Iron Deficient Anemia and RA | Arthritis Information
2 months ago RD was super worried b/c I was anemic. I hadn't been religious about taking my iron at that point. My periods just started back in February, and they aren't fun, but not super heavy either. They have been worse.
Anyway, he almost gave me a GI referral. But at that appointment, my hemoglobin finally was in the 12's. My B-12 was high, folic acid was fine, but iron saturation was only 14% (not good).
Then a month later, after RELIGIOUSLY taking my prescription strength iron, I was down in the 11's again. I am on birth control now and if after this month & next month's test I'm still low I will get a GI referral.
No blood in stools, etc. but I did have that before when I was on Vioxx. On Meloxicam but also on Aciphex. I have crazy issues with being constipated but other than that no diarrhea or vomitting.
RD's theory is that MTX is not to blame because other counts are high, and last to go down is red blood cell count. So he is worried that i may be losing blood somehow.
Anyway I'm googling all this yesterday and it lists "iron deficient anemia' as a side effect of RA. But I guess he doesn't think that's my issue because maybe that would cause less to be made but I am supplementing so I must be losing blood someone? Maybe I have absorption issues?
There's no real point to this post, I'm just worried but I'm only 30 and really don't want a colonoscopy. If someone orders me to go, I will, but until then, I'm not that brave! I'm irritated because my RD (who I do like) seems so conflicted and part of me just wants him to say "go!" My grandfather died of colon cancer (he knows this) but was also super super heavy smoker/drinker. And he didn't die until his 70's, so my risk now shouldn't be too high.
Sigh.
Hmm I was just reading and fibroids can cause it too. My mom had fibroids. Since I wasn't anemic in January when I was still breastfeeding maybe this is to blame. Maybe I could have a scan for fibroids before the colonoscopy. They can also cause constipation...Just found this chart
http://www.aafp.org/afp/20070301/671-f2.gifKatie
I was anemic when I had fibroids- I was also bleeding very heavily every period though. After my procedures my anemia went away.
Iron pills and the constipation that they bring are a real drag.
[QUOTE=wanttobeRAfree]Katie
I feel like an old woman to say this but now I eat 5 dried prunes when I'm having trouble. They taste surprisingly good and usually work over night.
Man I felt like I was 85 when I said that!
Yeah I was a wreck when I was pregnant. I was on colace and eating fiber constantly. It never went away after I gave birth though. I am constipated without iron. And-I was not anemic when I was pregnant. So it may very well be fibroids (because those would go away while you are pregnant, or maybe just the lack of periods?) I don't think I have an iron absorption issue because I am on a prescription one and drink it with OJ and I don't think I have celiac. My B12 is high. So I need to accept that it probably is that I'm bleeding somewhere. I think they say the fibroids can require a lot of blood supply which might also do it? I dunno. I think I may call my gyn and schedule a scan to check for them, so I can know before RD refers me for GI.
I avoided the iron for a while b/c I was afraid of constipation but this supplement (Ferrex) almost seemed to make it better for a while then it just went back to normal. Actually I had a month there where I was having a BM every morning. But now I am back to every 3-5 days. I know they say 3 days can be normal for some people but it's not "normal" for me.
I notice you're taking Aciphex. Aciphex is a proton pump inhibitor which can greatly decrease the absorption of iron.
There is also Anemia of Chronic Diseases. My Dr. told me the more active your RA the better chance you have to be anemic.
googled and found this:
When taken without food, calcium carbonate did not inhibit the absorption of ferrois sulphate; however, at relatively high doses (600 mg), both calcium citrate and calcium phosphate significantly reduced iron absorption, by 49% and 62%, respectively. When taken with food, all three calcium supplements inhibited the absorption of the iron supplement, by 40-57%. They also inhibited the absorption of nonheme food iron. The degree of inhibition varied with the composition of the test meal.
I have anemia of chronic disease and my hemaglobin levels are often in the 9-11 range. I can't take iron so I have had a couple of iron infusions in the last 18 months. They work really well and raise your iron level quickly and for about a year or so. I am about to go to my hematologist next week so I had bloods done today. I will see how well the last infusion has taken. I can tell when my levels are down in the 8-9 levels because I get short of breath all the time. Other things don't help with low iron levels....mainly being female.
Keep an eye on things and let your dr know how you are feeling, hope they get to the bottom of it.
Interesting reading -
Pip
So sorry to hear this as I get tired from my RA. I take a multi vitamin and sometimes I take an iron pill. Were you very tired all the time or did you only know you were anemic from the doctor's tests?
Well I'm always tired, really, in some form or fashion! I was convinced I was anemic last summer when all of this started, I was EXHAUSTED. But I wasn't anemic. Checked again in October. Not anemic. Checked again in December. Not anemic. Then started NSAID and MTX in February, and also started my period (because I stopped breastfeeding so I could take meds, and baby turned 1).
So the anemia is either related to:
1. cycles--fibroids?
2. MTX? prob no
3. NSAIDs-stomach bleeding
But I have no signs of stomach bleeding.
I can't run around but I can walk for 30 minutes on the treadmill sometimes and I work all day but I have a desk job. The hardest for me is standing for long periods of times and I have to be careful with things like shopping to sit down and rest.
I like the idea of seeing a blood specialist over a colonscopy. Yes your counts are low at 11 but not terrible. My guess is that your anemia has to do with periods - just enough to make you a bit low. Take the iron and eat your prunes meantime. Hope your body straightens itself out! It gone through a lot of big change lately.
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