do all DS patients end up anemic ?

I tended towards anemia prior to my DS so I'm no help there. However, I still (4 year later) have not needed a transfusion. I do watch my labs really closely and supplement when things start heading downwards.

 I've never had any infusions.  Iron levels are good with what I eat and my vitamins.

I apparently was anemic before my DS (only found out in my run-up to the DS). I am four years out and have had three iron infusions, the most recent one last week. Honestly, I prefer them over taking oral iron every day because of sontipation and upset tummy. And the iron prescriptions I have been on do not bring/keep my numbers up sufficiently.

Nicolle

 Once I restored my levels 6 mos post op with supplements, I've had great numbers ever since without taking anything more than daily red meat.

I was borderline anemic pre-op and had been anemic for periods of time in the distant past. Post op my iron levels are just fine. I also had very low D levels pre-op, now they're stellar!

It's a mixed bag. As long as you take your vitamins post-op, chances are that everything will be fine but you will have to adjust your vitamin intake according to your lab feedback. Some people do have trouble absorbing certain vitamins, but it varies from person to person and sometimes your pre-op vitamin deficiencies carry over post-op, but sometimes this is actually improved by the vitamin regimen.

I would not say that it is "normal" or "expected" for DSers to need iron infusions for life, that is not true. What is true is that occasionally, yes, a person may experience trouble absorbing a certain nutrient post op that requires something like an infusion to remedy- but it's is not the norm.