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I am 4 1/2 years post op from an RNY. There were no post op complications and my labs until now have been picture perfect. About 5 weeks ago I started noticing my hair was thinning, I was tired all of the time, my skin was dry. I went to my doc thinking my thyroid was about due to go kaput (family history and I am almost 40yo). However my iron came back whacked. Here are my levels:

HGB 10.3
MCV 68
Hematocrit 32.2
Ferritin <1
Iron 22
TIBC 571
Saturation 4%
B6 and Vit D are low, everything else is great/normal

Kaiser is recommending 325mg ferrous gluconate (I got sick on ferrous sufate) for 6 weeks to 3 mos before they retest me and they have refused my request for a referral to a hematologist or iron infusion. From what I understand Kaiser's stance is that iron deficiency by itself is not a health problem that needs immediate or drastic treatment (iron infusion) and that the symptoms I have (hair falling out, dry skin, fatigue, shortness of breath and heart palpitations) are just uncomfortable. I am worried and tired and I feel sick.

Is Iron Deficiency a problem or is it only a problem when it causes severe anemia? What will happen to me if I have long-term iron deficiency and can't bring it up for 3 mos? The doctor says that my symptoms are out of line with my lab levels. Has anyone else experienced these symptoms with these levels - should I be looking for a different diagnosis? My protein is fine - I supplement daily.
[QUOTE=FLFLOWERGIRL;3999499]dawn999hall--Welcome to the boards! :wave:

Reading these thing gets me sooooo MAD. First of all, you probably are not absorbing because of your GB. Second, you should be seeing a bariatric specialist because they are the ones that know the real scoop on your situation. The others really have little understanding :dizzy:. Okay, I hear you saying that none of this is possible. So, If it were me I would give 1 month max on supplements because your blood will not drop overnight. But in a months time it could drop 1 point and that's not necessary or a good thing. After that, if you are not absorbing iron I would kick and scream for IV infusion. This is the normal and typical treatment for GB patients because you have altered the absorption process. Your Sat% is extremely loooow and you have no ferritin which is the iron storage in the bone marrow and organs that keeps the Hgb at normal levels so that you are not anemic. When that is gone then you begin to pull iron from organs which is not good. You do not give your RBC's but you are probably not making many at this point. Your symptoms sound more like a result of no ferritin more than the anemia itself. Your doctor is right about your symptoms, the shortness of breath is more when you have a severe anemia according to what we know about anemia. Also, remember that everyone is different and therefore suffer different symptoms at different levels. As far as the other things you are low in the B6 and Vit-D I am not sure in your case how you will get those, I guess supplement?? Take care and keep us posted. FLFG :)[/QUOTE]
FLFlowergirl - thanks for the reply. My doc gave up on me. He says that my symptoms don't match my level of anemia so I must need psych - forget the original symptoms I came in with 3 weeks ago (hair loss, fatigue and dry itchy skin) now that I can add shortness of breath and heart palpitations to the list then I must just be obsessing and none of my symptoms are valid now. According to him none of my symptoms come from iron deficiency and my anemia is so mild I should have no symptoms at all. I made another appt with him for Monday 6/1 - he gets a do over...if the dx is not iron deficiency then what is it? Let him tell me to my face that 3 weeks ago when I came in he should have diagnosed me mental. The problem is when my dh and I discuss it we cannot believe that I have mores stress these past 3 months then I have had in 2 years - I just changed jobs and I love my new job, I have way more free time than I have had in 3 years and make more money. So I can't understand how it could be stress - it seems too much like he is taking the easy way out and trying to not have to deal with me anymore.

On a side note my ferritin was in the 70-80 range until Nov 2006 when apparently it dropped to 22 but because that is considered normal he didn't say anything...I feel like I need my own medical degree so I don't have to rely on docs who don't know specifically about RNY patients.

Thanks to the forum for letting me post my rant. I am frustrated and still cold, tired, hair falling out, and out of breath!





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