So I went to the doctor about my fatigue. He did a CBC. Here is the results. The date of this is 9-08-2007.

WBC Low 4.25 (RR 4.8 - 10.8)
RBC low 3.87 (RR 4.2 - 5.4)
Hemoglobin low 10.3 (RR 12.0 - 16.0)
hematocrit low 31.8 (RR 37.0 - 47.0)
MCH Low 26.6 (RR 37-34)
RDW High 15.2 (RR 27 - 34)
C02 low 20 (RR 22 - 29)

Doctor ordered more blood work, and a stool card on 9-18-2007. Here is the results from this blood work.

Ferritin- Low 4 (RR 13 - 150)
Iron- Low 25 (RR 30-160)
TIBC- High 455 (RR 228-428)
Occult stool- negative

I went back to the doctor on 9-24-2007. He old me I have IDA, and put me on an iron pill. And more blood work. I had this round of blood work done on 9-27-2007. I went to the hospital to get the results today because I didn't want to wait on the doctor.

Ferritin- Low 6
Iron- High- 175
TICB- High 466

I started my iron pills on 9-24. Had this round on blood work on 9-27. 4 days seems like a short time for my iron to go up that much! I did just get off my period when I had the second round of blood work. Would that have any effect on the results? I'm worried that I don't have IDA. Even with my Iron up I still feel bad.

Any advice? What do I need to ask my doctor? What other test can I ask for to really find out the truth?

Thanks SO much!!!!

You still have IDA. Even though your serum iron test was high, that is because you were taking the supplements. Serum iron doesn't mean a darn thing really--it's just a measure of how much iron was circulating in your bloodstream at the moment you had the test. It goes up and down all day depending on what you eat. Not quite sure why the docs even run that anymore but I guess it's part of that "iron panel."

Your other numbers still indicate iron deficiency. Ferritin is *the* most important test for checking your iron status. At 6, you are still horribly low. That is good though that it even came up 2 points. Probably had a lot to do with the supplements and the fact that you haven't had your period in awhile. Keep up with the supplements and see where you are in another month or two. You will still feel bad until your ferritin comes WAY up. And I would bet that even with your small improvement, you are probably still anemic.

Thanks for your reply.

I'm starting to think I need to ask for the IV. The supplements really hurt my tummy, and have made me feel really sick.

Do you think a Ferritin of 6 is low enough for the IV?

tiffany1496--The way to tell that you are anemic is when the HGB and HCT are below range on lab results. Those two numbers are the indicators used by the doctors and Ferritin is the storage of iron in your body. Be sure to get copies of your labs and start a file.

Your periods will effect the test results, with supplements you might be able to stay at the same numbers and not drop. Without the supplements is usually when you start to drop blood counts. The Ferritin can take up to a year to fill up completely. But you have responded ~already~ quite well. That is a real good sign. IV iron is "usually" reserved for when a patient doesn't fill these stores on their own, or they do not absorb well. With numbers such as yours you should be able to correct the anemia fairly soon (as in a couple of months) if on a good dose of iron and eating iron rich foods.

The blood occult test only shows bleeding at the time of the test. I would want to have a colonoscopy and endoscopy to check for internal bleeding. It's just to be on the safe side, maybe not necessary. This is something that is routine when you have a low Ferritin and are anemic even if you have heavy periods. You are going to feel bad for a long time but it does get better.

As far as the supplements go, they hurt some of us like heck! My GI doc put me on one for GI upset, poly iron 150 2X daily which gives me 300 mgs of elemental iron per day. I can even take it on an empty stomach, it's great for me. This is a script but you can also ask for it OTC at the pharmacy and they will show you the generic type. Call your doctor and see what they can prescribe for you. You just have to keep trying until you find one that is right for you.

As for Ferritin anything under the charts value is extremely low. The Hematologist reserves the IV for severe cases. Some will give this based on Ferritin only but that is usually if they are not absorbing well. When I had issues the Hematologist just said to take less. Well, that made my blood drop again. I wouldn't take less or with food because this decreases your progress by far. You have to find something that you CAN handle that WILL give you the right amount. Feel better soon! FLFLOWERGIRL:)

Thanks for all the good info!!

So I guess I need to talk to my doctor about colonoscopy and endoscopy. I wonder why he didn't even talk to me about them. :confused: What is the best way to ask him for the test? I don't want to insult him.

Can anyone tell me what the TIBC is? And why mine is going up?

Thanks for all the good info!!

So I guess I need to talk to my doctor about colonoscopy and endoscopy. I wonder why he didn't even talk to me about them. :confused: What is the best way to ask him for the test? I don't want to insult him.

Can anyone tell me what the TIBC is? And why mine is going up?

He may have not ordered teh colonoscopy/endoscopy based on your age. Because I was 43 and in that "gray" area of needing one, my doctor pushed for it. My GI told me that even with the anemia, he would not feel a colonoscopy was necessary if I was around 30. So, if you are young, the chances of you having a GI bleed are rare. The older you get, the higher the chance.

The TIBC, I think, is the Transferrin Iron Binding Capacity. I can't explain it but know that in iron deficiency anemia it gets elevated. I would concern yourself with the raise on that one. It has a wide range and even lab error rates could account for the difference. This is one of those tests where it's going to take some time to see the number go down.

My anemia must have come on slowly and I caught it right at the beginning. I have IDA but my red blood cells had only just started shrinking and my TIBC was still in the normal range. The longer you go on with the iron deficiency and anemia the more these numbers will get worse.

Hi everyone, I just wanted to put in my two cents regarding the iron supliments. I have stopped taking the prescription pills and I am now taking a liquid form called Floradix it is from the health food store or on line. It does have lower amounts of iron but it is easily absorbed and it is not constipating. I called the company to find out if the dose could be increased like the doctor had prescribed and they said it was no problem. All this said, I do have to warn you that it is a bit costly. I hope this helps and I hope everyone will recover quickly.

Laura

Hi everyone, I just wanted to put in my two cents regarding the iron supliments. I have stopped taking the prescription pills and I am now taking a liquid form called Floradix it is from the health food store or on line. It does have lower amounts of iron but it is easily absorbed and it is not constipating. I called the company to find out if the dose could be increased like the doctor had prescribed and they said it was no problem. All this said, I do have to warn you that it is a bit costly. I hope this helps and I hope everyone will recover quickly.

Laura

I did try this also and I found that it was staining my teeth!! I don't know why but it is a problem for some people it seems. They say if you drink it through a straw this helps.

Also, it is a very low dose but I think it could also be good to add in throughout the day even when you are taking higher doses of other iron.

Thanks so much for your replies everyone!

ChristineVA- I am only 25. So that maybe why he didnt order the colonoscopy/endoscopy. I may talk to him about it. I really think I need an endoscopy anyways. I have had tummy problems before.

I'm really thinking about talking to him about the IV. I really feel like it would help me. Anemia seems to be taking over my life. :( I just don't feel like doing anything any more. And its causing problems at home.
The doctor put me on an antidepressant. I do think I'm depressed, and I think its because of the way I feel and the problems its causing at home (with my husband, if you know what I mean).

The doctor also ordered these test:
Urine timed protein electrophoresis and
Protein Electrophoresis
Anyone know what these test are for?? I will be going to the hospital tomorrow to get a copy of the results.

How often should my doctor check my Ferritin and Iron levels?

Also I have not had a bowel movement in 4 days. Is this normal?

Thanks so much!!

Thanks so much for your replies everyone!

ChristineVA- I am only 25. So that maybe why he didnt order the colonoscopy/endoscopy. I may talk to him about it. I really think I need an endoscopy anyways. I have had tummy problems before.

I'm really thinking about talking to him about the IV. I really feel like it would help me. Anemia seems to be taking over my life. :( I just don't feel like doing anything any more. And its causing problems at home.
The doctor put me on an antidepressant. I do think I'm depressed, and I think its because of the way I feel and the problems its causing at home (with my husband, if you know what I mean).

The doctor also ordered these test:
Urine timed protein electrophoresis and
Protein Electrophoresis
Anyone know what these test are for?? I will be going to the hospital tomorrow to get a copy of the results.

How often should my doctor check my Ferritin and Iron levels?

Also I have not had a bowel movement in 4 days. Is this normal?

Thanks so much!!

Okay, I can see why he wouldn't order the colonoscopy. It would be extremely rare for a person in your age group to have a colon cancer. There can be other sources of colon bleeding, but if you are lacking any symptoms then I can see why no colonoscopy.

Please be careful with iron IV. I know that this is the "answer" for many people. But like the other poster pointed out, it is a last resort. IV iron can cause allergic reactions and it has its own side effects depending on what they use. Some of them can make you feel really bad for a week after the treatment. Oftentimes, they have to administer Benedryl with the IV iron because many people react to the IV iron. This is not something you want to do lightly--it is a last resort. If you can get some improvement with the supplements, that is the way you should go.

As for the antidepressents, they cause many of their own side effects. Constipation is one (the iron will do this too). When I took antidepressents it slowed down everything for me. I found it intolerable. I believe antidepressents have their place and are a godsend for those who need them. I get annoyed that general practictioners are loosely prescribing them. I would question why he is giving them to you. Of course, you are depressed, you have anemia. Depression is a side effect of anemia.

As for your blood tests, I've never heard of them before so I can't help you on that.

I found info on electrophoresis. Can't comprehend the info right now, but here's a link: http://www.labtestsonline.org/understanding/analytes/electrophoresis/test.html. Btw, this is a fabulous site and moderator-approved. :)

Offhand, it sounds like he's looking for a kidney problem. Has your dr ever mentioned that?

You might consider taking 200-400mg of magnesium citrate to help combat your constipation. Its easily absorbable and most people find it easier on their stomachs than other forms of magnesium. And, of course, drink lots of water.

Tiffany1496--I agree, you do have to be careful what the doctors prescribe to you. Many PCP's are extremely willing to give meds. They had me on Xanax due to anxiety from my anemia. I kept asking about the usage of it and they just said you can even take more. I didn't need more! When I went off it my body really felt it. I would never let another doctor do that to me again. Next, they wanted me to take an antidepressant for anxiety to replace this. I feel so much better getting off the medication. Mind you some people do need it, that is correct. I only had/have anxiety at doctor's apts. You can LOL exercise to feel better or go for walks if you can, it really helps to get through this. Try not to worry TOO much that just stresses you more and that is really hard on your body.

As far as Ferritin testing and iron, the docs usually test the HGB and HCT with or without a CBC to see where your anemia is and track that. Sometimes they add the Ferritin or an anemia package which I believe includes Ferritin, it just depends on the doctor while others only use a CBC. Ferritin takes soooooo long to build they are not too concerned as to it's progress. Now that I am no longer anemic my Hematologist will retest my Ferritin in 6 months to give you some idea. Too many test are not necessary unless you are really feeling very bad, then I would say once a month and that's a lot, just so you know. I had to do this at one point in two weeks time by the Hematologist.

Keep us posted on your test results. Feel better! FLFLOWERGIRL:)