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[QUOTE=steph74;3340340] Yes, 1. Why the discrepancy? [COLOR="Red"]There is no discrepancy with this. I would fully expect your hemoglobin levels to be low with a ferritin of 1. My hemoglobin dropped down to 11 when my ferritin was at 5, so it makes perfect sense to me.[/COLOR]The doctor was very agitated about how "severely anemic" I am--she said she would transfuse me except for the risk of HIV. I'm a little confused. Which number is more important?[COLOR="Red"]She is probably concerned with both numbers but the almost non-existent ferritin is probably what is most alarming to her. You have no stores left--this is why you can't properly make red blood cells.[/COLOR]

I pretty clearly have iron-deficient anemia and now the question is why. I am a vegetarian, but I eat a VERY healthful diet and include many sources of iron. (Of course everyone secretly thinks it's my diet, but I don't.)[COLOR="Red"]Even the BEST vegetarians have a problem with iron. While you may be eating TONS of iron rich veggies, it is non-heme iron and it is poorly absorbed. Even when you do everything to maximize it, you are only getting a tiny amount of it from your food. I just finished reading The China Study. The author is a HUGE proponent of a vegan diet and all its associated health benefits. But he even says that if you do this, you really need a B12 and iron supplement. It is extremely hard to get it from a veggie diet. Also, our food quality has gone down to boot so the nutrients just aren't there.[/COLOR] I
(1) Which level, hemoglobin, hematocrit, ferritin, etc. is the most important number here?

[COLOR="Red"]Ferritin is the most important for monitoring the status of your iron deficiency. Once it is determined that you are iron deficient, ferritin becomes *the* number that is looked at. However, hemoglobin and hematocrit are extremely important while you are in the stage of anemia. You want to see that go up quickly, or at least stabilize.[/COLOR]

(2) Are swollen hands and feet a symptom of anemia? (This one is new to me!)[COLOR="Red"]I never had this problem myself but that doesn't mean it's not a problem.[/COLOR]

(3) I'm taking 2 slowFE a day (three was pretty intollerable). Is this sufficient?[COLOR="Red"]For as low as you are, I'd say that it is going to be a long, slow climb out of it. Sounds like you need a prescription iron to me.[/COLOR]

(4) Should I be seeing a hemotologist instead of an internist?[COLOR="Red"]As long as you know the reasons for your anemia and the internist is responding appropriately, I don't believe a hematologist is needed. However, if you are not responding to basic treatment or you don't know the cause, a specialist would be the next step.[/COLOR]

Steph--When I was dx'ed with anemia my Ferritin was a 2 and my Hgb was 8.6. My experience was within 2-3 days of 3X Ferris Sulfate (which I do not recommend) daily I went to a 3, that somehow sounded better to me than a 2 LOL. At least you caught it in time that you do ~not need~ a blood transfusion. Transfusions are usually given around a 7 Hgb. You are not mildly anemic you are definitely moderate. And... I do believe that an iron script strength is needed. I take Poly Iron 150mgs X2 daily for a year in Jan. to fill those iron stores and fix the anemia.

Are you still having periods? This is usually the reason for most IDA in females. Most all of the people that are on this board have had GI testing to r/o internal bleeding or absorption issues. You may want to discuss this with your doctor. These are just some of the reasons for blood loss. If you are having periods and/or a diet of veggies that is enough to cause your blood results to be sooo low. I think this was a lot of my problem I was not replacing iron fast enough over a long period of time. I had Resistant Iron Deficiency Anemia for 6 months because I was unable to take the right amount of iron and still had periods. Because I was responding slowly to the iron they did not infuse me with IV iron or transfuse me with blood.

I did not have a problem with swelling either. I had palps very badly, especially after eating, for many months. As soon as the anemia resolved it went away. Always check it out but know that it is a common symptom for many. FLFLOWERGIRL:)

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