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Medical Forum / General / General / July 2005Anemia
Hi everyone! I have a question that I'm hoping someone might have some ideas. First off, I'm a female and I'm 31 years old. My dad and my grand dad both had the same surgery I mention next. I was never obese to begin with and I do have chronic nausea. That said, my nausea has been under control for the last three weeks before I had my iron test mentioned below done. Here goes my story....Last July I had a Vagotomy, Antrectomy and Roux-n-y because I had a 2.5cm bleeding ulcer. They removed 2/3 of my stomach in order to save my life because I was bleeding to death. Anyway, that's all good now except for one thing. I have developed anemia. I do take Iron liquid medicine twice per day and yet my iron is all still low. I had an Iron Absorption test and that was fine. I absorb Iron just fine. My total iron today was 9, iron saturation was 3.0, HCT was 33.9, Hemoglobin was 10.9, Ferritin was 5 and my RDW (or was it RBC?) was abnormal. I'm guessing that last one is the shape of the red blood cells. This is all with eating just fine and taking Iron liquid form. I'm always tired and when I'm tired, I can't just wait to sleep....I have to sleep right then and there. No matter what I'm doing. My doctors are all confused by this and don't know how to help. I know there's something going on with me and if I could just fix this problem, I'd be 100%. Does anyone have any ideas? Thanks, Lisa http://tinyurl.com/96zn4 Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore DEAD PEOPLE WALKING http://pages.ivillage.com/ironjustice/deadpeoplewalking > Hi everyone! I have a question that I'm hoping someone might have some > ideas. First off, I'm a female and I'm 31 years old. My dad and my [quoted text clipped - 19 lines] > Thanks, > Lisa I know this may have come up last year, but were you tested for gluten intolerance (celiac sprue)?  SignatureDavid Rind drind@caregroup.harvard.edu > > Hi everyone! I have a question that I'm hoping someone might have some > > ideas. First off, I'm a female and I'm 31 years old. My dad and my [quoted text clipped - 26 lines] > David Rind > drind@caregroup.harvard.edu COMMENT: A good thought, but if this was operating by affecting absorption, then the absorption test would be off. If (morely likely) it was operating by causing micro-bleeding, then she should still be quaiac pos (which I assume has been tested, yes?). Anyway with a feritin of 5, good absorption, good supplements, guaiac neg, and no improvement over time, the blood must be going somewhere intermittantly (rather than oozing, as with sprue). Ulcers usually don't bleed like that. Occasionally you get a colonic venous abnormality (AVM) that does. We need to know a retic count, which will at least insure that the iron absorbed is being used to make blood. If that's high, then the new blood being made can only be going one place. That means guaiac every stool until you catch it. SBH Thanks for the post. I'm going to print all this out and bring it to my doctor. The Hematologist also said that I'm probably losing blood somewhere. I haven't noticed any blood being lost through the bowel but sometimes you just don't know. When I had my bleed last year, it was all due to the 2.5 cm ulcer. They found a pool of blood upon entry with the endoscope. I also vomitted a lot of it up. Quite scary. Are you suggesting I save all stool until they find it? Is there such thing as being able to do the test to see if there's blood in my stool from home? I know they've given me the kits but I'd have to mail it in everytime I go. There has to be an easier way no? Thanks! Lisa >>I know this may have come up last year, but were you tested for gluten >>intolerance (celiac sprue)? > COMMENT: > > A good thought, but if this was operating by affecting absorption, then > the absorption test would be off. If (morely likely) it was operating > by causing micro-bleeding, then she should still be quaiac pos (which I > assume has been tested, yes?). Good point. I can't say I've ever heard of an iron absorption test, though. Do you know anything about its sensitivity? SignatureDavid Rind drind@caregroup.harvard.edu As for the iron absorption test I had, it was done over a few hours. I was fasting and they did a baseline. From there I had to drink a lot of the pediatric liquid iron supplement. Then an hour after the Iron was taken, they drew blood again and then drew it yet again an hour after that. That was the extent of my Iron absorption test. I also had bloodwork for Pernicious Anemia done. They checked my Vitamin B12 to check for it. Is there any other specialized bloodtests that I should be getting done for the anemia that they might not be thinking of? Thanks a bunch guys! Lisa > As for the iron absorption test I had, it was done over a few hours. I > was fasting and they did a baseline. From there I had to drink a lot [quoted text clipped - 8 lines] > Thanks a bunch guys! > Lisa It sounds like an iron absorption test -- it's just that I've never seen or heard of one being done, and I don't know anything about how well it predicts actual problems with iron absorption. By and large the diagnosis of iron deficiency anemia in most situations is pretty easy -- the blood tests show anemia and low iron levels. At that point, the cause is either inadequate intake, inadequate absorption, or blood loss. Most blood loss that causes anemia is pretty obvious (menstural, gastrointestinal). There are some odd ways to lose blood (such as in the urine) that can be tested for, but I would guess that if people are doing an iron absorption test they've already looked for blood loss. Gastrointestinal blood loss is usually looked for with repeatedly testing for blood in the stool. SignatureDavid Rind drind@caregroup.harvard.edu Hi there. Nice to see ya again. No I haven't been tested for gluten intolerance. Can you tell me a bit about that? Yes, it's been a year since I've posted. I'm doing much better than the last time we spoke except for the anemia. It's just more of an inconvenience than anything. Thanks for the response. I just looked in my medical files and yes I have been tested for gluten intolerance and I'm fine. I'll type out the abnormal amounts on this last bloodwork from this week: HGB 10.9, HCT 33.9, RDW 18.3, Plt Cnt 434, Lymph Abs 3.6, Total Iron 10, % Saturation 3, Ferritin 6, RBC Morph Abnormal, Plt Estimate Slt. Inc. I understand totals except for Lymph Abs, RBC Morph and the Plt Estimate. Would you believe that my doctor mailed these test results to me in the mail? She said to continue taking my iron as I have been for months. I just want to figure this out and get back to normal. Any tips? Lisa By the way, I'm not sure if this affects my question but they're also thinking I have gastric motility. I guess that comes with the territory after the surgery I had. Can it affect my iron? > By the way, I'm not sure if this affects my question but they're also > thinking I have gastric motility. I guess that comes with the > territory after the surgery I had. Can it affect my iron? Decreased gastric motility should not affect iron absorption. Decreased stomach acid from surgery can somewhat decrease iron absorption but not usually by so much that it can't be overcome by taking iron supplements. SignatureDavid Rind drind@caregroup.harvard.edu |
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