I guess I'm anemic now. Thoughts? Guidance?

So - had the sleeve surgery, life has been great, got to goal faster than I thought (honestly thought I wouldn't make it - thought I'd hit 210, maybe 200), haven't really had any issues (that is, I've been lucky and fortunate).

So, I'm gearing up for plastic surgery in one month.  Cirangle pushed my annual comprehensive blood labs ahead a couple months just to make sure I'm really healthy for my lower-body lift.  But it seems like I'm anemic.  Which I guess I find myself surprised about - I wasn't expecting it with the VSG and especially at this time?

Sleeved on July 6th last year -
-- Had blood test with Cirangle around Aug or Sept
-- Had blood test with my PCP around Oct
-- Had blood test in early Jan
And none of those showed any issues with the CBC values.

So now in late April, I'm coming up anemic.  And I'm ill-prepared, because while I did a lot of due diligence in vitamins and nutrition for the sleeve, anemia/iron-deficiency was one thing I really did not study well.  And I'm searched "anemia" here on the OH boards, but a lot of stuff I find seems to pertain to RnY and/or DS surgeries, or extreme anemia causes (I think mine is less extreme?)

But it's left me with some questions, for those of you who may have more experience in this arena than me:

1)  Why did it take "so long" to become anemic?  Somewhere between 7-10 months post-op.
2)  With the different posts on here, I'm having trouble understanding "how bad" mine is.
3)  I'm supposed to run a 5K race (my first!!!) tomorrow morning... this is still ok to do, right?  After all, I've been training for two months without (?) apparent ill effects.
4)  I guess I'm really really worried this may delay my plastic surgery, which I have pretty much now cemented into my work schedule.  I just did my PS's blood test two days ago, so he'll probably receive these results in a couple days.
5)  How "fast" can anemia be rectified?  Days?  Weeks?  Months? (Again tying to question 4).

Here are (what I think are) the relevant  values of my labs:

CBC - RBC count
3.70 (4.20 - 5.80)

CBC - Hemoglobin
12.0 (13.2 - 17.1)

CBC - Hematocrit
35.5% (38.5 - 50)

CBC - MCV
95 (80 - 100)

CBC - MCH
31.9 (27.0 - 33.0)

CBC - MCHC
33.7 (32.0 - 36.0)

CBC - RDW 
14.6 (11.0 - 15.0)

Vitamin panel - B12
873 (200 - 1,100)

Iron panel - Total iron
80 (45-170)

Iron panel - Total iron binding capacity
249 (250-425)

Iron panel - Transferrin saturation
32% (20 - 50)

Iron panel - Ferritin
329 (20-345)

So Cirangle has told me to start taking a source of ferrous iron, 65mg, twice a day, with vitamin C to increase absorption.  I see posts on here that people 'really' need to take carbonyl iron with acid (vitamin C) or iron-bound heme (without acid) as "the best" - but that seems to be for more severe anemia?  Does this seem like a good start?  How "bad" is a hemoglobin of 12.0?

Ugh - sorry - just mildly panicking, as is my personality.   Any thoughts, comments, suggestions, personal experience stories would really be appreciated. 

Hey Ruggie, I'm no expert at all, but I just had my labs done to prepare for my xtended tummy tuck on the 23rd. My iron was normal, but I had been worried, so read as much as I could. I don't think yours is very low so I would think it would be easier to bring it up. Supposedly a lot of was people order a specific iron online from vita lady, I cant remember the name of it. I do green smoothies a few days a week and put lots of spinach, along with some fresh lemon juice and a small amt of other fruit or veggies. I think you can usually still do surgery if your iron is low but not too low. Good luck, I will be just ahead of u on the plastics.

Hi Anne!

I saw that you mentioned green smoothies.  Do you use the whole fruit and vegetable and blenderize everything with some water, or do you use a juice extractor and throw the pulp away?

If you do use the whole fruit and vegetable, how long do you think one might wait after a surgery before eating totally blenderized/liquefied and diluted green smoothies.

I make them now with kale, baby spinach, bananas apples and blueberries.

I feel that would be a good way to get vegies in post-surgery, but am not sure how many days or weeks I would have to wait.

I am only 8 pounds away from being the right weight.  Then all that is left is my doctor to submit my referral, so I'm trying to think ahead.

Thanks,

Anita

Thanks for the suggestion, and good luck with your own plastics! ;)

My labs looked OK for the first few months. My 6 month lab results showed an Iron deficiency I also noticed that I was getting cold. To the point where sometimes I would shiver. My doctor said the same. I tried a variety of Iron supplements. Vitron-C is what got my Iron levels up. But I also started to experience constipation problems. Brandilynn turned me on toProferrin. Which was easier on my movements and didn't have alot of the other restrictions that most Iron supplements have. E.g. you can't have anything with Calcium prior/after taking the Iron supplement. I have been taking proferrin for at least a year and my Iron levels are good.

http://www.proferrin.com/proferrin-es.php

Hi Mikey -

Thanks for writing.  The Vitron-C is what I just started taking, but I'll look into ProFerrin as well - thanks a lot for the tip!  Too damn easy to get constipated as a post-op as it is!

Also, thanks about the reminder about calcium.  So, I'll wait two hours between iron and calcium pills, but is it okay to take the iron pill and eat food containing calcium, like cheese, do you know?

No, any calcium including milk in your coffee.

The usual recommendation is to take iron away from everything else, which is why many people take it at night, before bedtime. The rule for separation also applies to calcium containing foods, such cheese, milk, etc. Iron and calcium compete for the same receptor sites and iron loses that contest. The vitamin C helps to increase the iron absorption by the body.

D'oh - bedtime is a great idea - thanks!

Your iron deficiency isn't too bad.  In fact, it would be considered "borderline." You have a great Ferritin level, which is an indication of your iron stores. I don't know that you can bring it up within a month. With plastics, you will be losing some blood volume, so I would check with your plastic surgeon. You really need to go into plastics in good shape, with good labs. Plastics sound like a grueling recovery and you don't want to go into it with anemia.

I had anemia early on, which was related to a complication that I had at the time. I was treated with iron infusions. It is actually not uncommon with gastrectomies to have anemia early and later on. That is why our labs are monitored, so that we can catch trending down lab values.

gail