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pcutil--Hello again! :wave:

Anemia is [B]ONLY[/B] a [U][B]symptom[/B][/U] not a disease in and of itself. It is telling you that something in your body is not working correctly. You have to find a cause. I was taught that it is not proper to begin iron supplements without first finding a cause for this. That is the first step, next would be to DX and eventually treat according to findings. Blood loss is the most common cause for IDA in women. [U]This is clearly not your case [/U]so it is important to begin looking for the culprit, there is one and you have to find it. It took me over a year to find mine. And I am still not so sure it is a definite cause, who knows? I have to remain on iron for the rest of my life, that is my prescription.

If you are seeing a PCP at this point I would highly recommend that you see a GI doc next. They are the profession that is experienced with types of malabsorption syndromes and other related issues to be ruled out at this time. There are many gastrointestinal conditions. We are just mentioning the most frequent that appear here on the boards. There are (AI's) autoimmune diseases and many things. There is no reason to wait 3 months in my opinion [U]being a male without known blood loss[/U]. Colonoscopy and endoscopy would rule out several things for you and should be one of the steps in diagnosis for you and even perhaps a small bowel study. No, you do not need to worry about colon cancer at this point. It is not just due to blood loss. There are many things that can and do go wrong within the GI tract. When going through these periods of not knowing, and uncertainty, the best practice that I have learned myself is NOT to worry UNTIL you have something to actually WORRY about. This is so true. It will save your sanity many times. So, don't worry about it. Just run tests and learn all that you can. Especially with a long history as you say. Hair loss can be due to many things; low ferritin and protein just to name a couple. However, there can be many causes for this.

Celiac is one of the first things too that should be ruled. Malabsorption is not uncommon in IDA because the iron is absorbed in the duodenum (1st segment of small intestine) and the upper part of the jejunum (2nd segment of small intestine), you should also have your Folic acid levels checked because they are also malabsorbed in Celiac and so is B12 but to a lesser extent. Whenever Anemia is present B-12 and Folate always need to be checked. Many doctors believe it or not, do not always run these tests which are a necessity. I didn't see that you have had these tested either! This is a must.[B] Even if you are not anemic [/B]at this point your ferritin is low for a reason.

You say you are physically active, are you overactive in sports? This can lead to a low ferritn. Use of certain drugs, i.e., advil can cause bleeding in the stomach too, if you use any of those. Any stomach problems?
None of us claim to be doctors, we are only able to give our personal experience and what we have learned from it. You need to consult a specialist to get proper diagnosis. I hope this has helped a little.

We are here for your support. Keep us posted. FLFG:)
I think I agree with FLFG and would ask for the GI testing and additional bloodwork now before you start the supplements. In my case I tried to donate blood on July 2 and was turned away because of my blood levels and was given a note to bring to my PCP. Saw the PCP last week in July and he sent me to the GI who ordered the celiac blood test, had me do stool samples, did the c'scope and even a capsule endoscopy (I had to swallow a pill that had a camera in it which transmitted pictures for 8 hours to show what my small bowel looked like - it is not seen in the upper endoscopy or c'scope). Since they were all negative for bleeding and I am postmenopausal with no more periods and no bleeding of any kind, I was sent to a hematologist who drew lots of blood and then finally put me on the iron supplements on November 18 which I took until April because my ferritin increased.
I was lucky that I didn't have any really bad symptoms but can say that I did experience some minor ones - fatigue, some leg cramps more like a charleyhorse in my calves, a little hair loss but I have very thick hair so it is not noticeable to anyone only to me when I look at my hairbrush or the bathroom floor. Ironically I think I did feel better back in the spring and lately have been thinking that I was experiencing some return but I don't really know for sure.
So I guess I would urge you to follow up with your doctor.

Don't be frightened about seeing the hematologist or having an upper endoscopy or colonoscopy. You need answers to what is causing your blood to be so low. The only thing I would warn you about is that often the hematologist is also considered an oncologist and sees patients with cancer. Mine does and it was a little scary at the first visit because I didn't realize that. Not everyone with a blood disorder has a blood cancer so don't let your mind play tricks on you. You can scare yourself silly.
As for the scopes, within the last 5 years I have had 3 colonoscopies and 4 upper endoscopies. Neither is painful - you will be sedated for both and usually will not feel anything. For one of my endoscopies I was not totally out of it when they started and I remember feeling like I was gagging but that only happened once.
I can't help you about the transfusion but there have been a number of threads about them. try to do a search on this board.
Keep us posted on how everything goes.

of course I will post my test results! you can count on it. October 14 is my appointment and I am going to call the week before to ask if I can go in the day before to have my blood drawn so my results are there when I'm talking with the doctor. Makes no sense to me the way they do it - see the doctor w/o the results.

Best wishes to all!

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