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As a GB patient you have to have monthly B-12 injections AND oral iron along with all the many other supplements as you may already know. Was she taking her vitamins, iron and B-12 as required?

My sister is also a GB patient and she was non compliant (crazy), her ferritin and RBC count dropped so she became anemic. She was lucky and caught it sooner than later by chance. After GB her ferritin typically ran only 40 which is a low ferritin to me. So, when she became non compliant (for whatever reason), she used her ferritin stores as the body to tried to keep up. Some people are still able to absorb enough iron from supplements, but when they deplete the ferritin it becomes too hard for them to absorb enough iron to replete stores and and IV iron treatments are required. She may be able to use oral iron after that is over, but that is undetermined right now. My sister recovered her stores with oral iron therapy. She is also about 4 years post op. It takes years to deplete the ferritin stores unless there is an acute blood loss. There is also a special oral iron for GB patients that has IF intrinsic factor in it already and B-12, Vit C and iron for absorption.

There has been several people on here in the past that were not told to take B-12 by their specialist, if you can believe that? This no less becomes a deficiency leading to anemia. As I said before, a low MCV is indicative of iron deficiency BUT if there is anemia from a B-12 deficiency this can skew the results and make them appear more normal as her labs look with an MCV 82 (in range) low/normal range. This is just a guess, I am just a dumb patient:). It can confuse people though. Perhaps this is what her doctor was talking about.

I would recommend that you get her labs prior to surgery if possible to see where her normal range of ferritin was. It will tell you if she was anemic (as Steph asked) before her surgery and tell you what her baseline for ferritin is. This is something important to know. If you cannot get those labs get more current labs (prior to this time), and look for B-12, folate, ferritin and H & H, RBC to see what her normal counts run, low, normal or what and compare. If she has a history of anemia, I would think that this would have been reviewed prior to the doc agreeing to surgery because this could cause a major complication especially after gastric bypass. You should also keep a record of her lab copies to reference. A cause should have been found prior to surgery of that was the case. Hopefully, this is just a typical ID/b-12?? due to malabsorption as a result of surgery. This is quite common by the way.

To answer you question; yes, IV iron replaces feritin stores and builds the Hgb back to normal non anemic levels. B-12 injections will be needed if she is deficienct.
I hope your daughter is responding to IV treatment well. Keep us posted. FLFLOWERGIRL:)

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