Questions about anemia

[TravelingChris]

My dd18 in college has been diagnosed with anemia. On Monday, she went to student health because she had been feeling poorly since the previous Friday. They said she has low normal iron and took some blood for more tests. On Tuesday, she passed out, and was told she needed to go to the ER so an ambulance took her to it. There they found she was quite anemic and did an IV with both salt and iron (she already has neurally mediated hypotension which also causes pallor and weakness). She was prescribed three iron pills a day and told not to go to class until this coming Monday. Today she went back to student health where the provider thought she wasn't doing that well and was happy to hear that she will be seeing a cardiologist next Friday. Whatever she said seemed to dd that maybe she isn't having anemia just from the bad diet at the cafeteria or her being a female but something else more serious.

 

How long should it be taking for her to feel better? She felt best after the IV but the next day and up to today, she doesn't sound good (sounds weak), looks pale, and feels weak too. Is there anything else besides taking pills and eating meat that she should do? I have told her not to take ibuprofen right now. I am worried that she may have a bleeding ulcer. Any other suggestions?

[Kathryn]

IDK, but I've never "met" anyone outside of my family diagnosed with NMH! Most healthcare providers don't even know what it is.

 

I've also been diagnosed as anemic at various times in my life. When I was at my worst with that, it took several weeks of spinach, red meat, and supplements for me to start feeling "well" again.

[momtoamiracle]

do you know what her hematocrit and/or hemoglobin count are? When I had a ruptured ectopic my hematocrit dropped to 18 and my hemoglobin was 6. I was on 1000mcg of folic acid a day along with 300mg of iron, along with 1000mg of Vit C (necessary for iron to absorb) I ate three iron rich meals per day - meat, leafy greens, bananas, and I was told to rest.

 

 

In two weeks I was feeling better.

 

However if her condition is chronic, it might not be until they find what the problem is before she feels better.

 

I hope they find it soon.

[LizzyBee]

My dd18 in college has been diagnosed with anemia. On Monday, she went to student health because she had been feeling poorly since the previous Friday. They said she has low normal iron and took some blood for more tests. On Tuesday, she passed out, and was told she needed to go to the ER so an ambulance took her to it. There they found she was quite anemic and did an IV with both salt and iron (she already has neurally mediated hypotension which also causes pallor and weakness). She was prescribed three iron pills a day and told not to go to class until this coming Monday. Today she went back to student health where the provider thought she wasn't doing that well and was happy to hear that she will be seeing a cardiologist next Friday. Whatever she said seemed to dd that maybe she isn't having anemia just from the bad diet at the cafeteria or her being a female but something else more serious.

 

How long should it be taking for her to feel better? She felt best after the IV but the next day and up to today, she doesn't sound good (sounds weak), looks pale, and feels weak too. Is there anything else besides taking pills and eating meat that she should do? I have told her not to take ibuprofen right now. I am worried that she may have a bleeding ulcer. Any other suggestions?

 

Dark green leafy vegetables also have lots of iron. I eat a lot of salads with romaine and green leaf lettuce, and I would think I was on an iron supplement if I didn't know better.

 

If her hgb goes below 7 or 8 (different practitioners have different cut-offs), I would think she'd have a blood transfusion. The difference is amazing, but of course it's temporary until they discover and fix the source of the iron deficiency.

Edited February 24, 2012 by LizzyBee

[Harriet Vane]

I didn't feel much better until I had been supplementing for a month. It took eight months for my iron levels to get measurably better.

 

She can take a couple tablespoons of blackstrap molasses on top of her supplements. It's an incredibly rich source of iron. In her situation I would probably have two tablespoons at each meal.

 

If she does this, she should dissolve the molasses in lukewarm water to help it go down better. Taking it straight off the spoon leaves your mouth coated with molasses and sticky for some time afterward.

[brendag]

I've had issues off and on for years with anemia. One time I wasn't showing up as anemic with the general test they do in the gp office, but I had a high white blood cell count that wasn't going down. I had to go to an oncologist/hematologist and found out through more extensive testing that my iron stores were really low. I had the iron transfusion which helped, but it took about 6 months to get my iron store numbers up to normal.

 

I hope your daughter is feeling better soon.

[TravelingChris]

Okay thank you all for telling me it is normal for her to still be feeling bad. Neither dh (who is out of the country of course) and I have really had any experience with anemia. I have lots of experience with chronic diseases just none with anemia. I am wondering why the ER referred her to a cardiologist rather than a hematologist?

 

Did you all just have iron deficiency anemia?

[LizzyBee]

I've only had minor issues with iron deficient anemia. I was never severely anemic until I got leukemia and my wbc's were crowding out production of other blood cells.

[JumpyTheFrog]

Has she been checked for b12 anemia as well?

[bnrmom]

This sounds like something more severe than anemia. I am no expert - I will say that right away. However, I have struggled with anemia most of teenage/adult life, and at my last test my doctor commented that my numbers were so low she didn't know how I was still walking around. I do feel tired quite a bit, but I have never passed out, and I can function quite fine on a day to day basis. I also have Hashimoto's (thyroid issues).

 

I would want her seen outside of the clinic - full blood workup with a hematologist at the least.

 

Also, I honestly can't tell you how many times I've had to demand the doctor check more boxes on the lab slip. It really takes some deterimination to get to the bottom of these things sometimes. I have had a family doctor and a specialist both tell me that they are under severe scrutiny and pressure from insurance companies to order the most minimum of tests, and you really have to insist to get certain things tested. Is she near enough that you can attend an appointment with her? It can take some maturity to stand up to a doctor and demand the care that you need.

[lailasmum]

I have been anaemic for a long time though I feel a lot better now. It does take a long time to feel well. Did they tell her what her iron stores were?. Mine were very low, I did have ecg when I was first diagnosed because I had low blood pressure and a fast heart beat, that cleared up after a while of treatment, that could be the reason for the cardiology appointment. I also had a few funny turns, ending up very faint, with a cold sweats on the floor, again they stopped with treatment.

 

I know you can do stuff like take the tablets with orange juice to help absorption. And avoid calcium and tanins around the time of taking the tablets. It usually says these things on the medication leaflet. I sometimes found after re-starting taking iron supplemements I get a rush of energy after 3 days but it doesn't last and you aren't better and need to continue with supplements for many months.

Edited February 25, 2012 by lailasmum

[Sneezyone]

I've also been chronically anemic for so long that I don't really remember/know what it's like to have a full store of energy. They always tell me they don't know how I'm still up and about. Her b12 levels should also be checked as the two often go hand in hand. I have to supplement for months (which I hate to do...rough on ye old posterior) and do injectible b12 for months before I start to feel what most folks would consider 'normal'. Still, anemia in and of itself isn't usually life threatening; it just makes me chronically tired and my thinking a little fuzzy.

[Nature]

My husband has had chronic anemia for many years. Beets are known for helping to increase hemoglobin so my husband has beet juice every day. In addition to meat and dark green leafy veggies, kidney and pinto beans are high in iron.

I am surprised that she was referred to a cardiologist instead of a hematologist. In can take quite awhile to feel better, so tell her to hang in there.

[dancer67]

I have IDA. I see a Hematologist. To get a true picture and get an accurate DX of IDA, she should see a Heme Dr. She needs a full iron panel, which includes full CBC, Ferritin(Most important, these are iron stores),Iron Saturation, and TIBC.

 

Most Dr's only look at HGB and HCT, and many times those numbers can be normal, but your iron stores(Ferritin) can be low, and you are still considered anemic.

 

As far as why she was referred to a cardio Dr., severe cases of anemia can lead to heart issues. So maybe that is why. Or, they do not feel that her anemia was the cause of her being so ill.

 

I also had IV iron(no fun), and now I have been on 3 iron pills a day for the past 18 months. It takes a LONG time to build your ferritin levels back up especially if you still have your period. I had a level of an 8.(Normal should be at lest 50-150), and I am finally at a level of 48.

 

I would make certain she has that iron workup done by a hematologist, and keep the cardio appt as well.

 

I am a firm believer that when you start your period, that you should be getting more then just a finger stick at the GYN. ALL DR'S should be doing a full iron panel on all women who still have their periods. And fingersticks are never correct.

 

ETA: You also want to make sure the anemia is not being caused by something else, so an endodoscopy and colonoscopy is always highly advised. Even at the age of 18.

 

:grouphug:

[Harriet Vane]

I have IDA. I see a Hematologist. To get a true picture and get an accurate DX of IDA, she should see a Heme Dr. She needs a full iron panel, which includes full CBC, Ferritin(Most important, these are iron stores),Iron Saturation, and TIBC.

 

Most Dr's only look at HGB and HCT, and many times those numbers can be normal, but your iron stores(Ferritin) can be low, and you are still considered anemic.

 

As far as why she was referred to a cardio Dr., severe cases of anemia can lead to heart issues. So maybe that is why. Or, they do not feel that her anemia was the cause of her being so ill.

 

I also had IV iron(no fun), and now I have been on 3 iron pills a day for the past 18 months. It takes a LONG time to build your ferritin levels back up especially if you still have your period. I had a level of an 8.(Normal should be at lest 50-150), and I am finally at a level of 48.

 

I would make certain she has that iron workup done by a hematologist, and keep the cardio appt as well.

 

I am a firm believer that when you start your period, that you should be getting more then just a finger stick at the GYN. ALL DR'S should be doing a full iron panel on all women who still have their periods. And fingersticks are never correct.

 

ETA: You also want to make sure the anemia is not being caused by something else, so an endodoscopy and colonoscopy is always highly advised. Even at the age of 18.

 

:grouphug:

 

:iagree: Very thorough explanation--well said.

[AuntieM]

I have IDA. I see a Hematologist. To get a true picture and get an accurate DX of IDA, she should see a Heme Dr. She needs a full iron panel, which includes full CBC, Ferritin(Most important, these are iron stores),Iron Saturation, and TIBC.

 

Most Dr's only look at HGB and HCT, and many times those numbers can be normal, but your iron stores(Ferritin) can be low, and you are still considered anemic.

 

As far as why she was referred to a cardio Dr., severe cases of anemia can lead to heart issues. So maybe that is why. Or, they do not feel that her anemia was the cause of her being so ill.

 

I also had IV iron(no fun), and now I have been on 3 iron pills a day for the past 18 months. It takes a LONG time to build your ferritin levels back up especially if you still have your period. I had a level of an 8.(Normal should be at lest 50-150), and I am finally at a level of 48.

 

I would make certain she has that iron workup done by a hematologist, and keep the cardio appt as well.

 

I am a firm believer that when you start your period, that you should be getting more then just a finger stick at the GYN. ALL DR'S should be doing a full iron panel on all women who still have their periods. And fingersticks are never correct.

 

ETA: You also want to make sure the anemia is not being caused by something else, so an endodoscopy and colonoscopy is always highly advised. Even at the age of 18.

 

:grouphug:

 

:iagree: This about covers it! With such low levels she should be checked for other things, the scoping and possibly for leukemia. I was tested for all that plus lupus, but my doc felt sure my extraordinarily heavy cycles were the root cause. I am scheduled for a check soon.

 

Iron is a difficult supplement. You have to take a lot, but the absorption is not always terrific. It is important to take the iron with Vitamin C, but NOT with caffeine or calcium. Iron can really slow down the digestive system, so adding a small daily dose of Miralax or Konsul at bedtime is helpful.

 

If this were my dd, I would be sure to step in and advocate for her. I am working on transitioning my oldest to self-care, however, the circumstances you describe are seriously affecting her day to day activities so it's time to get to the bottom of things and find the cause.