5
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Re: Low Low Low

Thanks.

And yes, I've been battling anemia since I had gastric.

My whole point was that its different.

Sorry just struck a nerve lol

Ty for your time.

Last edited by Officerswife; 01-17-2013 at 07:30 AM.

 
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Old 01-17-2013, 11:19 AM   #6
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Re: Low Low Low

Well anemia is anemia and I can tell you I have had every single symptom you have listed and then some. I chewed ice till my teeth broke. It doesn't feel good and it can be very frustrating. I saw what you said about bone marrow too and was just trying to think of more positive things because to me that would be very scary, my Dr. hasn't even suggested checking that yet. I would probably freak out and panic. I hope that whatever is causing it is found. Maybe someone else who has had gastric bypass will see this and be able to offer you a little more insight.

 
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Old 01-18-2013, 04:19 PM   #7
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Re: Low Low Low

Hi there...

I'm three years out from bypass and I recently was diagnosed with anemia... my ferritin was 5, but iron was also low along with low red blood cells, hemoglobin and hematocrit.

At this point, for you it could just very well be due to the malabsorption of iron... that's the assumption we're operating under for me at this point. I had an iron infusion about 5 weeks ago and still feel awful... pretty much exactly how you describe with the dizziness, coldness, etc. Since it's been about 5 weeks since the infusion for me, I just asked my hematologist if I should still be feeling this dizziness and she said the iron usually takes a good 2 months to make a difference... but she said we could check a CBC to see if my hemoglobin was coming up. Sadly, when that was tested for me yesterday, it actually had done DOWN since the infusion.

From what my hematologist says, this is very common for people in our situation so I hope your doctor continues to take this seriously and gets you the iron infusion. From what I understand, most of the time that helps tremendously (eventually)... most people won't need another infusion for a long time. They can supplement iron orally for a period and eventually might need another infusion, but can usually get by for a long period before numbers drop low enough to cause issues again.

Keep up on it because from what I've experienced on this so far is that once it starts to go bad, it goes south FAST and it's hard to stop. When I first started feeling a little tired over 6 months ago, I upped my iron supplements bigtime and even doing that, by the next time my blood was checked, the numbers had totally tanked. It was like once it started going, nothing was going to stop it...

So take it seriously. Good luck...


- tori

Last edited by vslane68; 01-18-2013 at 04:20 PM.

 
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Old 01-18-2013, 04:31 PM   #8
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Re: Low Low Low

Oh, one more thing... the reason us bypass peeps have trouble with iron post-bypass isn't necessarily due to the food we eat or don't eat, but due to the bypass of the duodenum which is the primary absorption site for iron in the intestine. The remaining intestine can absorb some iron... some of us just do it better than others. More studies are showing that more and more bypass patients experience anemia to some extent, and obviously it's usually the women who still menstruate who seem to suffer the most.

Many docs will try to get you to eat handfuls of various types of iron supplements and the bottomline is that you can take as much orally as you want, but when only a tiny fraction of what you consume is actually being absorb/utilized, it becomes a losing battle. Add to that the fact that many oral iron supplements cause major gastric distress in high amounts (thank goodness for carbonyl and heme iron supplements, though!), and that seems an unworkable solution.

All the research I've read in addition to the countless discussions I've had now with my hematologist bring me back to one conclusion... must infuse iron to try to get back to near-normal state, then do oral supplements as long as possible until other options are again required.

Hang in there... I'm in the midst of it still too (this dizziness and coldness SUCKS!), but hope all I've been told is the truth! It WILL GET BETTER!!


- tori

Last edited by vslane68; 01-18-2013 at 04:33 PM.

 
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Old 01-21-2013, 07:05 PM   #9
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Re: Low Low Low

Have they done any testing for you for bleeding or just putting you under the assumption of a gastric patient and pumping you with iron? I've been told not to do that, even as a gastric patient. That just "getting iron numbers up" is a bad idea bc it's just masking the Initial problem and assuming its bc of gastric surgery could be a very dangerous assumption.
Hope you feel better!
I go in to my primary tomorrow. We have ruled out heavy periods for loss of blood through my gyno last week and she ordered a stool sample test to see if there are trace amounts of blood loss there as well.
Hopefully I get the answers I need! :-( I just won't take "oh you're gastric" as an acceptable answer for me personally.

 
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Old 01-21-2013, 07:45 PM   #10
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Re: Low Low Low

We haven't tested for anything else because we can see the trend of iron going down over periods of time for me... it wasn't like it just suddenly bottomed out. However, once it got to a certain point, it DID just drop despite the increased supplementation... but feedback from a ton of others on RNY forum I'm on tells a similar story. I'm also at an age where I'm seeing increased weirdness with my periods (increased severity of bleeding, shortened cycles, etc), so it's not unreasonable to look at the big picture and see this as a logical conclusion.

Per my hematologist, they will usually talk about trends and ask about abnormalities in stool (bleeding, etc) and other issues (past ulcers, colitis, etc), but for the first time will initially administer iron without too much time and expense put into digging up a cause that may or may not be found. If it happens again or if the iron levels don't come up or do come up and then drop again quickly, at that point full attention is put into work-ups to determine underlying cause.

I know my situation and was comfortable with this approach but you have to be comfortable before you move forward... whatever you do, make sure you don't wait too long before some action is taken, one way or another because it can get very serious! Good luck to you...

 
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Old 01-21-2013, 07:48 PM   #11
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Re: Low Low Low

We haven't tested for anything else because we can see the trend of iron going down over periods of time for me... it wasn't like it just suddenly bottomed out. However, once it got to a certain point, it DID just drop despite the increased supplementation... but feedback from a ton of others on RNY forum I'm on tells a similar story. I'm also at an age where I'm seeing increased weirdness with my periods (increased severity of bleeding, shortened cycles, etc), so it's not unreasonable to look at the big picture and see this as a logical conclusion.

Per my hematologist, they will usually talk about trends and ask about abnormalities in stool (bleeding, etc) and other issues (past ulcers, colitis, etc. as well as family history for these things), but for the first time will initially administer iron without too much time and expense put into digging up a cause that may or may not be found. If it happens again or if the iron levels don't come up or do come up and then drop again quickly, at that point full attention is put into work-ups to pinpoint underlying causality to the best of their ability.

I know my situation and was comfortable with this approach, but you have to be comfortable before you move forward... whatever you do, make sure you don't wait too long before some action is taken, one way or another because it can get very serious! Good luck to you...

 
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