My wife is 35 and in very good phyiscal condition. She's been a regular blood donor for years and never had a problem with the basic iron test they do before you can give blood.
About 2 years ago, she started having acid reflux issues. She was put on daily Prilosec by her DR. In Sept. 2007, she tried to give blood and was told her iron was too low. Blood test confirmed, so DR put her on birth control with an iron supplement for 3 months. In Jan 2008, blood test again showed low iron and animea. DR put her on an OTC iron supplement and sent her to a hemotologist. Hemo DR looked at blood work and sent her to a Gastro DR for an upper (endo) and lower (colon) scope.
We just can back from the scoping and both were clear. Thanks to this forum, we were prepared for that result. Everything we read says that animea is caused by something else. Here are the numbers from her most recent blood test. Please tell us what you think and what is normally done from here. She goes back to her regular DR in a couple of weeks. We are hoping for something more from the DR than "just keep taking your iron pills".
Sorry, but I didn't know which number were relevent, except for the ferritin number.
Any thought on her condiition are much appreciated
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ChristineVA
02-04-2008, 08:32 AM
Well, your wife certainly has iron deficiency anemia.
In the absence of GI issues, which you've ruled out, the most common cause is the menstrual flow. But it seems as though you've worked on that.
How long has she been on the iron? It takes a LONG time to get the ferritin levels back up. Many, many months to years.
One thing that no doctor will tell you (because there have been no studies done) is that if she is taking medication for GERD, it *could* be impacting her absorption of iron. Studies have already been done to show that it impacts calcium absorption and causes a higher rate of hip fractures in people taking the PPI medications. Most nutrients require stomach acid in order to be pulled from teh food and absorbed. If these medications inhibit calcium, they most likely inhibit iron absorption.
I only ran across ONE study on the internet that discussed this. There were a group of men who were anemic for unknown reasons (they also happened to be taking Prilosec). They were given iron supplementation and their anemia did not improve. After they removed the Prilosec and continued the iron supplementation, they rapidly improved. So, the Prilosec-type medications probably have some impact on iron absorption for supplements.
Having said all that, I do take Prilosec daily. I am also on iron supplements. It has taken a year, but my ferritin has gone from 5 to 29. So I *am* absorbing but not very quickly in my opinion. Probably due to the meds.
IamUnique
02-04-2008, 11:29 AM
Just a thought but I read that stomach acid is necessary for absorbing Iron and B12. The Prilosec could be part of the cause.
Good luck with everything.
glocker
02-04-2008, 04:31 PM
[QUOTE=ChristineVA;3425186]Well, your wife certainly has iron deficiency anemia.
How long has she been on the iron?
QUOTE]
The Hemotologist put her on the iron about one month ago. You are also correct that the menstrual flow is not the issue.
We also thought it might be the PPI meds, but then we got stuck in this loop. If you stop the PPI and the iron goes up but then the reflux makes the day terrible, have you really gained anything.
She decided to alter her diet even further after the "clense" provided by the colonoscopy prep. Maybe she can think about stopping the PPI again. She sees the Hemo DR again in 2 weeks.
So I guess it is a possibility that we may have to live with "Sorry, don't know for now, just keep taking your iron pills and we will test your blood again in a few months."
ChristineVA
02-04-2008, 06:36 PM
[QUOTE=ChristineVA;3425186]Well, your wife certainly has iron deficiency anemia.
How long has she been on the iron?
QUOTE]
The Hemotologist put her on the iron about one month ago. You are also correct that the menstrual flow is not the issue.
We also thought it might be the PPI meds, but then we got stuck in this loop. If you stop the PPI and the iron goes up but then the reflux makes the day terrible, have you really gained anything.
She decided to alter her diet even further after the "clense" provided by the colonoscopy prep. Maybe she can think about stopping the PPI again. She sees the Hemo DR again in 2 weeks.
So I guess it is a possibility that we may have to live with "Sorry, don't know for now, just keep taking your iron pills and we will test your blood again in a few months."
Regarding the PPIs--I was never really able to stop them altogether (same issues of feeling terrible); however, I was definitely able to take less of the medication than my doctor prescribes and do just fine. Rather than take 40 mg of the PPI per day, I can successfully take half of that. I figure that *some* stomach acid is better than *no* stomach acid.
glocker
02-04-2008, 08:02 PM
Interesting idea about lowering the amount of PPI.
Instead of posting a new thread, hopefully someone will see the following new question:
While reading the other postings for the different ways people are taking the iron pills (iron + vitC + lysine), I noticed that some people were taking them on an empty stomach in the morning.
My wife's Hemo DR told her to take the iron right after her biggest meal. Any thoughts? Why are some taking on an empty stomach?
thanks
FLFLOWERGIRL
02-04-2008, 09:22 PM
This is recommended due to the possibility of GI upset. Iron is very harsh for many people. By doing so decreases the amount of iron absorbed (up to 50-65%), and only a small amount is absorbed daily at that. So we are trying to take iron supplements on an empty stomach for Max absorption. I took iron on an empty stomach in the beginning and had enteritis for 3 months and ended up in the ER.
PS--I also take PPI's Nexium 40 daily and no way can I stop or cut back. It is very interesting how fixing one problem causes another. FLFLOWERGIRL:)
