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  • I don't think this is iron deficiency anemia.

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    Old 08-14-2014, 03:45 PM   #1
    biologygeek
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    I don't think this is iron deficiency anemia.

    Here are my lab results:
    WBC 6.6 (4-10.8)
    Ly 25.8 (20.5-51.1)
    Mo 9.7 (1.7-9.3)
    Gr 64.5 (42.2-75.2)
    Rbc 3.74 (4.2-6.1)
    Hgb 10 (12-18)
    Hct 30.3 (37-52)
    Mcv 80.9 (81-99.9)
    Much 26.8 (27-31)
    Mchc 33.1 (33-37)
    Rdw 14.5 (12-15)
    Plt 218 (130-400)
    Mpv 8.2 (5-10)

    My iron and ferritin were normal (don't have a copy of the results, just was told they are normal). Also, b12 and d are normal.

    What kind of anemia does this look like? I DO have a history of iron deficient anemia, but my ferritin was like a 3.

    Below are my symptoms. Saw the doc about a week ago, and symptoms are much worse than then. I am on an iron supplement.

    Extreme exhaustion
    Weakness
    Shortness of breath
    Chest pains
    Extreme lightheadedness/dizzy spells/near syncope

    Basically I am hardly functional. I have gone home early and missed a couple days of work, because I literally couldn't do it. I have had to spend almost whole days in bed. Very small things wear me out. I was placing items in a box (that was on my lap) at work today and got weak and short of breath.

    Does this not seem crazy for a hgb of 10?? I have been in the 8 range, and while I felt really, really bad, I was not this dysfunctional.

    Also, I have been having the dizzy spells/lightheadedness/near syncope and some actual syncope for over a year. The drs are still trying to figure this out. They are a good deal worse right now.

    Any thoughts or advice?

     
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    Old 08-14-2014, 05:09 PM   #2
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    Re: I don't think this is iron deficiency anemia.....

    This does look like iron deficiency anemia because your MCV, MCH and MCHC are all low. I'll bet your ferritin was on the bottom of the range. I would get your lab results sent to you so you can see for yourself. The question then is why are you so anemic? If you are on iron, you must be either losing iron somehow or not absorbing it well. In females, blood loss can be from heavy periods, or from the GI tract. Absorption issues are common in celiac disease, and some people have no symptoms other than anemia. I would ask to be checked for celiac disease, and since utterly exhausted, your thyroid should be checked too.

     
    Old 08-14-2014, 05:24 PM   #3
    biologygeek
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    Re: I don't think this is iron deficiency anemia.....

    The Mcv and mch are barely low, and the mchc is in the normal limits, though. I don't know. Ugh.

    My thyroid is normal. Pretty sure I don't have celiac, but I guess you never know. I have only been on the iron since the last visit, another dr (at a hospital) told me to stop when my hgb hit 12.
    My periods aren't light by any means, but I wouldn't consider them overly heavy. I am almost certain any iron deficiency is caused by malabsorption. I had gastric sleeve surgery in 2010. (Not bypass, but some of my stomach was removed, though functionally intact.) but, strangely enough, I didn't have the anemia issue until late 2012.

    I am headed back to the dr tomorrow or Monday, so I will get the rest of my results.

    Do you find it strange that I feel massively worse than when my hgb was close to 2 points less?

    Thanks for your reply!

     
    Old 08-15-2014, 07:16 AM   #4
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    Re: I don't think this is iron deficiency anemia.....

    In a way, yes, that's why I suggested looking at thyroid for another reason for your fatigue. I would differ with your Dr on stopping the iron when your Hb reaches 12. It takes at least 3 months to restore iron stores beyond the anemia being corrected, and if you have an absorption issue, it will take even longer. I would go more by ferritin, and because of your surgery, you may need to be on iron indefinitely. Vit C helps absorption of iron, so taking 500mg along with the iron can help. Iron deficiency causes small red cell size, reflected by low MCV. B12 and folate deficiency cause large cell size (high MCV). It is possible though, that you are deficient in other vitamins, and a folate, B12 and Vit D level may be helpful. I would also ask for your thyroid results on paper, as some Drs. let slide hypothyroidism that could be present making you so tired. I always like to see my results, not just accept their verbal "normal", as borderline numbers can be meaningful. If thyroid truly is normal, you might have serum cortisol levels checked to rule out Addison's.

    Last edited by ladybud; 08-15-2014 at 07:25 AM. Reason: added

     
    Old 08-15-2014, 02:32 PM   #5
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    Re: I don't think this is iron deficiency anemia.

    Were you saying your ferritin was 3 now? or 3 last time you were anemic? Even if your ferritin is higher or just in range, you could still feel horrible and run those numbers. We aren't machines and everyone is different. I also disagree with the doc that said to stop supplementing at 12. I have found that while supplementing my numbers are up, but my ferritin is still low. That doesn't mean you should stop. You will only lose any gain during your cycle. What is your ferritin now?

     
    Old 08-16-2014, 06:42 AM   #6
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    Re: I don't think this is iron deficiency anemia.

    Thanks for the responses.

    It wasn't my reg doctor who stopped my iron, I was in the hospital and that dr didn't really know my case. I probably shouldn't have listened to me.

    So, I went back to the dr yesterday, and am now more frustrated than before. My hgb was 11.4! My iron was 43 (40-175). I was mistaken about having the ferritin checked. So, while I am slightly anemic, and my iron is just in the range of normal, my doctor and I both think that the anemia is not causing these symptoms.

    B12 was 369 (200-1100). He said we could do some b12 shots, but that is probably not my problem, either. D was 33 (30-100). I am already on a significant amount of D. (10000+ units a week.) it used to be a 14, so 33 is pretty darn good for me. My thyroid is perfectly normal (free T3 is 3.6 with a range of 2.3-4.2), I am actually on thyroid medication (for depression, not hypothyroidism), so the concern there would be of hyperthyroidism. I also had my cortisol tested a few months ago. It was 12.7 for which the range is 4.6-20.6/1.8-13.6.

    So, he has tested pretty much everything there is ( I have been to a heart specialist, a neurologist....) and there are lots more tests he has done as well. (I have dealt with some of these symptoms for over a year, just not this intense). I see my psychiatrist on Wed, and I am going to see if he thinks that this could be from my depression. I am very medicated for my depression, because it is that bad, and all the meds are actually energy boosting, so I don't know on that front. The dr also sent of a mono test, so we shall see. There doesn't really seem to be much left to check. :/

     
    Old 08-16-2014, 06:44 AM   #7
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    Re: I don't think this is iron deficiency anemia.

    Oh, my monocytes were up a bit, which is why he is seeing if mono could be a cause.

     
    Old 08-16-2014, 07:50 AM   #8
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    Re: I don't think this is iron deficiency anemia.

    Really need to get that ferritin checked. You can order it yourself from an online lab. That's what I did. Iron is not a good reflection of your Iron stores. It can run high if you are supplementing. My iron was in the 60s but my ferritin was 15, which isn't that low but I was getting anemic. Docs mistakenly read iron instead of ferritin. It just shows how little they know. Sad.

    Last edited by Administrator; 08-16-2014 at 12:07 PM.

     
    Old 08-16-2014, 08:07 AM   #9
    kalouise
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    Re: I don't think this is iron deficiency anemia.

    Ugh, I feel for you! Its so disheartening when they keep finding nothing...and especially when they do find something, like your possible low iron and tell you its not that. So you are back to square one! So sorry you are going though this! I am too! you are in good company!

    I got sick about 5 times last fall (probably bc I was iron deficient) and the last illness was strep and bronchitis with a mild ear infection. Took antibiotics, but never felt the same since. kinda rebounded but then started feeling tired and have been sliding downhill ever since. Fatigue, foggy brain, dizziness, light headed (near passing out), headaches, neck and muscle pain, nerve pain, tingling (comes and goes). I have been to literally every specialty of doc there is, and after tubes and tubes of blood and scan after scan, I have no answers. Sometimes I feel like I must have some serious disease that is killing me slowly. That is how bad I feel. Going to sleep at night is now my fav time of day, because I look forward to maybe, just maybe waking up feeling better the next day. Hasn't happened yet, but hoping!

    My neuro thought my mono/ebv was high, but other docs dispute it bc once you get mono, your ebv numbers can stay high even though you are healthy. And you can't tell when you have had it in the past, only that you have had it. My infectious disease doc said you can't treat it anyway, so she ruled it out as a dx. I thought that was ridiculous. Do you rule out terminal cancer as a dx bc you can't treat it? Anyhow, make sure you ask for an EBV panel and not the mono screen test, which can be very inaccurate.

    Some of my docs think my low ferritin is partially to blame. It was at 15 which is borderline, but my blood counts showed mild anemia, so I started supplementing. In june after 1 month of supplements it was at 26. I had a lot of blood taken and a heavy period in July, so I am suspecting it may have gone down. I am still not feeling better and hoping maybe getting it up into the 50s will help. My neuro says it should be above 50. Its a slow road. Hoping and Praying.

    Good luck to you! If you find answers or feel better, let us know your secret! Thanks for sharing!

     
    Old 08-16-2014, 03:43 PM   #10
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    Re: I don't think this is iron deficiency anemia.

    Ok, that extra info is helpful. Glad your Hb is coming up. One last thing to check, with your B12 on low side, as well as Vit D, high monocytes can occur in lupus, which can cause terrible fatigue, iron deficiency anemia, low B12 low Vit D. I would ask your Dr to check a sed rate, CRP for inflammation, ANA, RA, and follow up on any elevated results with a rheumatologist. Mono infections in past can trigger lupus to develop later in susceptible people.

     
    Old 08-22-2014, 05:35 AM   #11
    biologygeek
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    Re: I don't think this is iron deficiency anemia.

    Sorry it has been a while since I responded. I really appreciate all the suggestions and advice.

    My mono (ebv) test showed a past infection, but no current one. They had to redraw it, because the first time it didn't get run... So I had them run a ferritin, also. It was 12. The nurse said he wanted me to continue my iron.

    I am a little confused. While I didn't get his full opinion about that specific ferritin level, my friend, who is a doctor, says she thinks I need to see a hematologist and get iron infusions. However, besides reading what you guys say here about ferritin levels, the rest of the internet (medical sites), seems to point to my level as normal or barely low. I don't know if I can actually do iron infusions, due to finances and a very full schedule, but I kind of feel like I will get laughed out of a hematologist's office. The last one I saw, when I had a hgb of 8.8 and a ferritin of 4, really brushed me off. When I had a follow up and my hgb was 11, he "guessed" that my ferritin was a 30, and should be fine. They wouldn't even redraw it!! But, if I do go to one, I will be seeing someone else.

    I haven't thought about or researched lupus at all... So I will do so, and see what my doctor thinks. Especially since we have no real clear cut reason as why I tend towards anemia. (By the way, my D levels have been a 14, I have had to heavily supplement to get that up--- over a year or more, actually.) I did have a gastric sleeve surgery, which we have suspected could cause absorption issues, but iron supplementation seems to help my hgb, especially, so I don't know if that is the true issue.

     
    Old 08-22-2014, 05:37 AM   #12
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    Re: I don't think this is iron deficiency anemia.

    Oh, also, I was starting to feel marginally better, like not having to be in bed all day, but still really crummy, but it feel like I am sliding back. Yesterday, at work, I was SO short of breath and had serious chest pains.

    Last edited by mod85; 08-22-2014 at 10:09 AM.

     
    Old 08-22-2014, 09:14 AM   #13
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    Re: I don't think this is iron deficiency anemia.

    I understand that there is differing info online about ferritin levels. The fact is that

    1. "ranges" that labs use are based on past tests, and guess what? Those people are usually not healthy! So they really aren't a proper demonstration of healthy levels!Studies have shown that iron deficiency is prevelant around the world, so even healthy people getting check could be low.

    2. Within range is a lot different than "optimal"

    3. Doctors a very limited in nutrition training. They react to medical problems and aren't in the business of keeping your health optimal. Most are not well versed in deficiencies, which is why they mistakenly check you iron rather than your ferritin. So if they don't know what test to order, why would you trust their opinion on the condition they are testing you for?

    My hematologist has said that anything below 30 can cause fatigue.
    12 is low. too low...and its showing up in your blood counts. It sounds to me like you have symptoms of anemia. I read a study that concluded that of those with ferritin under 20, at least half had 0 ferritin found in there bone marrow on biopsy.

    Keep up the iron and hope you find some answers and get better!

    Last edited by kalouise; 08-22-2014 at 09:16 AM.

     
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    Old 08-22-2014, 10:23 AM   #14
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    Re: I don't think this is iron deficiency anemia.

    Well, I am headed to the ER. I can barely walk, am weak, shaky, and felt like I was about to pass out while driving. My dr ran all the tests that he could get results back right then. My CBC was pretty much normal. Monocytes were slightly elevated, and there were still a few low values, but everything had gotten better. Hgb was 11.6. My RDW was a 17, though. My blood sugar was a little low (67). He told me to eat, and if I didn't feel better go to the ER, as they can do a battery of tests and get them back today, where he wouldn't have results until Monday.

     
    Old 08-22-2014, 11:16 AM   #15
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    Re: I don't think this is iron deficiency anemia.

    Oh, no!
    I really hope they can help you! I haven't had much luck with the ER bc they usually only do standard tests and just make sure you aren't in danger and then tell you to see a doc soon! Its frustrating. I have had the same issues! I literally would wake up drag myself out of bed, try to make a smoothie while I shook with tremors. I felt like I would just drop dead at any moment.
    I guess low blood sugar could make you feel bad, but doubt its low constantly, so not sure if that would explain your symptoms.
    Let me know what you find out! I hope you get some answers and get a bit better!!

    Last edited by kalouise; 08-22-2014 at 11:18 AM.

     
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