Iron levels and labs....

Howdy,

I went to the rheumatologist last week and he ran my labs. Some were specific to my autoimmune issues and some I asked him to run like ferritin. I had my labs done 2 months ago by my primary care physician because my bariatric surgeon is not local so my post RNY care is handled here in GA instead of TX.

This is what my labs were last week:

Hemoglobin 10.3

Iron Total : 43mcg

RBC: 3.42x 10E6/UL

Hematocrit: 32.4

Ferritin: 8.7 NG/ML

This is what they were two months ago.

Hemoglobin 11.4

Hematocrit; 34.8

Ferritin: 13 NG/ML

Hemoglobin 4 1/2 months ago when I was discharge from hospital was: 13.9

Hemoglobin at last Rheumatologist visit: 14.0

My rheumatologist wants me to run a fecal occult test and go to the gastroenterologist. I told him I had a revision RNY and he thinks I have a gastrobleed....really?

I call my primary care physician and he wants me to come in and see him to discuss next course of action and take a fecal occult test.... whaaat? Why not just send me to the infusion center?

Sent a message and copies of my labs to bariatric surgeon thinking this might be a faster way to get to iron infusion.

Just frustrated...... I was thinking that my hemoglobin has dropped significantly in the last 4 1/2 months even with daily iron supplementation. Just frustrated..... I am taking all my vits and iron daily so dunno what else to do. At what point if you needed iron did you have an infusion?

Doctor's don't necessarily understand that low ferritin is not an uncommon side effect of RNY.

I also had normal hemoglobin. Your hemoglobin while it dropped doesn't seem significant to me, but I could be wrong.

My ferritin was dropping and my PCP immediately wanted to go for an endoscopy and colonoscopy.... I had to say wait.... redoing the blood work soon.

6 months or do ago when I first was checking into it and reading research... it said 50% of RNY could expect to have some kind of iron problem by year 7 even if they were compliant with their vitamins. The percentage was higher for menstruating women.

IWith a Ferritin below 10 I would go see a hemotologist.

Hi,

10.3 is not a normal hemoglobin for a post menopausal woman age 52.

Five months ago it was 14.0. Usually when it hits below 10, they recommend infusion. Considering I am only 4 1/2 months post op, this is going down 1.00 per month. That is a quick drop.

Below 10 for the iron infusion is for the Ferritin... you are below 10, that's why I said you should see a hemotologist.

Years ago I had a blood infusion for severe anemia not iron transfusion. My hemoglobin was just below 4. So I guess 10.3 didn't strike me as that low based on personal experience but again I said I could be wrong.

I would see if you could get a referral for a hematologist. My low iron is due to heavy periods, so if you're not having that, it's probably good to make sure there isn't bleeding somewhere. That said, I'm not sure why you couldn't get the iron infusions going regardless. I'm not a doctor, of course. Maybe if you highlighted any symptoms you might be having related to low iron, that may pu**** in the right direction.

I had low ferritin (and sometimes hemoglobin) before I had RNY, but now the symptoms are way more pronounced. My hematologist says that if the ferritin is around 20 or below and I have symptoms, he'll like me to get infusions regardless of my hemoglobin. Having symptoms was what triggered the infusion for him.

I hope you are able to get a resolution.

Karen

I would get in to see a hematologist, but it wouldn't hurt to do the fecal occult test -- it's about as easy a test there is. It's always good to rule out a bleed.

This kind of drop is not unusual though, especially for a revision.

Thanks! I have an appt to my primary care tomorrow. He is going to do the fecal occult. My bariatric surgeon sent me two prescriptions for INTEGRA and Ergocalciterol. She says my iron saturation is too low. She did not mention anything regarding infusion or the need to go to a hematologist but I am keeping my appt anyway with my primary care to see what he thinks.

Based on everything I know about taking these products, I may not tolerate higher doses of D and iron.