Low Hemoglobin

[carriej22]

Well, this is a new one for me.

I went in yesterday and discovered I have low hemoglobin, pale cells, and she said something about iron but I can't for the life of me remember.

She has put me on a special diet, protein based, and going in a few weeks for a recheck.

Anyone else have these issues?

[mrtmeo]

My mom has low hemoglobin, hemocrit and rbc's from the disease, but she doesn't have pale cells.
Her iron is fine, but they still call it anemia.
I believe hers is due to some internal bleeding that they can't find.
When she was on 1 mg mofetil, it was going away, but she can't tolerate the 1mg everyday.

Did they do the iron panels?

[carriej22]

They did not. She added a bunch of stuff onto my bloodwork in a few weeks time, and in the mean time has me on a very protein oriented diet... Which normally isn't something I eat a lot of. Red meats, fish, eggs.

I'm kind of confused because upon googling this seems like it could be a somewhat pressing issue and she was just sort of brushing it off.

[mrtmeo]

They did not. She added a bunch of stuff onto my bloodwork in a few weeks time, and in the mean time has me on a very protein oriented diet... Which normally isn't something I eat a lot of. Red meats, fish, eggs.

I'm kind of confused because upon googling this seems like it could be a somewhat pressing issue and she was just sort of brushing it off.
Unfortunately, we humans can't survive without eating animals and animal products without some serious supplementation.
There is almost no b12 in vegan foods that is absorbable in the human body.
Do u supplement with b12?

The iron fortification in foods is of ferrite form (iron filings) and this is not the form the body can use.
Humans need the ferrous forms of iron, but there should be enuf in vegetables, such as spinach.
Folate is another item that might not be asorbed by those who have an MTHFR mutation.
This mutation is becoming very common and they usually supplement with L-Methylfolate.
MTHFR genetic defect - Stop the Thyroid Madness? (http://www.stopthethyroidmadness.com/mthfr/)

Eggs are very nutritious because it is a whole food that makes a whole chicken.
Butter is also, very nutritious when it comes from grassfed cows without antibiotics or hormones.

Do u have another dr that you could get a 2nd opinion?

[carriej22]

Oh don't get me wrong, I eat meat... Just not very much fish (not a fan) and red meat because here, beef is very expensive. We eat a lot of chicken and that sort of thing.

I do have a second doctor who I am waiting to call on Monday when he gets back. He would have seen these lab results and never said anything, so I'm not sure what to think of that.

[mrtmeo]

Oh don't get me wrong, I eat meat... Just not very much fish (not a fan) and red meat because here, beef is very expensive. We eat a lot of chicken and that sort of thing.

I do have a second doctor who I am waiting to call on Monday when he gets back. He would have seen these lab results and never said anything, so I'm not sure what to think of that.
You can call his office and ask questions and the nurse may get your answers for you and call back.
If you have a rheumy or nephrologist, they might tell you more.

[Thinker]

I have had low hemoglobin and rbcs from the time of my diagnosis, I've never heard of pale cells though. It depends on how low your tests are. When I was mildly anemic, my doctors didn't do any intervention. I did become severely anemic, Hemoglobin of 6.6 when my bone marrow was being too suppressed by Cytoxan and they had to lower the dose. My nephrologist told me that if your hemoglobin gets below 7.0 you need a blood transfusion. I never had one as my lowest measure of 6.6 was taken in the ER when I had an unexplained fever and they wanted to rule out infection. I was already just started on a prescribed oral iron supplement from my doctor and had just lowered my dose of Cytoxan so the ER doc wanted to wait and see if it would come up on its own. When it was that low I felt very tired, low blood pressure, muscle cramps, pounding heart rate, so you would also probably have some symptoms if it was really low. Do you have access to an online portal to see your lab results. Many hospitals and clinics are now offering this service to their patients and you can see if any labs are abnormal, what the normal range of values is, and research what the tests mean.

My rheumatologist had done a lot of tests to see why I was anemic, and they all were normal including B12, etc so they told me I had anemia related to having a chronic illness. I took the iron supplements for about a month and my hemoglobin is back in the normal range, although my red blood cells and hematocrit were still low on my last labs. Many of the medications we take for Wegeners can cause anemia as a side effect also and even something such as a medication to decrease stomach acid can cause decreased absorption of nutrients contributing to anemia.

Iron from animal sources is better absorbed by our bodies than iron from vegetable sources. Eating a food rich in vitamin C along with your meal will also help increase absorption of iron. You can google a list of foods that are good sources of iron. I also now take a multivitamin that includes iron. If you want to do that, check the label on the vitamin bottle as many adult multivitamins do not include iron, I take a children's chewable.

[JeanMarie]

Hi Carrie,

Depends on how low your hemoglobin is. The doc will probably check
things like iron and the b's –there are different kinds of anemia &
that's what they want to find out. Most people with kidney disease
will be anemic at some point. They may want you to see a gastro doc
to rule out internal bleeding. If your Hg is above 10 they won't rush
to treat, they'll make sure they know the cause first. It's really
important not to take iron supplements without your doctors
approval—your iron can be too high and that's a problem as well.
Hope you get a solution soon.!!

[carriej22]

Thanks guys. I guess I will just wait and see what happens with the testing.

[mrtmeo]

Let us know how things go.

[Empty bucket]

Have you had Rituxan treatments? Maybe the cause of low IgG.kills the B cells right? My doctor is kinda thinking that's why mine is low. I had treatments yearly 09,10,11,&12. Had my IgG checked last year and it's 450-500. Either it's been that way for most of my life or the Rituxan could have caused it. Of course it was never checked until last year. The reason it was checked was because I could never shake the sinus problems no matter how good I felt other wise. Be interesting to see if those who received Rituxan have low IgG levels. I actually started a thread about this a while back but didn't get any response.
Maybe That I don't know what I'm taking about. That's definitely a possibility!:rolleyes1:

[mrtmeo]

Have you had Rituxan treatments? Maybe the cause of low IgG.kills the B cells right? My doctor is kinda thinking that's why mine is low. I had treatments yearly 09,10,11,&12. Had my IgG checked last year and it's 450-500. Either it's been that way for most of my life or the Rituxan could have caused it. Of course it was never checked until last year. The reason it was checked was because I could never shake the sinus problems no matter how good I felt other wise. Be interesting to see if those who received Rituxan have low IgG levels. I actually started a thread about this a while back but didn't get any response.
Maybe That I don't know what I'm taking about. That's definitely a possibility!:rolleyes1:

My mom's IgG levels are below normal and very low IgM which, I believe, is from the Rituxan, but she has MPA.
I have read that rituxan can lower igG, IgM and IgA levels.
IgA levels effect the mucosal secretions in the GI tract, respiratory and sinuses.
Selective IgA Deficiency | Immune Deficiency Foundation (http://primaryimmune.org/about-primary-immunodeficiencies/specific-disease-types/selective-iga-deficiency/)

[greenjeep]

Chemo really jacks up your blood counts. I had low heme in the hospital. They watched it daily and finally had to get a transfusion. I was in renal failure at the time. Everything was so messed up I don't really remember what caused what. But now - 2 years later - my labs are beginning to resemble normal values of some of the parts.
Basically, you are anemic. Just got to figure out why.


Sent from my iPhone while driving on the freeway, eating salt, and drinking a 78oz soda.