Low Hemoglobin, Ferritin, and Iron 3 years out, anyone else?

[FishingNurse 1,210]

Hello all!

All my labs were normal pre-op, at 1 year and at 2 years, and now at nearly 3 years I am very low on multiple labs. Has this happened to anyone else? My nutrtion is much better now that it was at year 1 and 2.

I am going to see a hematologist and possible get Iron transfusions. I am scheduled for a endoscopy as well. My primary doesn't seem to think this is related to my surgery. I am a RN and my thought is the prilosec I take for my horrid reflux could contribute to the lack of Iron absorbtion.

Thanks for reading! My results are listed with the normals after. Any thoughts or comments appreciated.

WBC: 3.3 (3.8-11.0)

RBC: 4.47 (3.7-5.2

Hemoglobin: 10.1 (11.8-15.5)

Hematocrit: 33.8 (35.0-46.0)

Iron: 20 (50-165)

Iron binding capacity 427 (250-450)

Iron Saturation 5 (20-55)

Prealbumin 17.3 (20.0-40.0)

Ferritin 2 (10-291)

everything else was normal.....

[swimbikerun 1,038]

Did they do a CBC w/diff? What about B12 and rbc & serum folate? UIBC?

Someone needs to take a serious look at that prealbumin. Are you losing weight? That's a serious Protein issue. I do mean really ... I was on TPN at that point when mine was 20 and went to 15 in 2 days.

[FishingNurse 1,210]

I have been at about the same weight for 2 years.... up and down with the same 10 pounds. Currently 5 poiunds from my lowest. I eat 75 or more grams of Protein a day and 1800-2000 cals a day. I just don't see how this is happening!

no diff, but all of the others listed are normal.....

Edited June 19, 2014 by FishingNurse

[FishingNurse 1,210]

@@swimbikerun why did you need TPN? did you have a leak?

[swimbikerun 1,038]

No malnutrition and cachexia.

[swimbikerun 1,038]

We dont either, its odd they say. I show signs of malnutrition but bloodwork is ok. I said that's probably because bloodwork is not an absolute and they should know that. That's why so many people get hurt, as a doctor should know that just because bloodwork is "normal" by the computer doesn't mean it is "normal" for that person.

[swimbikerun 1,038]

The PPI is a good cause of problems.

[lsereno 2,525]

My three year labs are still in the normal range, but I notice when comparing two and three year labs, the numbers are all lower at three years. I do take a full course of Vitamins and a PPI daily. I'm considering stopping the PPI because some other meds changed and I may not need it now.

Lynda

[swimbikerun 1,038]

Hmmm I'm not into believing that mess that just because your values are not lower than the computer range of values for 95% of the "healthy" population means that are you are not sick. You are right to compare and watch them.

My GI took me off the PPI. Gave me something more appropriate. Not that I dont need it now and then but I'm trying to stay off such things as I am having problems with meds.

[MichiganChic 3,262]

I'm 18 months out, and my labs are all normal, as of yesterday. I take 45 mg of elemental Iron daily. I want to get off of it, but my doc (PCP) doesn't want me to. He said he has a few patients with sleeves or RNY who have low Iron even with supplementation. I'm going to go off of it (against his recommendation) and have it checked again in a couple of months. I have read studies where some people are anemic even with lots of supplementation after WLS, just as some become hypoglycemic, despite adequate intake.

I did recently get off the PPI successfully.My Calcium levels are a little high, and I don't take any Calcium. I've had my had PTH checked, and it's OK, but something we have to watch. I also have to get off the mild diuretic I've been on for a few years for pedal edema, since that might elevating the calcium levels........Hate taking pills, but I hate Water retention worse.

[swimbikerun 1,038]

I was on 8 months of supplementation before I said forget the PCP and went to a hematologist.

Best thing I did. If you don't get things up with pills, after several months, its time to head to the specialist. It took 5 rounds of IV Iron, AND a B1 shot, AND a B12 shot before mine finally started to come up. Several months passed before that happened. In other words, waiting and waiting and waiting just doesn't cut it. What are they waiting for, Christmas?

The other issue is that anemia is an issue for malnutrition. It could be they are treating the wrong thing. B12 is needed for your blood. Folate is. Pernicious anemia is not a joke. Zinc, copper, are those getting checked?

Um ... your Calcium levels? Are those your ionized or serum/blood Calcium and has a urine 24 hour calcium been done and what are the results? Have you had dexa scans?

Have they figured out why you have pedal edema?

[CowgirlJane 14,259]

Try dgl licorice to replace ppi

[gomekast 559]

Try dgl licorice to replace ppi

What is dgl licorice?

[slvrsax 301]

@@CowgirlJane I just picked up some DGL yesterday. I saw it at the healthfood store while I was looking for a more complete Multivitamin and remembered you mentioned it. I'm staying on my PPI for now but will use it instead of tums. I tried one last night, tasted fine!

By the way - you are such an inspiration to me! I read your posts with great interest! I'm six months out and turning it up a notch so to speak. Buying my first pair of running shoes at Jock and Jill at Greenlake on Wednesday!

[CowgirlJane 14,259]

@@CowgirlJane I just picked up some DGL yesterday. I saw it at the healthfood store while I was looking for a more complete Multivitamin and remembered you mentioned it. I'm staying on my PPI for now but will use it instead of tums. I tried one last night, tasted fine!

By the way - you are such an inspiration to me! I read your posts with great interest! I'm six months out and turning it up a notch so to speak. Buying my first pair of running shoes at Jock and Jill at Greenlake on Wednesday!

Remember to give it a crunch or two then hold it between gums and teeth to melt. It coats the esophagus and helps protect it naturally.

Glad to hear you are doing so well... another seattle area sleever!!!