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Hi everyone,

I've been having problems with anemia off and on since I was pregnant with my second daughter. I've had the gamut of symptoms, SOB, palpitations, fatigue, etc., the worst of which was my daughter was growing too slowly prenataly--luckily iron supplements really helped and her growth caught up.

Not wanting a repeat of that 4 years later with my third, I was supplementing from the get go. My hemoglobin level dropped even further that time to 8.5. I ended up taking 3 SlowFE a day and my daughter was born three weeks early...

So now, a year and a half later, I start having weird symptoms again--palpitations, swollen feet and hands, SOB, fatigue, you all know. I went to the doctor and the bloodwork came back with hemoglobin of 9.7 (which I tend to think of as "mild to moderate" anemia) and my ferritin level is 1! Yes, 1. Why the discrepancy? 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?

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.) I have an appointment with a GI doctor and wore a holter monitor last week--still waiting for the results.

So here are my questions--

(1) Which level, hemoglobin, hematocrit, ferritin, etc. is the most important number here?

(2) Are swollen hands and feet a symptom of anemia? (This one is new to me!)

(3) I'm taking 2 slowFE a day (three was pretty intollerable). Is this sufficient?

(4) Should I be seeing a hemotologist instead of an internist?

Sorry for the overly long post...

Yes, I've thought of that--the more I read about it the more I realize that I've had diffuse symptoms that weren't ever put together (not by me or the doctors) that I attributed to "getting older" (I'm 33 and in otherwise good health!)

I'm realizing that many of these symptoms are likely caused by malabsorption problems (lack of vitamin K = easy bruising, low B12 = tingling in arms & legs, ...) I also found out I have exceptionally low cholestrol (97!) but I attributed this to my healthy diet... Now I worry that I will gain weight when I start absorbing food well again. I've often noticed that I eat the same amount of food as my friends who are overweight, and if anything, I'm underweight (or on the very low end of normal).

There is still a 5-10% chance that I don't have celiac. The blood tests were very HIGH positive, but there are false positives, so I won't know for sure until after the biopsy.

I'm not thrilled about the prospect of being gluten free, but I know there are so many worse things that it could be. I know many other people with autoimmune disorders (RA, MS, etc.) that are not treatable and progressively get worse. This at least is treatable, even if the treatment isn't easy and will make me feel like a bit of a freak.

So my new anemia question is this--if I do have celiac, and it will take ~1 year for my intestine to recover, is it pointless for me to be taking all this oral iron if I can't absorb it anyway? Should I be getting infusions or something else?


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