Questions about anemia; new to board! Thanks!

Hello everyone,
I have been followed by my PCP in WA and a different PCP while I was in eating disorder treatment, and NOW have a different PCP in AZ following my care, so I feel a little lost on what should be done with my anemia. I feel very cold at times, my toe nails look like they are a bluish/pale, and I have had a fast heart rate at times and have felt short of breath, and of course very tired all time time, and have had restless leg feeling at night and towards the end of the day making it uncomfortable to sleep..ugh!

Originally my labs were on 5/7:
Ferritin 8 (10-180)
serum iron 20 (40-155)
Transferrin saturation, direct 5 (10-45%), transferrin, TIBC normal
Hemoglobin 11.1, Hct: 35%, RBC: 4.03, MCHC 32.1 a little low; MCV, MCH normal, RDW has been 15.2 elevated
platelets have been elevated at 403 (150-400)
Folate 6.2 (greater than 5.2 normal)
B12 474 (180-914), Vitamin D level: 16.9 (20.1-50.0), TSH was 2.84 in March so my Levothyroxine was increased from 150 mcg to 175 mcg/day

SO, long story short, I was placed on Ferrous Sulfate first slow release uped to reg strength 325 mg tabs: 1 tablet twice a day since 5/28, and it is now 8/30, and my labs in July showed my iron level only going up to 24, and they had put me briefly down to once a day in June because my H and H looked "good", so then back up to twice a day

Now in Aug 13th, my labs were:
RBC: 4.22 (4.3-5.4)
HGB: 12.0 (11.5-15.0)
HCT: 36.8 (35.0-48.0)
RDW 15.0 (11.5-14.5)
PLT 450 (130-450)
Iron Serum now 39 (35-155)
all other normal, except my vit D still low at 20.8 (32.0-100), B12 is 442 (211-911), and my TSH was 1.9 (0.3-3.0), Free T3 1.3 (1.45-3.48), and Free T4 0.8 (0.71-1.85) so I am asking my doc about needing a T3 drug for my thyroid, and she increased my Vit D to 4,000 I. U. every day.

But my main question is she kept me on the Ferrous Sulfate tabs of 325 mg PO twice a day, and she said I would just need to be on it for 6-12 months, and she hadnt checked my ferritin level or any other other iron related levels, and I am wondering if I need intramuscular or IV infusion to get rid of some of my symptoms quicker, because I am miserable, or just wait it out?!?! I have to go back to work and I am exhausted. I feel like maybe the anemia is affecting my thyroid and other things also. Does anyone know also if I need anything for my RBC being low? The reason I have the Anemia is from restricting my food intake a lot from Dec 08 to June 09 and purging, hence needing to go into eating disorder treatment.

I am just desperate for some help; I know this is long, and I am copying and pasting the results I typed out for when I see my doctor again next, but my co-pays are so expensive I can't go often, so would love some advice.

THANKS!!!![/FONT]

I would suggest that you have your PCP refer you to a hemotologist for the blood analysis.

Dear Melnwest:

Having had the experience of having less than half my blood volume (7.2) and a ferritin of 2; I speak from experience when I tell you to “wait it out”. Having an IV infusion has a side effect of death; it is VERY hard on the system. Some people can handle it; others cannot. Unfortunately, there is only one way to find out.

As far as iron shots go; use to have them twice a week until a few years ago the patent ran out and they came out with a “new & improved” which is also very hard on the system and I got purple blotches all over. This has made it very difficult to get my ferritin and hemoglobin up. Even with the shots, it took years for my blood to be within the normal ranges.

You didn’t get this way overnight and your body just can restore its supplies overnight either. Give it time.

Having said that; thyroid issues and low ferritin seem to go hand in hand. Also, estrogen dominance can play a role. Are your periods regular? Painful? PMS? With the eating disorder you can confuse your hormones as well. This can also lead to tiredness and your restless legs at night. * Disallowed website and related information removed by hb-mod, moderator *


As far as iron goes, what keeps me going is: Floradix Iron + Herbs (yeast & gluten free one) liquid 2x a day; Floradix Gallexier Herbal Bitters just before my meals to make sure that I am digesting my food, have Orange Juice when I eat eggs (as often as I can). And eat range-free, grass fed meat at least three times a week. The acid in the orange juice/herbal bitters helps absorb iron. When I take iron, I always take it on an empty stomach. If I can’t take the liquid with me, I take an iron supplement plus an ascorbic acid from of vitamin C. Again, acid helps absorb iron. Stay away from products that have tannins in them (like non-herbal tea); tannins bind with iron. Lightly steam spinach (wilt it) for your salad; this helps break down the iron. All your leafy greens are good sources of iron; however, best if wilted or steamed. Raisins are good source of iron as well. Your body only absorbs up to 30% of any iron we ingest. This high amount is only when we’re very anemic. It can plummet to as low as 5% when your body has had enough—even though your ferritin is low. Iron can be toxic at certain levels. Be patient; your body knows what it is doing.

Started a new product by Cardiovascular Research, Ltd. called Ferritin; have no idea if it will help and won’t have new blood work for 3 months. Plus just read where l-lysine is needed to utilize iron. Just bought tonight capsules of 500 mg. of l-lysine * Disallowed website and related information removed by hb-mod, moderator *
and will start taking that 20-30 minutes before my iron supplements. Again, won’t know for 3 months.

Hope all this helps. Stay encouraged! You’ll get through this with flying colors. You’re not the first to go through this and am sure not the last. These forums are great.

Be good to yourself. Stay in touch.

You need an increase in T4 as well as T3. Maybe an up in synthroid and add cytomel. Or you could try something like Armour or Naturethroid which has both.

Thanks ladies and pbahm,

I guess I have always been rather impatient at times, so I need to give things a chance....my PCP is having me go see a hematologist, because she isnt comfortable with following my IDA with all the other issues I have been having, so we'll see. I realize the iron shots/infusions are really dangerous, so I don't know if that's such a good idea like you said.....I had just been having a lot of diarrhea so she is having me stop the oral iron until I see the hematologist, to see if it could be contributing to the severity of my diarrhea (I do have IBS), but it has been really bad since the iron, though I know most people get constipation and not diarrhea......anyways, I checked with Flora on the Floradix and they said I would have to take 40 ml of the liquid iron supplement and not sure on how many of the pills to equal 2 of the 325 mg tablets a day I am still taking....that is kind of a lot....seeing that I can't stand liquid medicine, so I don't know.

I also checked with my PCP and she upped my Levothyroxine to 200 mcg tablet/day, but didn't add any cytomel, because she said that would just make me anxious since I have generalized anxiety disorder, so I asked her about the armour thyroid, since I used to be on it, and she said they are phasing armour out, so not really prescribing it anymore, so I just went with the up in Levothyroxine, mainly because I can't afford another co-pay to see a endocrinologist also....too many specialists! I know they have the compunded type T3 meds, but I imagine that would need to be from an ENDO....my co-pays for specialists are $50 a visit...ugh!

Well, thanks for the assistance, and I am going to see how the hematologist visit goes on the 10th of Sep, and I have labs for my thyroid again in 8 weeks I think....

thanks again,
Melody

I had diarrhea from iron tablets as well. I started taking amino iron and I haven't had any issues with that so far. It is supposed to be more absorbable also. Doesn't even cause the black stools either.