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  • Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

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    Old 11-19-2014, 03:16 PM   #1
    Vicksburg91
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    Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Hello all,


    Can Anemia at this level cause my fatigue and heart rate/bp issues? Also any ideas on what could cause a ferratin drop like that? Im assuming all of this started with my diarrhea symptoms.

    Last edited by Vicksburg91; 12-14-2014 at 08:12 AM.

     
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    Old 11-19-2014, 06:58 PM   #2
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Yes, your level of anemia and iron deficiency can cause tachycardia and severe fatigue. It normally does not cause high BP though. You have some interesting findings on blood count and kidney function tests. Your ferritin (stored iron) is extremely low. This could have been caused by donating too much blood too frequently, or possible GI bleeding from the esophagitis. The diarrhea can result from the irritation of blood in the GI tract. It seems that ruling out GI bleeding would be important to do with a series of stool tests. Your GI Dr. could do those. The high calcium may be related to the elevated kidney function tests, elevated creatinine. Your parathyroid glands produce parathyroid hormone (PTH) and if in excess, it will cause high calcium levels. The PTH can be measured in the blood to see if it is excessive. It is unusual to see BP's this high in someone your age, and a good Dr. should do a work-up looking for physical causes of the high BP related to kidney blood flow and hormone levels, like adrenal hormones in excess. I think you need to see a good internist, hematologist, and endocrinologist in addition to your GI Dr. The high eosinophils can be seen in parasitic infections of the GI tract, like giardia, which cause diarrhea, so a stool test for parasites would be very important.

     
    Old 11-19-2014, 07:26 PM   #3
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Thanks for the reply. I was beginning to feel like I was being a hypochondriac with the fatigue and tachycardia! Im seeing a hematologist next week so hopefully that will reveal more. My GI doc did the colonoscopy and didn't see any bleeding and didn't feel the esophagitis was severe enough to cause anemia. He did some thyroid testing bc of the Calcium and it seemed normal. Also looked at Cortisol and it was in normal range. As far as the high blood pressure no one has really looked into it…ER suggested I was worked up about tests and school work. I dont think its that bc Im a senior and had fine blood pressure until this started. I was at my campus health with a sinus infection a month before all this started and had very normal bp then.
    Is it common to see kidney function off and the morphology issues with Iron Deficiency Anemia? The ER thought the kidney function was bc of dehydration- though only my Potassium was off to a minor degree. Im getting the levels rechecked tomorrow on doctor's orders tho.

     
    Old 11-20-2014, 12:09 PM   #4
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    So I had some more bloodwork and these are the results- my GI doctor ordered these and the WBC stuff seems to be on a different scale than my Campus Health Lab. Anemia was about the same but there was also some White Blood Cell stuff this time. Just listing stuff that was in the abnormal range
    CO2- 32
    BUN- 25
    Creatinine- 1.6
    Urine PH- 9
    Calcium- 11
    Potassium (low) 3.1
    Random Glucose- 120

    White Blood Cell Count- sorta high at 10.89 (lab lists 10.8 as normal)
    Neutrphils high at 7.03
    Monocytes high at 0.86
    Eosinphils high 0.69
    Basophils high at 0.021 (lists 0.02 as normal)
    Immature Granulocytes high at 0.3 (0.2 norma)

     
    Old 11-20-2014, 07:54 PM   #5
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Your BUN and BUN/creatinine ratio is more an indicator of dehydration. Your BUN is at top of range but not high enough to explain a creatinine of 1.6. Chronic kidney disease can cause anemia, but it is not normally iron deficient, it is anemia of chronic disease, which looks different than yours. Thyroid levels have nothing to do with calcium. Parathyroid levels do, and they are 2 totally different things. A parathyroid hormone level (PTH) should be done, best fasting, to evaluate the high calcium. The hematologist is a good idea. The slightly elevated white count with high neutrophils may be related to the diarrhea, as it indicates possible infection. I hope you get some more tests to clear up what is going on. Gluten intolerance can cause severe iron deficiency anemia and diarrhea, if it is celiac disease. Did they do any small bowel biopsies when endoscopy was done to check for celiac disease? Any family history of autoimmune disorders should be relayed to your Dr.

     
    Old 11-21-2014, 08:45 AM   #6
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Yeah. They did biopsies that came back normal and blood tests for Celiac also showed nothing. I think they tested the Parathyroid as well and didn't see anything. Im hoping the hematologist figures something out. I feel like a hypochondriac because diagnostic stuff keeps coming back clear. They weren't sure on the creatinine level being high. I did have acute kidney failure a few years ago when I had a infection of Lyme Disease but that was treated and resolved. They considered hospitalizing me because of the kidney function and white blood cell count but decided it wasn't severe enough to warrant it and are just monitoring it for now. I see the hematologist on Tuesday
    The doctor seem to think more than just iron is involved since my kidney function has been up and down and now the WBC count. What could cause both red blood cell and white blood cell stuff?

     
    Old 11-21-2014, 10:58 AM   #7
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Your creatinine may be elevated a little fro. Your previous renal failure. That may be your normal now would have to compare previos levels. Kidneys produce a hormone that stimulates red blood cell production (erythropoietin) and your level could be low. Inflammation such as that occurring in autoimmune diseases can cause high wbc and anemia. That may be worth looking into. Hematology doc could do that.

     
    Old 11-21-2014, 04:47 PM   #8
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    I had thought of that but Ive had several blood works since that and my kidney function was always normal. It wasn't until recently that creatinine started to rise. It was 1.17 on the test three days before it rose to 1.4 and has been between that and 1.6 since on each bloodwork. Including ones that showed I wasn't dehydrated so Im unsure what could be causing that. Hopefully the hematologist will have some ideas. Could the Anemia cause a mild rise in CO2 like seen in my bloodwork?

     
    Old 11-22-2014, 12:13 AM   #9
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    I don't think so. It is an acid-base balance thing that probably has to do with either your kidneys or the diarrhea.

     
    Old 11-22-2014, 02:32 PM   #10
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Sometimes you can have sensitivities to gluten.. Maybe try cutting it out. I have ibs and have absorbtion issues. My ferritin was negative at one point and I felt like death. Take it easy and please fight to get answers. I know how it feels to not have answers.
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    Old 11-24-2014, 09:19 AM   #11
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Thanks for the advice! My grandmother on my Dad's side had Celiac Disease and I was tested with numerous tests and told I dont have it or gluten sensitivities. Im seeing the hematologist tomorrow so hopefully he has some answers. I feel fortunate that my friends have remained supportive through this. Its frustrating not to have an answer and feel crummy most of the time. My mom seems worried that I might have Leukemia since my grandfather on her side had something called Myelodsyplia. I dont think it could be something like that because I would think I would feel a lot worse. Hopefully the hematologist has some answers. The fatigue is frustrating and makes me feel like Im being lazy. The Kidney bloodwork definitely has me a little concerned since the CO2 level was raised.

     
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    Old 11-26-2014, 11:16 AM   #12
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    The appointment with the hematologist went well! He feels I dont have any blood disorder and it is related to the iron. My RDW went up to 19 on his bloodwork. He did some work on the iron and found my level was a 17 and the iron saturation is only 4%- which he said is very severe iron deficiency. My TBIC was high at 444 and Unbound Iron Capacity high at 427. He advised being worked up in depth for the small bowel and Crohn's Disease because he feels that only blood loss could cause a deficiency that severe in a male my age.
    He wants me to see a kidney doctor as well to look at the Kidney levels more and feels that is more related to the past kidney failure episode. Also my Alkaline Phospohate was low at 51, which he found unusual but not serious.

    I did get my first Iron IV today (he's ordered a month long session of 6 infusions) and have more energy than I have in awhile. They did say it will take a few before I feel a major difference though.

     
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    Old 11-26-2014, 12:03 PM   #13
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    Sounds like your on the right path!! Hope all your work ups come back great!
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    Old 12-12-2014, 06:42 AM   #14
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    So glad you are getting answers and feeling a bit better. Getting your iron up will make a big difference, probably by new years. I agree that GI blood loss is a good idea to pursue since celiac was ruled out. Your hematology doc sounds good. Take care.

     
    Old 12-14-2014, 08:07 AM   #15
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    Re: Anemia, Weird RBC Morphology, Fatigue/Heart Issues. Just Iron or More?

    I'll be seeing my hematologist again in a week but the GI doc seems to have ruled everything out besides the esophigitis. Anyway I ended up at the doc's again recently and had more bloodwork done. Seems like my anemia hasn't improved at all and a few numbers got worse from the hematologist's bloodwork. I had two Iron IVs about three weeks ago. Is it normal to have numbers go down after the Iron IV? I know it takes awhile for full effect just seems weird to go down tho. I still feel really tired and crappy
    RDW went from a 19% to 21.6%
    HGB is 11.2
    HCT is 35
    MCH 25
    Also I found it odd that my bloodwork said "Macrocystosis" present since previous work had indicated microcytes.

    I do a have a bit of a cold right now but my Eospinhils have been raised on every bloodwork (this time 8.8%) and my monocytes were 9.8%, Lymph was low 18%. Also immature granuloyctes high at 0.03% again.

    Also my calcium is up to 11.4%
    CO2 is up to 33% (lab range is 22-30)
    Creatinine is 1.45%
    BUN was 21%
    Urine PH was high at 8.5
    Total Protein was high at 8.3 (range 6.4-8.2) I do take protein powder for the gym so I figure this might the cause of that

    Anyone have any ideas. Im getting frustrated and feel like Im being an alarmist but I feel really crummy.

     
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