Anemic again & my liver function is still off- Including my labs, maybe someone else can...

~ Mar ~
on 3/30/11 5:14 am - San Antonio, TX
A few months back my PCP had found me "slightly" anemic, she told me to re-test my CBC in a month. I started myself on 2 Proferrin ES every day so when I re-tested my numbers had gone up a bit. Two months later it was time for my 1 year labs so I did them and she said I was no longer anemic. I didn't really see much change in my numbers (ferritin and iron had stayed the same and CBC numbers had changed slightly). Anyway, less of them had an L next to them so I figured that was a good thing, right? She told me to re-test again in about 3 months. I actually waited 4 and just got my results back. She says I an anemic again. What I am really worried about is that my ferritin and iron numbers have gone down. I am still taking 2 Proferrin Forte's a day and an occasional Proferrin ES at night  when I remember (about 4 times a week). I am going to be diligent from now on and take the Proferrin ES EVERY night, but I am still concerned. I would think that by taking 2 Proferrin's a day I would have at LEAST kept the numbers the same.
Maybe someone can understand this more than I can? By the way, my AST and ALT have gone up too, and my protein and albumin which was also tested by my GI doctor have only gone up a teeny tiny bit since starting my shakes. I was only doing 1 scoop at that time though, I started doing a double shake now instead and I have upped my protein much more through food... about 25-50g more a day. So I am calculating I now get about 175-200g of protein a day with the shakes included (at the time of the testing it was probably between 125 and 150).
The GI doctor is not too concerned about my liver functions, he says to re-test in 3 months and if it is still off then we will discuss it. My PCP wants me to re-test in 1 month for my anemia, and if it is still off then she is referring me to a specialist. She is testing my B-12 and Folate next time, but my B-12 always at 800 plus since I get a shot once a month (all depends when I got my shot, sometimes it is up to 2,000 if I had it really close to when I got my blood drawn.) and my folate has been increasing. I am guessing because it is in my Proferrin Forte.

I am including what some of my numbers look like. Maybe this will make some sort of sense to someone else. By the way, I just noticed my lab report says Anisocytosis +1, a quick google  tells me it means abnormal variations in size, should I be concerned?
    05/03/10 08/03/10 11/02/10 03/17/11
Protein: 7's   6.5 7.2 6.7 6.8
Albumin: 4's   3.6 3.9 3.7 4
Iron: 80-100   90 130 130 78
Ferritin: 200-300   23 14 14 10
Vit B12: 1000 +   845 2000 820  
Folate: >5.4   9 9.8 15.4  
    05/03/10 08/03/10 11/02/10 3/17/2011  
AST (sgot): Below 40   21 21 34 45  
ALT (sgpt): Below 40   18 18 36 94  
             
CBC   5/3/10 8/18/10 9/15/10 11/12/2010 3/17/2011
White Blood Cell Count   6.1 6.6 7.2 5.9 6.1
Red Blood Cell Count   3.63 3.5 3.7 3.49 3.48
Hemoglobin   11.9 11.6 12 11.9 11.1
Hematocrit   35.8 34.7 36.2 35.3 34.5
MCV   98.6 99 97.8 101 99.1
MCH   32.8 33.3 32.5 34 31.9
MCHC   33.2 33.6 33.3 33.7 32.2
RDW   14.2 13.2 13.8 14.9 15.1
Platelet Count   145 135 144 138 150
Absolute Neutrophils   3806 3940 4442 3393 3782
Absolute Lymophocytes   2025 2277 2477 2272 2013
AbsoluteMonocytes   238 317 252 201 244
Absolute Eosinophils   12 46 22 18 61
Absolute Basophils   18 20 7 18 0

~Mar~



 

Julie R.
on 3/30/11 6:00 am - Ludington, MI
 Do I recall Mar that you're actually an ERNY?   You still have your RNY stomach?
It could be that no matter how hard you try on the iron you're not going to absorb it and that infusions might be the only option for you.  Do you have an iron saturation or TIBC count with your labs?
Yeah, your ferritin sucks....my hematologist says that it's only part of the picture though.
I bet you'll end up with infusions.   No biggie.   Lots of us have them, most of us with no problems whatsover.    
Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125

~ Mar ~
on 3/30/11 6:41 am - San Antonio, TX
That is a very interesting point Julie. I do still have my pouch. I hadn't even thought that it could be the reason of my levels. I have always heard of B12 deficiencies being prevelant, so I guess I didn't even think about it possibly affecting my iron.

 I don't see my TIBC  count on the lab results, unless it is called something else. It says my iron saturation is 20% with the reference range being 15-50%. I think I might just make an appointment to go see a hematologist now instead of waiting (I don't need a referral). It is pretty much certain that is where my PCP will send me sooner or later anyway.

At first I was trying to make it work with my iron, but infusions are starting sound better and better. The only thing I worry about is it hurting or being allergic or something. But I guess it would save me a lot of stress in the long run and I bet it would make me feel more energy, because I keep feeling tired all the time.

Thanks Julie, you really gave me something to think about.

~Mar~



 

Amanda-DS
on 3/30/11 6:58 am
I would suggest getting to a hematologist ( check that he has treated wls patients with anemia before). I did the transfusions and am very glad myself, once I saw my ferritin was low I did not waste anytime.

Helps hubby and I are both physicians. My hematologist actually did my consult by phone and my exam on the day I started my first infusion I met him at the infusion lab.

I wouldn't hesitate a minute to do the transfusions again.
Gratitude is my attitude

Amanda-DS October 2001
highest >350/342 start of wls journey/ 192 @8years

~ Mar ~
on 3/30/11 7:19 am - San Antonio, TX
Thanks for the suggestion. I will ask when I start calling hematologists. I am so ready to get my energy back!

~Mar~



 

Julie R.
on 3/30/11 7:05 am - Ludington, MI
 My last iron sat, I think, was just under 30, and my hemo infused me.   She told me that after the first couple of infusions, she lets her infusion patients let HER know when they're ready to be infused, because we always know inherently when we are being depleted.    When my ass starts dragging and I fall asleep by 6 pm, I know it's infusion time!

I say, go ahead and schedule an appointment.
Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125

~ Mar ~
on 3/30/11 7:17 am - San Antonio, TX
Yeah, I have been taking naps at lunch and after I get home. Especially on days I have to work my second job that night (only about 2.5 to 3 hours a night thank goodness). If I have to work at my part-time job more than 3 consecutive days I am in a world of hurt for the rest of the week. I just can't seem to get enough rest!

I am researching hematalogists taking my insurance right now. Hopefully I can get an infusion ASAP. Thanks again Julie!!

~Mar~



 

Lynda D.
on 3/30/11 9:49 am
Not sure if this will help you or not, but I recently had some trouble with my iron, and it was because my kidneys weren't working as they should. The kidneys put out some kind of hormone that signals red blood cell production in the bone marrow.

Just something to think about and my two cents. I hope you get it worked out. It sucks to be fatigued all the time.

Lynda

First Surgery Date: November 5, 2005
Surgery Type: RNY--Proximal
Height: 5' 3"
Beginning Weight: 250 lbs.
Lowest Weight: 125 lbs.
Current Weight: 230 lbs. Seeking Revision to DS

kidnee
on 3/30/11 10:18 am - WILLIAMSTOWN , NJ
 Its called erythropoietin, the hormone excreted by the kidneys to help replenish Red blood cells in Kidney failure patients. 

Donna

Donna      HW 242   SW 227  CW 117 

            
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