RNY & Anemia

Hello:

Today, I was diagnosed with Iron Deficiency Anemia. My symptoms of extreme fatigue, awful/recurring headaches, sleepiness, body aches, difficulty concentrating, and lack of appetite came on very suddenly this past Thursday, when I had to go home from work halfway through the day. Friday was the same way. I slept those days, plus most of the Labor Day weekend. Tuesday, I made it through an hour and a half of work and today I called in. :(

My doctor put me on 3 iron pills daily (ferrous sulfite), plus one vit. C pill daily. She also suggested I take a stool softener. Both my ferritin and iron levels were low...Everything in my CBC was OK, except hemoglobin, which was low (big surpise).

It has been just over a year since my RNY. When anemia symptoms come on suddenly, like mine did, can they be related to the gastric bypass? Or is it more of a gradual thing? Although I am being treated for it, I want to get to the root cause.

I have read some articles that mention B12 levels associated with anemia; I don't know if B12 was checked or not. If they were, then that test has not come back yet.

I just want to be able to help my doctor figure out the root cause of my anemia. Sometimes we have to be our own advocates. Since I had a hysterectomy, I should not be getting anemic from menses. I thought I would ask here about the RNY, since I had one last year.

I hope I am wording this properly. Due to my brain fog, I am having trouble expressing myself.

Thanks a bunch!

J

yes. RNY related. Some of us do not absorb iron. I don't.
I just had a second iron infusion series. (last year one, this year just finished them month ago)

check other posts - that and Reactive hypoglycemia are problem for a lot of people who get issues even if they do what they are told to do...  
http://www.obesityhelp.com/search/action,search_oh/?q=iron&c x=000946886326336472648%3Ae-vpeg4uyxw&cof=FORID%3A9

I don't know how bad your numbers are but is an iron infusion an option?  That should bring your numbers up pretty fast.  I have heard that people with an RNY do have more of a chance of being anemic.  I would also find out about your B12 levels and perhaps see about getting shots.

Have you been taking iron?

I just wanted to mention that ferrous sulfate is not absorbed real well in RNY folks because we don't have much stomach acid, and it also tends to cause pretty severe constipation.  If that's the case for you, you might want to try carbonyl iron instead.

As far as vitamin C goes, if you take it with your iron, it aids in the absorption of iron.  You need 200 mg C for every 30 mg elemental iron.  Keep in mind that 325 mg ferrous sulfate only has 65 mg elemental iron (the rest is iron salts, which is what causes the constipation), so you would need about 400 mg C for each 325 mg ferrous sulfate that you take.

 Usually, symptoms come on gradually, but surgery may have sped things up. I've suffered from anemia for a long time prior to surgery, and whenever I stopped my supplementation, it usually took 2-3 months to get to the symptoms you're describing--pre-op.  Also, if you have heavy periods, that can make it worse. 

I recently started taking a different type of iron instead of the ferrous sulfate--carbonyl iron. I also have a Mirena IUD, so my periods have gotten considerably lighter. We'll see if those things have helped when I get my labs done in a few months. Good luck!

I can and probably is related to your RNY. I'm also anemic, didn't happen to me until almost 5 years out. Do you have copies of your labs? Depending on how low your numbers are iron infusions May be your best option. They really help a lot.

what are the general symptoms of iron infusions?

congratulations on your progress.....I have always been anemic but only during my pregnancies......I had 10 kids, then my anemia got better until after I had my RNY and it got bad and is still bad.....I have all of the symptoms you have and more......Now with the b-12 levels, I get a 1,000mcg injection per month from my doc but after I have had my reconstructive surgeries I have them 2x per month, still no help.

Also my iron is so low, my doc put me on INTEGRA iron prescription and I take it with a zinc supplement and vitamin C supplement and I admit I do not do it faithfully because of constipation!...

I have also developed PICA the last 2 years where I crave the taste and texture of only ARGO cornstarch....and my periods have always been heavy......I am facing 2 more reconstructive surgeries so I am looking into an iron infusion and maybe having my uterus taken out when I have my yearly OB/GYN appt.  I cannot have anymore kids,  I had 10, 3 were emergency c-sections and the last one had my uterus cut into a "Y" cut so I currently have a permanent tubal ligation, a procedure called ESSURE, which inserts coils that look like the ones in a ballpoint pen into your tubes and scar tissue blocks them over time for good....love it, but my periods are still heavy.

You gave me new insight though, now I know where my headaches are coming from frequently.

Well, what are your numbers exactly? That would help us help you better since we don't know if you're kinda low or in the toilet low. When my numbers got in the toilet, I started having the symptoms you have.

We don't absorb the ferrous salts well. That would be ferrous sulfate, ferrous gluconate and ferrous fumarate. They also can cause alot of GI upset even in normal folks. You'd be better off getting on 300mg of carbonyl iron. That's a true 300mg of elemental iron unlike the ferrous sulfate which only 65mg of the 325mg is elemental -- the rest is the salts. Many of us absorb carbonyl very well. If your numbers really suck bad you can go to a hematologist for infusions. Side effects vary and there's several different brands which do make a difference, as far as I've read. I don't have insurance, so I'm taking alot of pills to get my numbers up. In the meantime, I've just got live with the anemia side effects.

As for sudden onset, so was mine. I was fine and then I really, really wasn't fine. Our numbers can drop very quickly, unlike normal folks. Mine was a combination between suddenly heavier periods and working out hardcore. I was burning right through the iron stores because I wasn't taking any supplements at all. BUT you can also have some kind of internal bleeding like from an ulcer that's causing it too. Just because you've had RNY doesn't mean you can't get anemic from other stuff rather than just malabsorption. You might check into other things, just to be sure. In my case, I know 5 years of not supplementing just caught up with me... and the heavy periods and all that just sped up the inevitable.

Hello everyone!

Thank you all for your insight. I am taking ferrous sulfate 3X daily, plus vitamin C 500 mg once daily. The doctor said to take 250 mg of vitamin C, however the pills only came in 500s, plus I've read that the body can absorb much more without a problem. Judging by what I read here, I may call the doctor's office and ask about the different types of iron pills, as well as the infusions and my B12 levels.

The nurse read off my levels, however I could not write them down fast enough. The result of my iron and CBC tests are supposed to come in the mail today. I will post them when they arrive.

I am still not back to work...I don't think my boss is too happy with me. :( I cannot help the way I feel, though. I would not have been able to function yet, so what would have been the point?

How long should I give it, before I call the doctor, asking about infusions?

Thanks again,

J