Anonymous wrote:

Anonymous wrote:Start taking supplements daily. And see ghost you feel. You should feel better in a week of taking iron. (Maybe not 100% better, but substantially better. ). If you still feel the same after daily supplements get further testing.

For further testing, have you had a sleep study?

Why would she need a sleep study????

To Check for sleep apnea, which be causing the debilitating fatigue.

I have iron deficiency anemia. I felt like absolute dog poo all the time and I would get random waves of intense fatigue throughout the day. Before they even found the anemia, my cbc at my annual showed elevated white and red cell counts and a host of other things that were out of range. My pcp sent me to a hematologist. One week after my first iron infusion I started realizing that my joint pain and swelling was improving and I was staying awake all day. After two iron infusions, my labs started to correct themselves.
For me, it was all due to the heavier and more frequent periods of perimenopause. So I ultimately had an ablation.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to talk to your PCP about recommendations. You are not anemic. You are iron deficient. You can take oral iron. Your B12 is low normal. Would ask about a supplement for that as well. Did your Vit D get checked? That can make people fatigued when low. Are you nursing? Are you drinking enough liquid? Are you sleeping OK? Is your baby getting up a lot? Your TSH is normal. Your FT4 is low normal- that is also something to look at, especially post-partum. Talk to your PCP. Hang in there!!

Umm Tsh and t4 were not listed on here...

On first page

OP here. My doctor didn’t mention anything about my thyroid to me. But it looks like my numbers may be on the lower side of normal? Perhaps something to watch?

My T4: 0.9 ng/dL
Normal range: 0.9-1.7 ng/dL

My TSH: 0.61 uIU/mL
Normal range: 0.27 - 4.20 uIU/mL

Your T4 is too low - it should be in the upper part of the range to feel normal. Your doctor should run an entire thyroid panel (Free T3, Free T4, and indicator for Hashimoto's). Sometimes there can be temporary thyroid disease after pregnancy that goes away - but I am not really knowledgeable about this. Do you have heavy periods that are causing the iron deficiency anemia? The cause could very well be thyroid.

Anonymous wrote:

Anonymous wrote:You need to talk to your PCP about recommendations. You are not anemic. You are iron deficient. You can take oral iron. Your B12 is low normal. Would ask about a supplement for that as well. Did your Vit D get checked? That can make people fatigued when low. Are you nursing? Are you drinking enough liquid? Are you sleeping OK? Is your baby getting up a lot? Your TSH is normal. Your FT4 is low normal- that is also something to look at, especially post-partum. Talk to your PCP. Hang in there!!

Umm Tsh and t4 were not listed on here...

On first page

OP here. My doctor didn’t mention anything about my thyroid to me. But it looks like my numbers may be on the lower side of normal? Perhaps something to watch?

My T4: 0.9 ng/dL
Normal range: 0.9-1.7 ng/dL

My TSH: 0.61 uIU/mL
Normal range: 0.27 - 4.20 uIU/mL

Oh just saw you posted the actual numbers. Agree on the oral supplements and food high in energy. Also, look into which foods and beverages and meds lower iron absorption.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You should get an EGD and colonoscopy

No not if she has heavy bleeding during her periods.

Have worked in hem-onc and GI and we do this to women all of the time. It can be both.

Agreed. I have had severe iron-def anemia, MOST LIKELY from heavy periods, for almost 6 years.

However, I had to go through the usual suspects and rule out other contributing factors, including those that could be causing the abnormally heavy periods.

Ultrasound, thyroid hormone levels, colonoscopy and upper endoscopy.

OP- if your PCP did not give specific instructions, it makes me think your hemoglobin and/ferritin weren’t low enough to warrant anything other than diet changes and possibly an oral iron supplement (can be w ur daily multivitamin) and then re-testing at your next check-up.

Anonymous wrote:You need to talk to your PCP about recommendations. You are not anemic. You are iron deficient. You can take oral iron. Your B12 is low normal. Would ask about a supplement for that as well. Did your Vit D get checked? That can make people fatigued when low. Are you nursing? Are you drinking enough liquid? Are you sleeping OK? Is your baby getting up a lot? Your TSH is normal. Your FT4 is low normal- that is also something to look at, especially post-partum. Talk to your PCP. Hang in there!!

Umm Tsh and t4 were not listed on here...

Not too bad OP. Take vitron C and I think it will help. My iron now is 17 and Ferritin is only 2. Still…no infusions recommendation. My doctor just told me to double my iron supplement, which I can’t because it upsets my stomach. I cry as I drive to work every day because I feel so exhausted and know how miserable my day will be.

Anonymous wrote:OP again. I do have GI issues, so maybe absorption is an issue. My MCHC levels are also very low— I’ve read that could be a sign of poor absorption. I also just had a baby in March.

Ask your doctor for a celiac blood test. Iron deficiency was one of my main symptoms that led to my celiac diagnosis. That and a few other GI symptoms.

Celiac

Oncology/heme nurse here--low iron stores will absolutely make you feel this bad. If oral iron doesn't help, they can do infusions and you'd be amazed at how it helps

Anonymous wrote:You need to talk to your PCP about recommendations. You are not anemic. You are iron deficient. You can take oral iron. Your B12 is low normal. Would ask about a supplement for that as well. Did your Vit D get checked? That can make people fatigued when low. Are you nursing? Are you drinking enough liquid? Are you sleeping OK? Is your baby getting up a lot? Your TSH is normal. Your FT4 is low normal- that is also something to look at, especially post-partum. Talk to your PCP. Hang in there!!

Oh, ok! Thank you! I’m not familiar with the differences. All my doctor wrote on the portal is “Labs show iron deficiency anemia”. He is a man of very few words and doesn’t explain things very well. I’m stuck with him until I can find a new PCP, which seems nearly impossible!

I did not have my vitamin D checked, so perhaps I should ask him about that. I’m not sleeping all that well. It’s not my baby—it’s me me. I’m a night owl + bedtime procrastination + insomnia. I’m trying to work on it. I’m not nursing, but I could definitely drink more fluids!

You need to talk to your PCP about recommendations. You are not anemic. You are iron deficient. You can take oral iron. Your B12 is low normal. Would ask about a supplement for that as well. Did your Vit D get checked? That can make people fatigued when low. Are you nursing? Are you drinking enough liquid? Are you sleeping OK? Is your baby getting up a lot? Your TSH is normal. Your FT4 is low normal- that is also something to look at, especially post-partum. Talk to your PCP. Hang in there!!

Anonymous wrote:Copy and paste your exact iron labs so I can see. Depending on how low you may need infusions and colonoscopy

I don’t think my numbers are bad compared to some I’ve seen online, but like I’ve mentioned, I literally feel like the the walking dead. My husband is so concerned about me. I feel so much mom guilt because I feel like I can’t even enjoy my 9 month old. I’m 33 next month btw. Thanks for taking a look.

IRON: 34

IRON BINDING CAPACITY: 358

TRANSFERRIN SATURAT.: 9

MCHC: 31.1

MCH: 36

Ferritin: 15

Vitamin B12: 328

Zinc: 76

Folate: 6.8

WBC: 5.26

RBC: 4.65

HCT: 38.9

PLT: 282

HGB: 12.1

HCT: 38.9

MCV: 83.7

RDW: 15.1

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, what was the treatment recommended for your anemia? Have you started it yet?

What further testing is planned to search for the cause of the anemia?

Unfortunately, there is no treatment or further testing planned yet. My doctor that I LOVED left the practice and I’m stuck with someone else. He is not on as on top of things as I would like. He wrote “labs show iron deficiency anemia” on my portal. I called the office to ask what my next step should be. Like, should I schedule an appointment, should I take iron pills, do I need an iron infusion, should I think about scheduling a colonoscopy!? I reiterated just how miserable I feel and that I would appreciate a call back soon. I’m still waiting.

if you can’t get an appointment asap with a hematologist, go to the ER and get a blood transfusion with iron infusion. You will feel better in days. I know I’m just someone on the internet but went through this same exact thing. At a minute, take the bone builder iron supplements.

You can’t get a transfusion unless your Hgb is less than 7. Start oral iron every other day and try to sort out either where the blood is leaking or why you’re not absorbing iron. MCHC and iron go together. Some insurances won’t cover iron if your numbers aren’t low enough. Recommend either hematology or gastroenterology as first stop.

That's true about the hemoglobin level must be under 7. I just assumed OP was under 7 by her symptoms. I was at a six, and they gave me to two pints of blood. I felt better the next day and my symptoms are nearly gone. It is very difficult to get into a hematologist. My gastroenterologist had to push an appointment up for me with the hematologist in order to get a colonoscopy scheduled asap.
Op - please be aggressive with the doctors underscoring the need for care. You want to enjoy your baby and with proper care you will feel so much better.