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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]

[FONT="Comic Sans MS"][COLOR="Green"]Hello all fellow anemics. I have chronic anemia currently thought to be caused by hypermenorrhea. I take two Slow FE per day in addition to the iron in my daily multi-vitamin. I have been taking this for several months and I am still in the moderate range for Iron and Hemoglobin deficieny. I have no idea what my ferritin is. I have the usual gambit of symptoms, chilly all the time, fatigued, arrhythmias irritability etc. However lately, when I take my medication I get nauseous and vomit...whether I take them with a bit of food or not. I feel better soon after but I not a fan of those feeling regardless. I have read than iron toxicity can initially cause gastrointestinal disturbances but my Iron levels are still low. Any thoughts?[/COLOR][/FONT]
Just an update...

I had repeat blood work last week. My iron levels are going up, I'm almost not anemic now. :-) My ferritin has gone from 1 to 3--so also increasing! My reticulocyte count is very low though. I'm hoping this turns around at the next blood draw in 6 weeks. Also, my vitamin d was low, consistent with celiac disease, which I just found out (officially) that I have. I had my biopsy on Tuesday and the office called a few hours ago to say it was positive. On the bright side, there is a cause for all of this that can be treated and will hopefully get better with a new diet.


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