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  • Does anemia always have an underlying cause?

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    Old 12-18-2014, 11:41 AM   #1
    littlej00
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    Does anemia always have an underlying cause?

    I have been called the "mystery woman" by two of the doctors I have seen. They pretty much left it at that. So I'm wondering, is there always a cause behind iron deficiency anemia? Nobody ever suggested to me that it was possible to be anemic just because, so I never gave it much thought. I don't appear to have any blood loss, and my GI tests have shown no disease or abnormalitites. My MPV has always been high with low hemoglobin, iron, and severely low ferritin.

     
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    Old 12-19-2014, 04:21 AM   #2
    sweetpeaz
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    Re: Does anemia always have an underlying cause?

    Get ready for your roller coaster ride of changing doctors and getting different diagnosis from each one! There is always an underlying cause of IDA. It will take time and patience to find it. Be persistant. Such causes as blood loss thru heavy menses or surgeries, pregnancy, malabsorption of iron in your diet, and so on. Keep doing your research and studying your blood test results. There are some great people on here that can comfort you with a wealth of info. Just be patient.

     
    Old 12-19-2014, 06:30 AM   #3
    littlej00
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    Re: Does anemia always have an underlying cause?

    Thank you for your response. I have seen 6 doctors so far (about to see my 7th) and I am at a loss because none of the causes you listed apply to me. I have gotten pretty good at reading my own blood tests though and I will keep looking for answers. It is very frustrating to feel so crappy for so long!

     
    Old 03-19-2015, 08:45 AM   #4
    Cristi667
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    Re: Does anemia always have an underlying cause?

    I went through the same tests. My Dr said he figures I just dont absorb dietary iron. I get infusions, my mom got transfusions for the same thing. No one is sure but I am tired of looking. Just give me the infusion! I have been anemis all my life though very little as a child, it has grown progressivly worse. My moms did too until she needed transfusions.

     
    Old 03-19-2015, 07:01 PM   #5
    lilyat
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    Re: Does anemia always have an underlying cause?

    What else is going on besides IDA? Do you have anything like celiac or gluten sensitivity that may interfere with absorption of iron and not just iron but other minerals and vitamins? Did your GI tests include an endoscopy and colonoscopy? Even though you say none of the previous posters suggestions apply, have you had an MRI to look for uterine fibroids? Have you seen a hematologist to look for blood disorders such as Von Willebrand's or any other bleeding disorder? Do you consume lots of milk products?

    Last edited by lilyat; 03-19-2015 at 07:04 PM.

     
    Old 03-20-2015, 12:21 AM   #6
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    Re: Does anemia always have an underlying cause?

    hey littlej00....as i understand it, there's a condition called "pernicious anemia", when someone is anemic with no underlying cause. i used to work with someone who had it....i could be remembering wrong though.....
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    Old 07-03-2015, 11:06 AM   #7
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    Re: Does anemia always have an underlying cause?

    You may have a B12 deficiency. That can cause all sorts of weird symptoms: fatigue, ringing ears, numb or tingling feet and hands, palpitations, balance issues, hair loss, and more.

    One of the causes of B12 deficiency is pernicious anemia (PA). Other causes can be drugs that deplete B12 (PPIs, H2 blockers, metformin, others) and gastric surgery.

    Pernicious anemia is detected by testing for antibodies to intrinsic factor. Intrinsic factor requires stomach acid to work, and extracts B12 from food. Destruction of gastric cells is usually found in severe cases of PA, and sufferers usually have various stomach problems because they have no stomach acid.

    Pernicious anemia is known to run in families. The H pylori bacteria has also been linked to it. The true cause isn't really known.

    A separate blood test needs to be run to look for B12 deficiency. The full blood test does not include this, and the marker for deficiency (the MCV value) isn't always elevated until the deficiency is very severe. So you must ask your doctor to test B12, they don't always think of it. And then if a B12 deficiency is found, the cause needs to be determined because if it is pernicious anemia then treatment is needed for life.
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    Severe B12 deficiency dx Oct 24, 2014
    Caused by pernicious anemia
    B12 below 450 pg/mL should be treated

     
    Old 07-04-2015, 03:52 PM   #8
    littlej00
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    Re: Does anemia always have an underlying cause?

    Hello all. I have had my B12 tested before, and that was good. For an update, I am seeing a new hematologist and the cause has still not been found. My latest blood work showed my iron at 16, and ferritin at 1. Those were the worst numbers. I have had several tests since, and my doctor said that since all my vitals are fine, he's going to start testing for the rare things. I have to take iron 4x a day, with blood work every month until December. The next additional blood tests are a G6PD, a screen for Paroxysmal Nocturnal Hemoglobinuria, and hemoglobin electrophoresis. My doctor says I should not be feeling as bad as I describe just from my iron, and that we need to find the cause of this. I really hope he can figure this out...I don't want to keep feeling worse!

     
    Old 07-04-2015, 05:28 PM   #9
    geekymom
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    Re: Does anemia always have an underlying cause?

    What was your B12 measurement? The current low value cutoff of 200 pg/mL used in the US and UK is way too low, in Japan they use 450. Neurological damage can start below 400. If yours was in the range 200 - 400 that is a gray area and should get treatment if you are experiencing symptoms. Don't let your doctor tell you it is normal, get the number.

    My B12 was 196, slightly below the minimum, my doctor thought it wasn't of concern but he was very, very wrong. I had severe neurological symptoms, and have some permanent nerve damage as a result.

    Since your MPV has been high, have you had your vitamin D tested? When I googled high MPV some articles popped up that suggest vitamin D could be low.
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    Severe B12 deficiency dx Oct 24, 2014
    Caused by pernicious anemia
    B12 below 450 pg/mL should be treated

     
    Old 07-06-2015, 06:38 AM   #10
    littlej00
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    Re: Does anemia always have an underlying cause?

    My B12 was 602. I don't think my symptoms support a vitamin D deficiency, but it wouldn't hurt to ask I suppose.

     
    Old 07-06-2015, 08:47 AM   #11
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    Re: Does anemia always have an underlying cause?

    The definitive test for celiac disease, which causes severe iron deficiency anemia, is a small bowel biopsy done through upper endoscopy. Unless you have had that done, you have not had a complete GI work-up. Your new hematologist sounds good in that he is looking for the reason. I agree with sweetpeas, there is always a reason. If nothing is found in the electrophoresis, G6PD, I would press for a re-look for celiac disease. Have you had the blood tests for it? Even if negative, you can still have it. Biopsy is the only sure way to rule it out.

     
    Old 07-06-2015, 09:31 AM   #12
    littlej00
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    Re: Does anemia always have an underlying cause?

    Hi Ladybud. I have had a complete GI workup. I have had the blood test (full celiac panel) done 3 different times, I have had 2 upper endoscopy's with biopsies, a capsule endoscopy, a colonoscopy, a small bowel follow through, a hydrogen breath test, and an ultrasound--I think that's everything I've had GI related...I just do not have Celiac. Since then, I have had an echocardiogram and a chest xray. I do think I have finally found a good doctor in that he is exploring all possibilities instead of just having me repeat iron treatments like the others. I am very nervous though that he is testing me for PNH...it sounds really scary and fits my symptoms (although mine are all pretty vague). I just want this to be over with!

     
    Old 07-07-2015, 08:52 AM   #13
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    Re: Does anemia always have an underlying cause?

    Littlej00, You are right, you do not have celiac after all those tests! I do hope there is some explanation found, something not serious and easy to treat would be nice. It sounds like you are in good hands with your new Dr. Let us know how your tests turn out, and I hope this search leads to you feeling better in time!

     
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