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I went to see a new primary care doc a couple of weeks ago because my [B]hair has been falling out[/B] and I feel very [B]fuzzy-brained[/B]--can't find the right word, forget names, etc. She gave me a blood test for TSH (normal) and [B]ferritin[/B], which came back a [B]6[/B]. She reported the results to me via email, and did no follow-up tests, asked me no questions, just told me to take an iron supplement. Wrote "if you don't see improvement, then you should contact a dermatologist." I'm an academic so I immediately went to the primary literature to read up on iron, anemia, etc. I'm still pretty ignorant, but it seems pretty clear to me she should have at least done a CBC, asked about my diet and other questions about overall health, and given me some dietary advice.

I have a few questions for you experts:

1) how badly do you think she screwed up by not following up with more tests, asking about my diet, or advising me on how to take the supplements? I did pester her and next week have an appointment with a hematologist. I sort of want to complain about her. A ferritin of 6 with an unknown cause strikes me as serious.

2) I don't have particularly heavy periods, eat lots of meat, fish, nuts and healthy veggies, and thought I was the picture of health (no illnesses, medications, etc) and youth at 45. Evidently not! Anyone else out there with low ferritin or anemia who has a iron-rich diet, and no other pre-existing conditions that they know of? Or, was anyone in my situation, and then found out what they had?

3) how likely is the hematologist to give me an [B]iron infusion[/B]? Why would I want to wait months, with foggy brain (not good for teaching) and hair falling out (not good for anything!) for my iron levels to go up, when I could get it injected (or infused) into me? The pills make me feel yucky in my tummy.

4) other symptoms--some restless legs, cramping in calves at night, mild vertigo, tired, especially at the end of the day, and headaches! But I'm still able to run every other day on the treadmill for 45 minutes, but don't have tons of energy like I used to. I have a two-year old and work full time, so I don't know what's normal and what's sick!

I've gotten lots of advice, support and info from stalking this forum since I got my ferritin level--thank you so much for any help you can give.
Hi Hoovlet,

Just a couple of questions first 1.) Have you ever been tested for an autoimmune disease? Some cause your ferritin levels to be high and some cause it to be low. And 2.) When you typed what your doctor said "if you don't see improvement, then you should contact a dermatologist." Did you mean to type hematologist instead of dermatologist? If your Primary Care Dr. said dermatologist, then find a new Dr. and don't look back....

Ok, now I'll quickly try to help you out on your other points.

1.) This new doctor is letting it be known that she doesn't have time for you. In other words...she's rude. A level of 6 is bad. The fact that she was so blase about it just reinforces her lack of empathy and ignorance in the subject. I know it's a pain finding a new primary care (again), but if I were you, I would do it anyway.

2) I too am a carnivore, with normal periods, etc., etc., etc... All my life I have been borderline anemic until I hit my late 30's and my body decided it didn't want to absorb iron anymore. I do have rheumatoid arthritis, but i was diagnosed at 28 & it has never affected my iron. There are some studies out there that blame RA for iron issues and some that say RA has nothing to do with becoming anemic. The sad part about it was that I had finally found an iron pill (Bifera, which can be bought at Walgreens) that didn't give me a stomach ache, just to find out that I was wasting my money for over a year buying monthly bottles.

3.) Make sure to tell the hematologist that you have tried taking iron and it makes you sick. Also let him/her know that you eat a diet rich in iron. If he/she doesn't bring up the idea of iron infusions, then you should. They have changed my life. I actually feel human most of the time now. I go to Dana Farber for a half day every week for two months period about once or twice a year. It takes a full month for the iron to recycle through the marrow before you feel a difference. Also make sure the doctor tests your B12 levels.

And lastly, restless leg and hair loss are very common in people with low ferritin (even if your hemoglobin and hematocrit are in the normal range). My hematologist told me to take 500 mgs of magnesium before bed every night. It can help with the RLS. It has for me. It seems to work for me. For all I know it may be a psycho-somatic thing but as long as it keeps working then I don't care!

I'm sure there's more I could say but it's 1:50 am and I am having trouble keeping my eyes open!

Take care and good luck. I hope things go well at your Hematologists!

Alison





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