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  • Am I taking enough iron?

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    Old 03-13-2009, 12:54 AM   #1
    Aeval
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    Am I taking enough iron?

    I'm currently taking Feosol (Carbonyl Iron) @ 45mg per day, as per my doctor's intructions. Given that my ferritin level is 5 and my iron is low (both have been low for some time), should I be on a higher dose of iron? It seems low to me, and my numbers haven't improved in some time.

    My symptoms are horrible right now. Brain fog, painfully fatigued, brittle/shedding hair, nails breaking, palpatations, headaches, body aches, restless leg (so bad!), etc. I don't know that the anemia is causing all of that (and other problems I didn't mention), as I'm dealing with health issues with overlapping sypmtoms (Hashimoto's - TSH is still very high, SVT, endometriosis, disc and nerve problems, fibro).

    Until recently my B12 was low, but shots helped me get back to a good level. Now that I'm off the bi-weeklly B12 shots, my symptoms feel worse.

    Anyway, any advice on what I should be discussing with my doctor would be appreciated. I'm spending most days in bed (and working from bed) and long to feel better than this.

    One additional point (on edit) is that I have very heavy periods. They last 6-7 days and my cycle is often 21 days or less.

    If it's any help, here are my full lab results and ranges (as of one week ago) for CBC, Iron, Ferritin and abnormals from my Urinalysis:

    CBC w/Differential/Platelet
    WBC - 10.0 (4.0-10.5)
    RBC - 5.12 (3.80-5.10) High
    Hemoglobin - 12.5 (11.5-15.0)
    Hematocrit - 37.8 (34.0-44.0)
    MCV - 74 (80-98) Low
    MCH 24.4 (27.0-34.0) Low
    MCHC - 33.0 (32.0-36.0)
    RDW - 19.0 (11.7-15.0) High
    Platelets - 358 (140-415)
    Neutrophils - 66 (40-74)
    Lymphs - 24 (14-46)
    Monocytes - 5 (4-13)
    Eos - 4 (0-7)
    Basos - 1 (0-3)
    Neutophils (Absolute) - 6.7 (1.8-7.8)
    Lymphs (Absolute) - 2.4 (0.7-4.5)
    Monocytes (Absolute) - 0.5 (0.1-1.0)
    Eos (Absolute) - 0.4 (0.0-0.4)
    Baso (Absolute) - 0.1 (0.0-0.2)


    Iron, serum 21 (35-155) Low

    Ferritin, Serum 5 (10-291) Low


    Urinalysis
    WBC Esterase - Trace (Negative)
    Occult Blood - 1+ (Negative)
    WBC - 6-10 (0-5)
    Bacteria - Moderate (None/Few)



    Thanks for reading all of this

    Last edited by Aeval; 03-13-2009 at 01:50 PM. Reason: Fixed lab detail/clarified/added additional info

     
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    Old 03-13-2009, 08:23 PM   #2
    FLFLOWERGIRL
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    Re: Am I taking enough iron?

    Aeval--

    I would agree that you probably need more iron. Especially because of the fact that you are still having periods. You are not anemic, were you? You want your Hgb to get to 14 to be optimal. And of course to fill your iron stores, but you want to do that without iron overloading. You can watch your Saturation every 3 months, it should not go over 45%, that's about all you need to know to be safe. You don't have to worry about the ferritin being high for a very long time. When iron is needed it's much safer than for someone that have no business taking iron supplements, this is what they warn people about or people that do not metabolize iron due to an iron disorder and some other reasons. You should always check with your doctor and/or pharmacist to be sure of the right dosage for you before making changes. I was told by my Hematologist to stay on iron until menopause. But I was also told by my GI doc to stay on it indefinitely because I take PPI's that inhibit iron absorption too.

    You will ~have~ to stop the blood loss or it will just be a cycle for you. As one of my doctor's explained it to me that I had a hole in my bucket that cannot fill up. You won't be able to take in enough iron to replete iron stores. A ferritin of 5 means you have no iron stores.

    You have several reasons for feeling bad, at least a few can be fixed fairly easy. After you up your iron you will be feeling better. Much, much, better!!! If I were you I would take sublingual B-12 in the form of Methyl--cobalamin to replace the IM that you are no longer taking, if I understood you correctly. What were your B-12 levels before and after? If they will not prescribe further shots you can take the SL B-12 instead.

    Are you being treated with thyroid meds for the Hashi's? Do you know if you are oscillating Hypo-Hyper-T. This *could* be a reason for some of your symptoms. Perhaps just the high TSH alone is causing mimicking symptoms of anemia which are very similar. You need to make sure that your are not taking iron near thyroid meds too. It can interfere with it's (T-4) absorption and go even higher. To this point I have addressed the Iron, B-12, Hashi's and the bleeding issue has to be stopped. Fixing all these things will get you on the road to feeling much better. Sorry, I don't know too much about the others that you have named.

    Hope this helped a little. These are the things that I would be talking to my doc about to get further results.
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    Old 03-13-2009, 09:59 PM   #3
    Aeval
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    Re: Am I taking enough iron?

    Thanks so much for your response. I really do appreciate it.

    You're right, I'm not actually anemic now. I was (Hemoglobin was lower a couple of months ago). As for my B12 levels, I started just below 200, and now I'm up to 410 (pg/ml). My doctor's goal was to get me over 400, so we've stopped the shots. He'll run B12 tests again next month. In the meantime, SL B12 is a great idea.

    I am on synthroid, and have been for the last 8 years. I don't take it near my iron, but thanks for the reminder. My TSH has only been in range once, for a few months, in all that time. It's been consistedly high (hypo) for ages now. It's a rough process, as I don't respond well to synthroid increases (get hyper symptoms with even the smallest increase, even though lab results show hypo). We (doc/me) recently had to lower my dose temporarily as my sypmtoms were so hyper, while my TSH was well in the double digits still. We'll try to go up to the next higher dose again next month. I don't mean to get too sidetracked on the thyroid stuff, but as you mentioned, it can mimick so many of the same problems of low iron/anemia.

    As for stopping the blood loss, this is something I've given a lot of thought. I see in your sig line that you've had endometrial ablation. Are you happy with the results of the procedure? I'm researching it now, and I've long considered bringing it up to my GYN.

    I was taking PPIs until a few months ago, bit I'm off them now until my iron stores increase, and I'm adjusting my diet and meal schedule in an attempt to reduce GERD sypmtoms until then.

    Truth is, I'm dealing with a lot of health issues now (in addition to the ones I mentioned), and even my doctor is torn about which problem is causing which symptom. I think I'm bit depressed/anxious about it all now and the lack on energy (along with stress, insomnia and constantly feeling "cruddy") is getting to me. I just want to figure out how to get my life back.

    I'll definitely bring up the points you mentioned to my doctor.

    Thanks again, FLFLOWERGIRL!

     
    Old 03-15-2009, 08:40 AM   #4
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    Re: Am I taking enough iron?

    Aeval--Glad your no longer anemic!

    I think that you really need to fight for your B-12 shots. If not, like I said you are supposed to be able to get the same in the SL according to the research that I have read. I usually run between 800-950'ish and I do take the B-12 because of my PPI's use putting me at risk for deficiency. That's one thing I don't have to worry about. 400 is still borderline symptom stage.

    I completely understand the Hashi's, I have been diagnosed sine 2005 and have only been in the optimal zone 4 times a little better than you but nothing to shout about, right? That's crazy, it's the doctor and soon he will be fired too, I hope. I keep a chart. I have only been Hyper one time that I know of. because of this he backed down on my meds 75 synthroid then up on the same dose again so I will know in a few weeks if this is going to work this time? I really don't understand that at all. Up and down the same dose?????? How high are your double digits, I can't imagine that? I think that 9.0 is my highest and 0.16 being the lowest with strange symptoms. If synthroid is not going to work for you then I think that it's time for you to find another T-4 perhaps/T-3 combo, easier said than done, I know. I am reading The Thyroid Solution and love it but to find a doc that subscribes to this is another challenge.

    I am so happy with the results of my ablation!!!!! It's the best thing that I have EVER done for myself and it's the gift that keeps on giving. Every month I am totally amazed. I also had 7 polyps show up at the time of the procedure, it wasn't found on my transvag US. I had many reasons to be anemic. I am hoping that it last until menopause or I will have it repeated. It was so very simple too. I am am a BIG chicken.

    I think that if you have real problems with the GERD or whatever, that you should probably stay on the PPI's, even when taking iron supplements. You may feel better for it.

    Sounds like you are needing a little sunshine, hope you can tap into some. Just take your symptoms one at a time and work on what you can, like iron, and things will eventually get a little better. Take care and keep us posted.
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    Old 03-16-2009, 08:56 PM   #5
    Aeval
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    Re: Am I taking enough iron?

    FLFLOWERGIRL -- Thanks for all the info!

    I'm going to talk to my doctor about B12 this week, instead of waiting. Considering how awful I'm feeling right now, I doubt he'd fight the idea of continuing the shots if I push for it. Thanks for letting me know that 410 still seems a bit low.

    As for the TSH, right now it's 16. It's been as high as 52 in the past. Crazy, right? The one time I was in range it was 4.2 (still high by some people's standards, but felt great to me). Here's hoping my numbers will improve again in time. The doc I see now isn't the same doc who started me on synthroid years ago, and I think the current one would be willing to give Armour thyroid a shot, if I ask, so that's an option.

    I'm glad to hear you're so happy with your ablation! When I'm feeling a bit better, I'm going to go for it. I think it would have a drastic effect on my iron, given the length and heaviness of my periods.

    Anyway, thanks again for all the support.

    Take care

     
    Old 04-03-2009, 05:44 PM   #6
    Aeval
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    Re: Am I taking enough iron?

    Just adding a bit of an update.

    I did speak to my doctor about the B12, and Iím back on the injections. He wants me to stay on the same level of iron for now (still just 45mgs a dayóIím still not certain thatís the right call, as Iím just soooo exhausted).

    I went to the OBGYN and discussed ablation in hopes of reducing the menstrual bleeding and thereby improving my iron stores. She gave me some pamphlets, but as Iím having new bleeding problems, it will be a while before we see if Iím a good candidate.

    Days after I posted my last reply, I started bleeding (in between periods). Ultrasounds revealed fibroids, a polyp in the uterine lining and an ovarian cyst . I have to go back soon for another ultrasound (theyíll fill me with saline this time) to get a better look at the polyp.

    I may be looking at a hysterectomy due to the fibroids, rather than ablation. Iíd so prefer ablation, so fingers crossed.

    Itís frustrating where my iron is concerned (and in many other ways), as Iím losing more blood than before (constant bleeding). Thereís even blood in my urine Ė like, red urine . Iím on antibiotics for a UTI now. I just had CT scans done day before yesterday, so that should reveal if thereís a kidney problem behind that bleeding.

    I get my iron/ferritin tested again in two weeks, as well as my B12 and thyroid. As of last week my hemoglobin was still hovering just above 12.

    Hoping to see some improvements in some of this stuff soon.

     
    Old 04-06-2009, 08:53 PM   #7
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    Re: Am I taking enough iron?

    You are very welcome. What did your doctor decide about the B-12? Are you feeling any better? I can't believe your TSH. You are true Hypo-T that's for sure. I will never complain again!!! I'm sorry that you have so much to deal with. Let us know if you have the ablation. Take care!
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