Vitamin Gurus--need IRON help!

I am concerned but not sure how to approach this--it appears that I am at least mildy anemic with no improvement.

Here is the timeline:

Surgery 12/22/09
Began taking 18 mg. of iron daily

6 month lab results:

HGB   11.5
HCT    34.9
RBC    3.91
Ferritin  429

I know HGB and HCT are low but were deemed within normal limits by that particular lab.  Everything else was great.  I took hemme iron for a month then begain taking to 90 mg of carbonyl iron (from Walmart) with 1000 mg of vitamin C daily.  After a few months when I met with the NUT she said that was too much unless the dr had ordered it and told me to reduce to 45 mg. daily which I did.  I continue to take the Vitamin C with it.

No labs ordered at 12 months--

Breast cancer diagnosis in February 2011 (had surgery and no additional treatment is needed).

Oncologist ordered the following on 2/1111:
HGB        11.7
HCT         34.9
RBC         3.79
Ferritin not tested.

Numbers are pretty similar to where I was in early June of last year.  I have drawn the conclusion that the increased iron has not helped.   It appears that these numbers are low rather than normal according to medical standards.

Also ALT and AST were elevated.  ALT was 83 and AST was 44.  Both were normal when tested at six months.  A few days ago PCP ordered additional tests for liver function and hep.  I am awaiting those results.

I had surgery on 2/25 (bilateral mastectomy) and lost blood during and after surgery (was discharged with 4 drains). I have been home recovering.  Now that I am up and about I feel so tired and dragged out. An hour out of the house and I am ready for a nap. I dont think I should be feeling this way since I haven't even had to deal with work or the stress connected to it in weeks.  I am wondering if the levels could have dropped further and if I should ask the PCP to redo the early February labs plus ferritin.

I ordered tender iron from Vitalady earlier this week thinking that a switch would help.  Waiting for them to arrive but wondering if now is the time to jump on this.

Any suggestions?

I think you are underestimating the wallop that breast surgery has had. It's only been a month and even minor procedures can hit hard. I had drains with plastics and they put a stress on the body as they do their job. I can't really help with the iron issues other than to say I only dealt with anemia while I was undergoing plastics - I had to bank blood for my LBL and that procedure depleted me. I had far less luck with supplements and far more with dietary iron (red meat (ground for me), dark leafy greens etc. I'm eating that way now again as I'm recovering from pneumonia and it's taken a toll on my diet and exercise. Good luck with the blood work and hope you feel better soon! Susan

Thanks Susan.  I figured that once my body felt better things would be ok and it was for a minute, then this.  I think you are right though.  There's got to be a connection between the surgery and this tired feeling. 

Additionally, the surgery was about 5 hours since once the surgeon was finished, the plastic surgeon started reconstruction.  I will have to go back to complete reconstruction in about 4 months which is yet another reason why I have got to get to the bottom of this now.

I agree with Susan.  The surgery is a trauma to your body.  Also after major surgery it takes a while to get back into normal eating and exercise patterns. 
Most people with iron issues have ferritin  that are way lower then yours. Ferritn is normal down to about 10 and you said your was at 429.  
I was diagnosed with breast cancer in Jan.  Medical oncologist/hematologist treat WLS patient with malabsorption issues.  I'm not sure if all do but mine does.  Talk to him/her about your concerns.  A breast cancer diagnosis is emotionally stressful.   Even when I think I am OK at times my subconscious mind is mulling over what is going on.  I know I have some sleep disruption from this.  Tiredness is normal and will get better.  Do you attend a breast cancer support group?  I think it helps. You are a survivor. Good luck.

The only input  I can offer on Iron is that what I heard at a recent Johns Creek Support meeting when a rep from Bariatric Advantage reviewed with us that we need to take our Calcium and Iron Supplements at different times due an interaction issue.