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    Old 01-26-2005, 06:41 PM   #1
    Lorton
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    Anemia Questions....

    I am a 45 yr old woman and I have recently been diagnosed with iron def anemia although I think I have had the problem for the last few years as I have been struggling with severe fatigue, weakness, rapid heart rate, dizziness, and shortness of breath for quite some time. It has gotten worse since now I am losing my hair, have itchy skin, sores that do not heal very fast, and some other irritating symptoms. My most recent blood test had the following out of range:

    Hemoglobin 8.8
    Hematocrit 27.7
    MCV 70
    MCH 22.2
    MCHC 31.7
    RDW 18.0
    Platelets 471
    Iron Bind 451
    UIBC 420
    Iron, Serum 31
    Iron Sat 7
    Ferritin 5

    My WBC and RBC levels are within normal range along with my B12 and folate. I am currently under the care of a GI doctor for chronic gastritis, GERD, and I had 6 colon polyps removed (benign). My Dr. thinks I may be bleeding somewhere but to date, I have had an endoscopy, colonoscopy, and barium tests of both the large and small bowel and all tests have come back negative. She has now scheduled me for a endoscopy capsule test next week. It is an odd test because you swallow a capsule that has a very tiny camera in it. You wear a small machine around your waist and for 8 hours the camera takes pictures as it is traveling through your upper and lower GI tract. Not sure what the next step is if this test comes back negative. I know I cannot continue to live like this. Every day is a struggle, some days worse than others. My Dr. suggested I see my Gyn to rule out any female problems even though I have always been problem/symptom free in that area. So, I have an appt. with a Gyn next week also. So...my questions are for anyone out there that may know:

    1. If this GI doctor can't find the problem, is there another kind of specialist I should see?

    2. Is it possible that a reason for my anemia may never be found?

    3. Why would my platelet count be higher than normal if everything else is lower than normal? What relationship do platelets have with iron deficiency?

    4. This is a weird question, I know...if camera's have been placed inside my upper and lower GI tract and no bleeds are detected, is it possible for an organ to bleed from the outside where a camera can't see? If so, is there another test that can show a bleed from anywhere in the body?

    5. I am currently taking 80mg of Nexium per day for my Gerd. I read somewhere on the internet that high or prolonged doses of acid reducers/prohibitors can possibly affect your iron levels. Has anyone heard this and is it true?

    Anyone out there that has some good insight into all of this....I would be eternally grateful if you could share your wealth of knowledge with me!

    Thank you!
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    Old 01-26-2005, 10:56 PM   #2
    Marimac
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    Re: Anemia Questions....

    Those are all very good questions. Generally, even microscopic bleeding can build up and cause anemia. The high platlet count indicates that you are bleeding some where or that the red blood cells are being destroyed too fast and that is triggering the platelets to form to try to stop the bleeding. My guess and this IS only a guess, is that you are or have been seeping blood from the GERD and that due to the aging process your red blood cell production is kind of behind. IF you can picture a conveyer belt of blood cell manufacturing going on and although your body is doing its best to keep up with demand, it is not quite making it. The spleen could also be involved in destroying your red cells too soon as well. But, take one step at a time so that you do not get treatment for the wrong disease. If you are seeping blood from any place at all and are still having periods as well, you could be losing more red blood cells than your body can produce efficiently. What I mean is that the cells are adequate in number but do not have sufficient oxygen density molecules and therefore the symptoms of fatigue etc, that you describe. If you have blood seepage from GERD that can be addressed better with better medication if that is the case. If not, then the doctor can move on to treat the next possible problem.

     
    Old 01-26-2005, 11:22 PM   #3
    Lorton
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    Re: Anemia Questions....

    Thank you Marimac! I appreciate any advice I can get right now. The GERD has been an annoying problem that I have had for about 5 years. The problem now is that I am maxed out on the medication used to treat it. Over time, she has steadily increased my dosage which helped each time but then it seems like my stomach becomes immune to the medication over time and I need more. According to my GI Dr., the only next step to treat this severe GERD is with surgery and this type of surgery is very major. They only do this type of surgery after every single other avenue is explored and even then...they hesitate. It requires opening your chest to gain access to the esophogus and they somehow re-route the plumbing (I don't know the technical details). And, the success rate for this surgery is only about 50-60%, last time I researched it anyways. Not good enough odds for me to undergo that major of a surgery.
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    Old 01-27-2005, 12:02 PM   #4
    turl
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    Re: Anemia Questions....

    Even with taking iron supplements, you're not feeling any better? I don't know much about iron def., but I do know a little about B12 def. I've since learned (after going mis-diagnosed) that serum levels of B12 don't mean much, and the other usual "sign"--a high MCV can be masked by a co-occuring iron def. ALSO, it is known that acid-suppressors cause B12 to be malabsorbed, so regardless, in light of your long term Nexium usage, I'd be taking at least 1000 mcg daily of B12 (preferrably in the form of methylcobalamin if you can get it).

    And while many things can cause the symptoms you mention, a deficiency in certain B vitamins can also be the cause......worth investigating.

    Good luck to you.
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