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  • Just discovered I'm Anemic - or am I?

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    Old 06-14-2007, 08:52 AM   #1
    Divermon
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    Just discovered I'm Anemic - or am I?

    Apologies in advance here I usually read a lot of these boards before I ask neophyte questions .... I have a test for tomorrow AM, and wondered if I should add B12 to it.

    I'm male, Hypothyroid, on T4/Armour, suspected adrenal fatigue, not on Cortef yet, all the obvious symptoms.

    Looking back at my labs over the past couple of years, I just noticed that my Ferritin has been low.


    2/2004:
    Iron 124 mcg/dl ( 35 140 )
    Ferritin 64 ng/dl ( 22 322 )
    Phosphorus 2.8 mg/dl ( 2.5 4.5 )
    WBC 7.5 k/mcl ( 4.0 11.0 )
    RBC etc. well in ranges

    11/2004:
    Iron 143 mcg/dl ( 35 185 )
    Phosphorus 2.6 mg/dl ( 2.5 4.5 )
    Ferritin 46 ng/ml ( 22 322)
    WBC 6.2 k/mcl ( 4.0 11.0 )
    RBC etc. well in ranges

    3/2005:
    Iron 62 ug/ml ( 55 165 )
    TIBC 310 ug/dl ( 250 400 )
    % Iron Saturation 20.0 % ( 15.0 45.0 )
    Ferritin 88.0 ng/ml ( 25.0 350.0 )
    Transferrin 234 mg/dl ( 175 350 )
    B-12 486 ng/ml ( 223 1132 )
    Folic Acid (Polate) 10.3 ng/ml ( 3.1 12.4 )
    Phosphorus 3.8 mg/dl ( 2.1 6.8 )
    WBC 4.8 10^3 ( 5.0 10.0 )
    RBC etc. well in ranges

    3/2005 (different test):
    Iron 98 mcg/dl (35 185 )
    Ferritin 33 ng/ml ( 22 322 )
    Phosphorus 2.6 mg/dl ( 2.5 4.5 )
    WBC 6.1 k/mcl ( 4.0 11.0 )
    RBC etc. well in ranges

    3/2006:
    Iron 106 mcg/dl (35 185 )
    Ferritin 45 ng/ml ( 22 322 )
    Phosphorus 2.4 mg/dl ( 2.5 4.5 )
    WBC 5.7 k/mcl ( 4.0 11.0 )
    RBC etc. well in ranges

    6/2007:
    Iron 98 ug/dl (40 155 )
    Ferritin 35 ng/ml ( 22 322 )
    Phosphorus 2.2 mg/dl ( 2.5 4.5 )
    WBC 6.9 x10E6/ul ( 4.0 11.0 )
    RBC etc. well in ranges

    Being male, I never thought much about the Ferritin. But that is anemic-ly low, even for a male, right? Now I'm reading that low phosphorus can cause anemia too.

    So, one of my tests this month has to be repeated. I'm thinking about adding a B-12 test to that. Does that make sense? Any preparation (avoid supplements for example)?

    And, what causes low phosphorus?
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    Old 06-14-2007, 08:53 AM   #2
    Divermon
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    Re: Just discovered I'm Anemic - or am I?

    Might be good to add the RBC, etc. values.
    These are about typical over the past couple of years:

    6/2007:
    WBC 6.9 x10E3/uL ( 4.0 - 10.5 )
    RBC 4.96 x10E6/uL ( 4.10 - 5.60 )
    Hemoglobin 14.8 g/dL ( 12.5 - 17.0 )
    Hematocrit 42.7 % ( 36.0 - 50.0 )
    MCV 86 fL ( 80 - 98 )
    MCH 29.8 pg ( 27.0 - 34.0 )
    MCHC 34.7 g/dL ( 32.0 - 36.0 )
    RDW 13.2 % ( 11.7 - 15.0 )
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    Old 06-14-2007, 09:53 AM   #3
    ChristineVA
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    Re: Just discovered I'm Anemic - or am I?

    Your labs don't indicate that you are anemic. Your red blood cells are of good size (indicated by the MCV). Your iron stores are low for a male but still within the normal range even though we know higher is better.

    Your B12 is normal; however, I've heard that higher values are desired. All in all, you are in normal ranges and not anemic. But it wouldn't hurt on trying to increase your iron stores and your B12 levels.

     
    Old 06-14-2007, 10:51 AM   #4
    sparkles916
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    Re: Just discovered I'm Anemic - or am I?

    I agree with Christine.

    You could optimize your B12 by getting it higher. Try sublingual b12 supplements.

    It is true that your ferritin has dropped over the course of time since 2004. I think you were better off at 64.

    According to my understanding, the mechanism in hypo situations is that a reduced gastric acid production can result in improper absoprtion of iron and other minerals, vits.

    Generally, a person who is treated for a hypo condition will have these problems resolve.

    So, the lowering ferritin could be strictly diet related, assuming that the gastric acid problem has been resolved following treatment with thyroxine.

    And, I have heard of antacids playing a role in this problem of malabsorption of iron.

    The current values for iron deficiency are generally lower than the range your dr used (22 as a low). So, most drs and hematolgists would be concerned if you fell below 12 or even 9.

    Clinical nutrition studies put deficiency at anything below 20 ferritin.

    The process is, ferritin falls first, then other blood values fall until you reach an anemic state. First, deficiency, then depletion, then anemia. You are not even at deficiency. So you are ok.

    I would focus on eating a properly balanced diet, that is more iron rich and also take a regular multi vitamin that contains the RDA for iron. See how you fare a few months down the road and recheck your ferritin, hopefully it is increasing and if so, continue till you get back to your old range.

    If you are using antacids, I would stop them for the period.

    Calcium interferes with iron absoprtion. Thyroid hormones are affected by iron. Just make sure you avoid calcium when taking your multi or with meals. Vit C assists in iron absoprtion. Avoid ingesting the multi within a few hours of your thyroid meds. Maybe take the multi at night with some oj (no calcium).

    The b12 supplementation may give you a boost. It is not toxic and is considered safe to self-supplement without supervision, as the excess is excreted by the body. My dr recommended 3000mcg per day to elevate serum b12.


    PS If you are going to test your serum b12, don't mega supplement prior to it

    Last edited by sparkles916; 06-14-2007 at 10:53 AM. Reason: On b12 testing

     
    Old 06-14-2007, 11:52 AM   #5
    Divermon
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    Re: Just discovered I'm Anemic - or am I?

    Thanks all -
    I'm trying to determine the cause for my extream fatigue. Thryoid levels are good. Suspect adrenals. But also noticed this iron thing... and the phosphorus.. not sure what to make of that.

    thanks again.
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    Old 06-14-2007, 12:50 PM   #6
    sparkles916
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    Re: Just discovered I'm Anemic - or am I?

    I am in the extreme fatigue camp as well. I was dx as hypo last year. Fatigue has been ongoing for years.

    Investigation pointed me toward anemia and adrenals. I found after researching, that I am iron deficient, this is below 20. As I said in my earlier post, my researched indicated that in the clinical nutrition field, 20 is the threshhold for deficiency. Hematoligists and mainstream drs are much lower. What made me consider siding with the clinical nutriiton studies were other articles concerning fatigue in persons who have a ferritin lower than 50. See the well-known BNMJ article:
    [url]http://www.bmj.com/cgi/content/full/326/7399/1124[/url]
    Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial

    I know you are a male, but I would think the conclusions could be applicable to you as well, esp as you are experiencing fatigue and your ferritin has been dropping over the years.

    I also had low (but not below range b12). Been working on that as well.

    I am at the moment focusing on the ferritin, since I have also had hair loss for years, and I understand that some dermatoligical studies on hair loss and iron status suggest that a level of 70 ferritin is necessary.

    If you talk to your dr, he/she will likely not suggest supplementing, esp as concern over hemchromatosis (iron overload) is all the rage, and drs seem to err on the safe side, that is, if you are not below range you do not have a problem.

    I will be investigating my adrenals in the near future.

    Incidentally, I did see a small jump in my energy when I added Armour to my meds - my free T3 was low even though I was on 100mcg of T4 and I could not tolerate anything higher.... I know you are on the armour T4 combo, but how are your free values?

     
    Old 06-14-2007, 03:23 PM   #7
    ChristineVA
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    Re: Just discovered I'm Anemic - or am I?

    I wanted to add that many people who have thyroid failure (I am one of them due to cancer) and are on strictly T4 supplementation complain of fatigue. Bottom line, in my opinion, is that synthetic thyroid hormone supplementation just isn't as good as what your body does. Sure, your thyroid numbers look good, but it's just not the same.

    You could carefully try adding some T3 to the mix. Some people have had success with that. I did not.

     
    Old 06-14-2007, 03:33 PM   #8
    Divermon
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    Re: Just discovered I'm Anemic - or am I?

    Yes, there is a reason the body produces 20% of the T3 it needs, under nomal conditions.

    I have replaced some of the T4, and was working toward furthering that - wanted to get to something more physiologic.

    Right now, I'm just crashing.
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    Old 06-15-2007, 08:28 AM   #9
    sparkles916
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    Re: Just discovered I'm Anemic - or am I?

    Divermon:

    Just wanted to clarify my last long-winded explanation. No, you are not iron deficient, but yes, you are below the ferritin level that many studies show can cause fatigue.

    So, you need to try to get your level back up to where it was four years ago, if not a little more.

    A ferritin below 50, while not deficiency, can certainly cause or contribute to fatigue.

    You will likely have to manage on your own. Only one of the many drs I have seen for my thyroid (gps) have said to take iron - and I was at 18....but still not "out of range".

    The hematologist I saw said specificially, "do not take iron".

    But, I decided to take the risks upon myself and do therapeutic supplementation. I cannot recommmend that you do the same, since I do not know your medical history. But, as I said, if you focus on your diet and taking the rda for iron in a multi vitamin - see how it works out over a month or two.

    But, in the event changing your diet etc does not raise your ferritin, You could try having a conversation with your dr about it, and maybe he will agree to supervise your taking iron. Otherwise, you'll have to consider supplementing yourself.

     
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