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  • Iron deficient, B12 deficient and frustrated!!

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    Old 09-29-2013, 05:21 PM   #1
    starbeth5
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    Iron deficient, B12 deficient and frustrated!!

    Hello,

    About 4 months ago my fatigue increased dramatically (I've previously been diagnosed with Hashimoto's thyroiditis, fibromyalgia, and Postural Orthostatic Tachycardia Syndrome so a certain degree of fatigue is normal for me). I went to my PCP and she ran my thyroid tests which indicated I needed an increase in my thyroid meds, 2 months later fatigue is worse instead of better so she decided to run some blood tests.

    My Hemglobin was 10 (12-15.6 normal), Hematocrit 30 (35-46),
    Ferritin 4 (12-157), B12 200 (220-850).

    That was 2 weeks ago, my doctor has now ordered a Methylmalonic Acid (MMA) and said we have to wait for the results before she starts any treatment. She also said she may not feel comfortable treating me and my send me to a gastroenterologist (I'm assuming she feels the B12 is Pernicious Anemia)?

    i'm in nursing school full-time and I work part-time and I'm fed up with feeling awful and knowing what is wrong with me but not being treated! Just needed to vent and ask for any help on this situation?

     
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    Old 09-30-2013, 02:53 AM   #2
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    Re: Iron deficient, B12 deficient and frustrated!!

    Whatever the MMA result is, and depending on how soon you get to see the gastroenterologist, I would make sure you get treated for B12 deficiency as soon as possible. However, document your test results because if you see the gastroenterologist after you start B12 therapy subsequent tests will logically show high B12 -- which may give the wrong impression that you never had low B12.

    Your iron is very low though and probably the main cause of the anemia (low hemoglobin and hematocrit). That on its own is a good reason for seeing a gastroenterologist (low iron can be caused absorption problems or blood loss in the GI tract). Since you have one diagnosed autoimmune disorder (Hashimoto's), you may be prone to other autoimmune-like disorders of the GI tract such as Celiac disease or Crohn's. **** talks about a possible link between Celiac disease (gluten intolerance) and Hashimoto's, which would certainly fit with the low iron and B12.

     
    Old 09-30-2013, 01:10 PM   #3
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    Re: Iron deficient, B12 deficient and frustrated!!

    Now I'm even more confused - my MMA result came back in the normal range - 0.26 where anything < 0.40 is normal. I've heard of people having a normal B12 but the MMA is too high (proving the B12 is low) - what does a low serum B12 and a normal MMA mean?

     
    Old 09-30-2013, 02:21 PM   #4
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    Re: Iron deficient, B12 deficient and frustrated!!

    Markers for B12 deficiency (including serum B12 and MMA) can be unreliable and it is hard to exclude B12 deficiency based on their results. Some labs have a high end of the reference range of 0.26 umole/L for serum MMA. So your MMA could be described as borderline too. If you doctor is pedantic she may refuse B12 therapy, but B12 therapy generally has few adverse effects and I would definitely make sure you get treated. If you don't get injections I would discuss taking 1000/2000umg B12 tablets or sublinguals.

    If you have neurological symptoms that can be attributed to B12 deficiency (which is a long list, including numbness and tingling in the extremities, balance issues, cognitive/memory problems, etc etc) you should definitely be treated ASAP. The low iron and anemia will also contribute to your symptoms, but more in the way of fatigue.

    Hopefully you will get treated soon (both for B12 and iron). If you have a malabsorption problem, other vitamins/nutrients like vitamin D may be low too.

    Last edited by vegator; 09-30-2013 at 02:40 PM.

     
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    Old 09-30-2013, 07:08 PM   #5
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    Re: Iron deficient, B12 deficient and frustrated!!

    I put a call in to my Dr. today - I'm determined to get some answers tomorrow

     
    Old 10-04-2013, 11:49 AM   #6
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    Re: Iron deficient, B12 deficient and frustrated!!

    Well my doctor's office called and said she had called me in some prescriptions and to take them for the next month, get my levels re-tested, and then she will reassess if the oral treatments are working or not. She started me on 325 mg of Ferrous Sulfate and 1000 mcg of B12 - I guess that is a start at least.

     
    Old 10-04-2013, 02:53 PM   #7
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    Re: Iron deficient, B12 deficient and frustrated!!

    Itīs good you are getting treated, but continue to be aware of the possibility that some GI disorder is causing the deficiencies. Heavy cycles can be a cause of iron deficiency, and your doctor probably suspects that is the case. If you notice other symptoms or have a family history of GI disease you should discuss it with your doctor.

    I am assuming you are getting oral B12 treatment (tablets). Even in people with decreased absorption of B12 (due to pernicious anemia or for some other reason), a small amount of the 1000mcg of B12 is absorbed so your B12 level should be up to, say, 600 in a month.

    Taking orange juice along with the iron may help absorption. It is likely the iron deficiency and anemia will disappear with treatment, which together with the B12 should improve your symptoms a lot. But even when they do, you should keep in mind there must be an underlying reason why the low iron and B12 happened in the first place, and that the deficiencies/symptoms could return in the long term.

     
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    Old 11-06-2013, 08:11 PM   #8
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    Re: Iron deficient, B12 deficient and frustrated!!

    Just got my labs back after one month of oral supplements (325mg Fe, 1000 mcg B12:

    Hgb 12.5, Hct 39, B12 291, Ferritin 6

    From what I can deduce even though my levels have gone up it doesn't appear to be enough. Although I'm not feeling any worse I'm certainly not feeling any better.

    How long does it take for the supplements to start upping the B12 and Ferritin levels? It's to my understanding that "optimal" levels of B12 are above 600 and Ferritin should be around 100?

    Any thoughts would be much appreciated, my doctor seems to feel that since my numbers all went up treatment is sufficient.

     
    Old 12-16-2013, 07:13 AM   #9
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    Re: Iron deficient, B12 deficient and frustrated!!

    Could you be having a POTS episode?

     
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