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    Old 05-10-2008, 07:47 PM   #1
    abeliarose
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    New Here and Iron Deficient with Questions

    I am new here and hoping for some advice. I have been in menopause since age 51. This past Oct, at age 53, I had a hysterectormy (LAVH) for fibroids. The fibroids were causing pressure symptoms, only miniscule spotting. I only lost about 150 cc of blood during the surgery and felt I was recovering well enough to resume exercising. In January I donated blood (standard pint), the first donation I'd made in over 20 yrs.. Over the following weeks I began to feel horrible. Extreme fatigue, short of breath with exertion, restless leggs, insomnia, muscle/joint pain..etc. Tried to donate blood in March and was told "no", my hematocrit was 35. I saw a doctor who immediately started me on Poly Iron 150 capsules 3X a day, gave me a b12 shot and ordered blood tests with the following results flagged as out of range:
    Iron: 30
    %SAT: 7
    Hemoglobin: 11.4L
    MCHC: 29.3L
    RDW: 14.7H
    EOS: 7H - I have bad allergies
    Ferritin: 5

    The nurse gave me the b12 shot before my blood was drawn and my b12 level was over 2000. I was retested a week later and it was still high at 931.
    My problem appears to me to be iron deficiency. Could a single blood donation deplete my iron stores that much? My CBC before the surgery in Oct. was "normal". I just had a colonoscopy in Jan. 2007, it was negative. I have taken Aciphex (PPI) daily for years. I am due to see my doctor this Tuesday and wonder what I should expect/ask from her in the way of follow-up.

    She also tested my thyroid, the results are "normal" but someone on the thyroid board said that they are not that good, so I wonder if I have two entirely separte issues going on.

    TSH: 2.877
    Free T4: .91
    T3 Uptake 24.6

    Sorry for such a long introductory post, but I feel absolutely miserable and want to be prepared for Tuesday's doctor visit.

    Thanks so much for any advice.
    Abeliarose

     
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    Old 05-11-2008, 09:03 AM   #2
    ChristineVA
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    Re: New Here and Iron Deficient with Questions

    Your iron has probably been depleted for years but your hemoglobin was still normal. Very common scenario. Your surgery and then subsequent donation probably "crashed" you at that point and now you are totally depleted and it is now affecting your hemoglobin/hematocrit finally. Again, this is commonly how it works. PPIs such as Prilosec, Nexium, and Aciphex can also inhibit some of your iron absorption. So, while they may not be the absolute culprit, they are probably adding to the problem.

    It is going to take awhile to build back up. You first must get enough iron circulating in your bloodstream for your body to function properly. Once that happens, and only then, will you start putting iron into storage (your ferritin levels will reflect that). It can take many months.

    As for your thyroid numbers, they seem fine although maybe not "optimal". You are in the normal ranges and probably no doctor would treat you at this point. I've been on the thyroid board too and many there are being treated for Hashimoto's so they are really into tweaking their numbers into perfection. That's all well and good but you are not at the point where you've got a problem.

     
    Old 05-12-2008, 09:17 AM   #3
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    Re: New Here and Iron Deficient with Questions

    abeliarose--I completely agree with Christine on all points that she brings up. I would like to add that your anemia is mild, so it shouldn't take you too long to build up the Hgb to get to those high levels that Christine is talking about storing more Ferritin. That is the trick if there is one and on the amount of iron your on you should do well. Also, I think that there is more to the PPI's use than we think. I have been on Nexium for 8 years and have finally, a year later (after fixing periods with SX) told that I am having malabsorption due to PPI's. It was determined because of the fact that I was on 2 Poly Iron 150 daily for a year and my ferritin only got to 43 in that time, the GI doc said that is ridiculous. I have asked many other questions but they have not been answered to date. I think for you this might be a bigger culprit than you know. I was told to take this iron for the rest of my life. I cannot stop taking PPI's, no way! Focus on the iron and and rebuilding ferritin levels. Good luck to you and keep us posted. FLFLOWERGIRL

     
    Old 05-12-2008, 06:29 PM   #4
    abeliarose
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    Re: New Here and Iron Deficient with Questions

    Thanks so much Christine VA and FLFlowergirl for your input. I was hoping to see my regular doctor tomorrow, but she is ill and they have rescheduled me for next Monday with her partner at which time I'll have my annual physical as well as a follow-up on the iron deficiency. I also see my GI doctor on May 19. I'm wondering if I should pursue an endoscope, since even with the Aciphex I have upper stomach pains and an uncomfortable fullness feeling after I begin eating. Any way, will see what both of the doctors have to say and go from there. Thanks again, Abeliarose

     
    Old 05-12-2008, 08:18 PM   #5
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    Re: New Here and Iron Deficient with Questions

    Yes, you should have the scope if you take PPI's long term. I found out from that test that I have a hiatal hernia and have been treated with PPI's and they do not treat or work well for HH. Now they tell me, 8 yrs later............It's a very simple 10 min. test and worth having. I also had a recent med change because Nexium quit working for me. It took a month to heal, but the new med. is working great now when Nexium did not. Maybe you should think about changing meds. ask your Gi about that. FLFLOWERGIRL

     
    Old 05-13-2008, 02:30 PM   #6
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    Re: New Here and Iron Deficient with Questions

    Quote:
    Originally Posted by abeliarose View Post
    Thanks so much Christine VA and FLFlowergirl for your input. I was hoping to see my regular doctor tomorrow, but she is ill and they have rescheduled me for next Monday with her partner at which time I'll have my annual physical as well as a follow-up on the iron deficiency. I also see my GI doctor on May 19. I'm wondering if I should pursue an endoscope, since even with the Aciphex I have upper stomach pains and an uncomfortable fullness feeling after I begin eating. Any way, will see what both of the doctors have to say and go from there. Thanks again, Abeliarose
    Definitely ask for the scope. I had been on Prilosec for 8 years and when I was referred to my GI for a colonoscopy (because of the anemia), I said "hey, why don't we scope my stomach and see how it's doing). I was having stomach issues also. My GI didn't think I needed to but I was glad I did because when he looked down there, I had gastritis and fresh bleeding of the stomach. This was not helping ANYTHING. So, if you are still having stomach issues on the PPIs, it is worth checking.

     
    Old 05-24-2008, 06:11 PM   #7
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    Re: New Here and Iron Deficient with Questions -Update

    Hello,
    I saw the doctor on Monday. it has been 7 weeks since I've been taking the polyiron 150 3 times daily. I'm not sure how I'm doing. She is running the regular blood tests associated with an annual physical. She declined to do another anemia panel, she said she could see (eyelid membranes) that I was still anemic and there is no use to check again until the 6 month point. I'm way more active than I was 2 months ago, but I find that with a little exertion my heart rate rises. I have been reasonably fit until the past Jan. and my pulse has hovered between 60 - 70 bpm. Exertion (just a fraction of what I'm accustomed to) sends it soaring. Walking around the grocery store pushed it to 101. Gardening or vacuming rapidly sends it to an intolerable level and I have to sit until it slows. My bp has also shot up to 150/101 and I have been taking Lisinopril HCZT for a week. I am scheduled for an endoscope on Jun 9 to make sure I don't have GI bleeding that caused the anemia. The doctor wants to schedule a stress EKG/Echo because of my shortness of breath, heart rate, chloesterol/triglyceride level and family history. I'm now a little worried that something other than anemia may be causing my symptoms. Don't know anything about stress tests....would the results be skewed by the anemia (since I assume I would not perform at my maximum)? I put her off when she suggested scheduling one, but I do see her again in 3 weeks. Any ideas anyone? Are those of you with IDA exhibiting similar symptoms? Should I do the EKG now or wait for the anemia to resolve? I'm so grateful to have this board to visit and ask questions. Sorry that y'all are suffering too, but it's great to have your wisdom and experience. Thanks.......abeliarose

     
    Old 05-25-2008, 05:10 AM   #8
    ChristineVA
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    Re: New Here and Iron Deficient with Questions

    First off, let me say that the stress/echo is a good idea. No the anemia won't "skew" the results. Really, what they are looking for is an abnormal rhythm. Since your issue is *probably* caused by anemia, they won't find one--just regular old tachycardia is my guess. By the way, I just had a stress/echo this past Monday (however, I am no longer anemic).

    Anyway, back when my anemia stuff first started, I was having the same heart issues as you. But, I will say, at that point I was not anemic yet. I had gone to the doctor for fast heart rate upon exertion (exactly how you describe). One night in particular, I got really scared. I had to take my son to our local ice rink. It was very crowded so I had to park in the lower lot and walk up a short, but steep hill to get up to the rink. OMG!! When I got to the top, I thought I was going to have a heart attack. I couldn't breathe, I was dizzy, sick, and my heart was racing. It took a good 30 minutes to recover and I felt awful the rest of the evening. I knew something was wrong. I went to the doctor and he did the regular tests. I was 'normal' believe it or not. My hemoglobin was a 12. At that time, I knew nothing and didn't even think of iron deficiency, nor did my doctor. So, he sent me to a cardiologist who just performed an echo (no stress test). It was "normal" however I had a rapid heart rate. That was the end of that and they sent me on my way. It was only 6 months later that the anemia showed up on a blood test at my dermatologist (I was having severe itching).

    So, even prior to my anemia I was having pretty bad cardiac symptoms (my ferritin was almost non-existent). I can only imagine that with you being anemic they are far worse.

    For what it's worth, I would still have the stress test. It will put your mind at ease and it will be fine. The only good thing is that you will probably reach your maximum heart rate faster and not have to stay on as long.

     
    Old 05-25-2008, 10:07 AM   #9
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    Re: New Here and Iron Deficient with Questions

    abeliarose--Your doctor is correct in not running the whole panel again, as long as she does the standard (CBC) which she should for your physical, so that's okay. CBC and the Ferritin is all my Hematologist ever ran for check ups. And, I should say that he was not at all concerned with the Ferritin because anything under 10 means that you have no iron stores and mine wasn't moving at all, it takes time. The H & H in the CBC are what you want to know to track your anemia. I would push for ferritin anyway but that's me.

    I also experienced all the symptoms that you are having. It is very scary and I encourage you to do the testing as well. I had all but the stress part and there is no way I could have done that, but it was not ordered. I had Tachycardia 133 because I had to go to the ER and it scared me. I would have palps from eating my meals. I did have the BP issue as you and the doc said you either have hypertension or renal artery problem. Most likely the BP is temporary due to the anemia. I had an US of the renal artery and Echo then and came back with hypertension at that time. They started me on BP meds that I couldn't take due to stomach issues. Now all is back to normal other than panic when I have to go to the doc but Xanax fixes that one for me.

    I'm a firm believer in checking out symptoms then you can rest at ease with the results. I'm sure they will be fine because this is so normal for anemia. Good luck to you and keep us posted. FLFLOWERGIRL

     
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