Low iron levels--at what point should I see a hematologist and/or inquire about an iron...

shutterbugjunkie
on 7/30/17 7:27 pm
RNY on 02/04/11 with

I'm 6 1/2 years post-op RNY and I've felt fantasti****il 2 summers ago. Then I had zero energy. And then all of a sudden I started getting migraines. I had testing done for the migraines & they haven't determined why I get them. Anyhow, I've recently had bloodwork done and my iron level was low. Hemoglobin was 10.6 the first time so my family doctor has me taking iron supplements 325 mg iron sulfate. Then bloodwork was rechecked again 3 months later. Hemoglobin was 10.8 and Ferritin was 8. He tripled my iron supplements (which btw I'm taking 500mg Vitamin C supplements w/ each iron pill.) I've read on here that our bodies don't absorb the sulfate iron as well as it absorbs the heme or carbonyl. So my questions are:

1) Should I let my PCP know about the other iron supplements & suggest that he prescribe one of those to me?

2) Should I go to a hematologist and seek his advice?

3) At what point does someone need an iron infusion? Does anyone know how low the Ferritin level needs to be?

CerealKiller Kat71
on 7/30/17 7:46 pm
RNY on 12/31/13
  1. As far as I know, prescription iron isn't heme or carbonyl. You'd have to purchase them yourself. I am currently using the patch (to bypass the missing duodenum), carbonyl and recently starting using heme iron after my last infusion. Truthfully, it doesn't seem to matter what oral iron I take as I am not absorbing it. I am hoping adding the heme and patch will increase the length of time between infusions.
  2. As far as I know, you will need a referral to a hematologist in order to get an infusion. Most PCPs will not order them and are not really as knowledgable as they need be to treat malabsorption caused non-anemic iron deficiency. I believe that is what you are suffering (I am not a doctor!) -- because your ferritin is SO low, and likely has been for a while, that your body has now become anemic due to losing your stores of iron.
  3. I get my infusions when my ferritin is under 50 -- as my insurance will not pay until I am under that level. I become symptomatic at less than 80. There are different standards for those of us with altered small intestines -- malabsorption issues -- and under 50 is that guideline. For normal people, over 25 is usually acceptable. Keeping mind that is quite different than what labs consider the "normal range" --- I recently had another infusion after having one last November -- I dropped more rapidly than expected and was at 4. I was miserable.

"What you eat in private, you wear in public." --- Kat

shutterbugjunkie
on 7/31/17 7:15 am
RNY on 02/04/11 with

Thanks for your input! I just scheduled an appointment to see a hematologist this Wednesday. Hopefully he can help me out.

CerealKiller Kat71
on 7/31/17 7:16 am
RNY on 12/31/13

I am so glad for you.

You can't believe how much better you will feel once this is handled.

It's night and day. Truly.

"What you eat in private, you wear in public." --- Kat

shutterbugjunkie
on 7/31/17 7:32 am
RNY on 02/04/11 with

Since I've been so tired for so long, I'll probably feel like a whole new person once my levels are back up & I have some energy again. Similar to like how I felt like a whole new person after my surgery---but this time obviously on a much smaller scale (pun intended).

Grim_Traveller
on 7/31/17 6:40 am
RNY on 08/21/12

The point to see a hematologist was 2 summers ago. I don't say that to seem flippant, but to underscore how serious it is.

You will never feel entirely well when your ferritin is in the tank. And you will never move the needle by taking oral supplements.

It's really common to need iron infusions after WLS. And to need more every 1 to 3 years.

I would see a hematologist ASAP.

Here's hoping you get some relief soon.

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

shutterbugjunkie
on 7/31/17 7:08 am
RNY on 02/04/11 with

Thanks! I actually just scheduled an appointment with a hematologist for this Wednesday. I'm anxious to see what he has to say. Up until recently I didn't know much about Ferritin levels and I guess my PCP doesn't, either because he never mentioned them being so low----only my hemoglobin levels. Thanks for your response!

shutterbugjunkie
on 8/2/17 10:53 am
RNY on 02/04/11 with
I saw the hematologist this morning. He's scheduling for me for one iron infusion a week for 8 weeks starting Monday. He said I should start having more energy in 2 weeks. Fingers crossed! Thanks again for your help!
Grim_Traveller
on 8/2/17 1:03 pm
RNY on 08/21/12

That's great news.

Please let us know when you've finished, and share your before and after numbers, along with how much better you feel.

A lot of doctors ignore ferritin as low as yours, and far too many WLSers defer to their judgement. There is just no reason to go on being so ill when there is an easy fix available.

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

Most Active
What's on your Monday Menu?
Queen JB · 49 replies · 481 views
What's on your Wednesday Menu?
Queen JB · 49 replies · 441 views
What's on your Tuesday Menu?
Queen JB · 46 replies · 450 views
What's on your Thursday Menu?
Queen JB · 44 replies · 394 views
What?s on your Sunday menu?
Melody P. · 2 replies · 110 views
Forum Search Error & 404
RNY2007 · 2 replies · 73 views
Recent Topics
What's on your Thursday Menu?
Queen JB · 44 replies · 394 views
What's on your Wednesday Menu?
Queen JB · 49 replies · 441 views
Forum Search Error & 404
RNY2007 · 2 replies · 73 views
What's on your Tuesday Menu?
Queen JB · 46 replies · 450 views
What's on your Monday Menu?
Queen JB · 49 replies · 481 views
×