Gina, I Need Help With Labs

I am concerned about my iron since it is still going down in spite of increasing my iron intake.  I had an iron infusion in 2010 and my ferritin has been trending down ever since.  I am officially anemic now and I will ask for another iron infusion but I doubt my doctor will go along with it. I am also concerned because my PTH was 99.5 in spite of the fact that my D is 85.4.  My calcium has been going down in spite of taking 630 mg 3 times a day.  I am increasing to 4 times a day and will see how that does.  I sent an email to my endocrinologist to ask about my PTH. The good news is my DEXA shows a lot of improvement since my Reclast infusion last year.  He wants to do another one but my calcium is too low right now. Hopefully this comes out in a readable form.  Most of my other labs were good, it's just the iron and calcium that I am worried about mainly. Also, I have been noticing my hands have been shaky lately.  It could be a side effect of my medication, though.  I cut back on it and I notice some improvement but I was wondering if that could be related to some deficiency.  I have also been tired more but that is probably due to the anemia.  

SODIUM, PLASMA (LAB) 136-145 mmol/L 135  (3/28/13 140)  

CALCIUM, PLASMA (LAB) 8.6-10.2 mg/dL 8.1 (3/28/13 8.3)  

TOTAL PROTEIN, PLASMA (LAB) 6.4-8.2 g/dL 6.4 (3/28/13 6.8)

ALBUMIN, PLASMA (LAB) 3.5-4.7 g/dL 4.1 (3/28/13 4.4)  

RED CELL COUNT 4.00-5.20 M/cu mm 3.63 (3/28/13 3.96)

HEMOGLOBIN 12.0-16.0 g/dL 11.6 (3/28/13 13.0)

HEMATOCRIT 36.0-46.0 % 34.7 (3/28/13 38.2)  

MCHC 33.4-35.5 g/dL 33.5 (3/28/13 33.9)  

VITAMIN D 25 HYDROXY 30-80 ng/mL 85.4 (3/28/13 59.5)  

3/28/13 IRON 30-160 ug/dL 63

IRON BIND CAP SERUM 240-450 ug/dL 386 (9/12/12 360)

% SATURATION TRANSFERRIN, 20-50 % 16  

3/28/13 FERRITIN 50-200 ug/L 76 (9/4/12 151)  

MEAS ICA, WHOLE BLD 1.14-1.32 mmol/L 1.16 (3/28/13 1.21)

PH, WHOLE BLOOD 7.34 (3/28/13 7.32)

CALC ICA, WHOLE BLD 1.14-1.28 mmol/L 1.13 (3/28/13 1.16)  

PTH, SERUM 15.0-85.0 pg/ml 99.5 (9/4/12 27.0)

If your DEXA scan is good, I wouldn't worry about the PTH. It's an indirect indicators. The DEXA scan is the actual indicator so it's what matters.

But low calcium in the blood is not a good idea as it can be bad for your heart. I'm sure your doctors will have a plan for that.

Hang in there with the PTH. I don't know what happens to those calcium, D3, PTH and osteocalcin after you take an osteoporosis drug but these labs seem to go bonkers for a few years afterwards. I agree with you about increasing your calcium a dose or even 2. The other thing to add is vitamin K2. I take 4 of Vitalady's 150mcg capsules a day. It's almost like the osteo drug turned my bones to cement, which isn't healthy either. Adding the K2 has help my bone issues and I've come off the Fosamax entirely.

The iron issue may be due to not enough supplementation of the right things. What kinds of iron are you taking and how much?

What was your B12 level?

--gina

Hi Gina - what do you mean the osteo [Fosamax] drug turned your 'bones to cement'?  As in solid, but brittle?

I think of it as solid. My osteocalcin was below the range for healthy bone turn over.

Hmm... I've not had osteocalcin measured - wonder if I can swing it to get that done next month.

That's good to know about the taking an osteoporosis drug.  I am increasing my calcium citrate up to 630 mg 4 x day, from 3 x day. I hope that helps.  I think the reason my D went up so much is because I have been riding my bike in the sun a lot.  I will add in some K2.  I have 2 more Reclast infusions to go, this year and next and then I won't need one for another 2 years or so.

It is good to look at labels.  I thought I was taking 100 mg of iron carbonyl a day but it turns out it is only 50 mg since I didn't notice that 50 mg is for a serving of two pills and I thought it was each pill, so I will double that.  I also take C with it.  And 36 mg with my multivitamins a day.  I just think it's strange that my levels dropped so much since March when I increased my iron at that time.  I hope I can get an infusion because I don't think I am absorbing iron that well.

My B12 level is good, over 1100.

My endocrinologist said the reason my PTH went so high is because my calcium is low so my parathyroids are trying to steal calcium from my bones.  I just think it is odd because even when my D level was undetectable my PTH never got very high and I would think with my D level being good I would absorb the calcium even better but like you said, it may be because of the Reclast.