Hi - I had RNY 4-years, 2-months ago. I have maintained a loss of approximately 190lbs! For the most part I am doing great! However, I am fatigued and my iron levels have been dropping. I have most recently been supplementing with proferrin (heme iron).

My latest labs:

Iron, total: 64 (40-190) so, still within "normal" range

Ferritin: 2 (10-54)

Hematocrit: 32 (35-45)

Hemoglobin: 10.4 **** 15.5)

MCH: 26.9 (27-33)

MCV: 83.1 (80-100)

RDW: 16.7 (11-15)

Red Blood Cell Count: 3.85 (3.8-5.10)

My B-12 is also low at 190 and my PCP now has me on a monthly injection -so I'm hoping that will improve soon.

I am feeling pretty wiped out. I have restless legs most nights. I am eating ice like crazy.

My pcp is monitoring my labs and didn't seem to think that I would be approved for an iron infusion at this point.

I am hoping to get some feedback on my labs from those of you who are familiar with them as well as whether or not an iron infusion would be appropriate at this point.

I will be seeing my PCP again on Monday and I'm wondering whether or not to push for infusions (or referral to a hematologist).

Thoughts and/or words of wisdom from those who have been there would be much appreciated.

Thanks so much!

So I have not had my surgery yet, but your lab numbers are similar to the 6 month numbers I had after having my son (developed anemia because of a complicated pregnancy and a lot of blood loss followed by heavy periods, go figure).  I would at least push for referral to hematology as they are more inclined to get you an infusion to get you "tanked up" to at least get you feeling better.  I saw a hematologist and was having an infusion 1 week later.  Helped a lot!  

That being said obviously they consider all the options, but seeing a hematologist is definitely a good idea for second opinion.  I see mine still and he's making recommendations for post bariatric surgery as well.

Good Luck!

You will never get your Ferritin numbers up without an iron infusion.  Ask you PCP for a referral ASAP.  You will feel so much better.  Many of us simply can not absorb iron from supplements and require periodic infusions.  My Ferritin was at 13 when I had my first infusion.  I am 5 years out and have had 3 infusions.  My PCP sends me to a Hematologist when my numbers get below 50.  She said there is no good reason to wait until I feel like absolute crap before I get infused.

I would run, not walk to a hematologist now!  My Ferritin hit 7 and they did an iron infusion immediately.  You will feel much better.

If the hematologist won't do it fine one that will.

My hematologist says that he has seen some after WLS who cannot bring their numbers up with just oral supplementation.  He has me checking my Ferritin every few months to catch things very they get too low.

I just had surgery and my numbers were abysmal and my Ferritin level dropped 110 points in about 6 months.  I'm going to push for another test and then see what my hematologist says.

Ferritin: 2 (10-54)

Hematocrit: 32 (35-45)

Hemoglobin: 10.4 **** 15.5)

that is bad.. get iron infusions... please... 

Whe is your PCP not concerned about your ferritin level?!? Even if your PCP is, for some reason, ignoring your ferritin level and focusing only on the total iron, I cannot imagine that a hematologist would!

If your insurance doesn't require a referral by your PCP, just find a hematologist who is covered by your insurance plan and make an appointment.  If you need a referral, just tell your PCP that you are very concerned about your almost non-existent ferritin level and flat out ask for a referral.

Lora

when my ferritin was 1, my PCP sent me for a blood transfusion. And to a hematologist for two sets of iron infusions. 

Your PCP has no place treating this.  You are in a specialist realm and need an expert to take care of you.  Not only in terms of iron infusions, but B12 shots.  You need them at least twice weekly until your levels are at 1000.  You are in danger of PERMANENT neurological damage.

Doctors are not infallible and you must be your own advocate.  Educate yourself and take control of your health as an active partner

Thank you all for your responses! I called a hematologist this morning and gave the office my information. They are going to get my latest lab results from my PCP, review them, and call me back with an appointment. So, hopefully this is the start to getting my health back on track... I'll keep you posted.  Thanks again for the information, advice, and the push! :)

-Amanda   

The hematologist has scheduled me for a lab appointment on 7/7 and an initial visit on 7/21. Off to the races!