But ask your PCP or a nurse about specifics, especially about travel.

as a supporting factor .

Note: high levels of red meat may encourage situations of gout. Good news: citrus will alleviate gout which I can anecdotally attest to. so now there are 2 key reasons to have citrus.

So you are saying Vit C is helpful here, I assume. Thanks.

if it occurs, plus more water

good luck

They will try to iron tablets first. Ferrous gluconate has fewer GI side effects beyond black shit. If it does upset your stomach, try over the counter Slo-Fe, it's timed release and I've never met anyone who's reacted badly to it.

As for flying anywhere, you will need supplemental oxygen with those numbers. Aircraft cabins have the same pressure as 8000 feet in altitude, meaning people with anemia won't get enough oxygen carried by their depleted red blood cells and can run into trouble. Call your airline and see if they have/rent oxygen setups for passengers with health issues. You might need to collect a prescription for it if the charge is substantial, it can be reimbursed. If uou need to organize your own, most medical supply stores rent them. Again, you'll need a prescription.

(Note I didn't mention pernicious anemia, I'm guessing your B-12 levels were checked)

VITAMIN B-12 398 pg/mL is the number and I guess safe range is
193 - 986 pg/mL


Thanks for the oxygen tip, we will ask doc for that.

AS to

Slow Fe, High Potency Iron 45 mg, Slow Release - 60 Tablets

On Amazon the prices seem to vary a bit...this is 45 mg and is taking 324 twice a day. This is sulfate not gluconate? The difference is ?

Would one expect which numbers to improve how much with iron supplements? The caca remark is concerning, but I also thought they didnt look good. They did a scan of abdomen looking for bleeding, didnt find any.

and is tolerated better by people who get bad digestive upset from iron gluconate. Few do. If you do, ren it by your doctor as to your dosage.

Sorry if that wasn't clear.

Remember, black poo is normal no matter what sort of iron supplement you are on. It's a feature, not a bug.

Is this something you know about as in you or a family member and if so what would a person expect to improve those numbers to by taking the supplements, etc?

the latter being sadly out of date, but some things don't change all that much.

The biggest pill bottle I've ever seen was when I was put on iron four times a day for a hematocrit quite a bit lower than yours. I have a rare blood type and it was the holidays, so no transfusion for me.

I was fine within a month.

Nobody tells you not to do that, at least nobody told me, but she shouldn’t be chewing on that. Root canals, implants cost 6k per tooth + pain.

Don’t chew ice.

Good luck with that anemia! Thanks for sharing the information that you can.

My levels were just hanging around 8. Besides red meat, sardines, oysters, and salmon, they told me to eat spinach (but make sure I had some citrus or oj at the same meal), beets, and add a couple of tbsp of black strap molasses to my daily intake, if possible.

Hope she feels better soon.

some of those things are the wrong thing to eat... Red meat, sardines, oysters, salmon, other fish all verboten.

Health Care Provider). In the area of chronic anemia, you should know that veterinarians routinely provide better care than many in human medicine in the treatment of chronic anemia from cancer, autoimmune disease, iron anemia and other chronic conditions. Their stand of care is far more responsive to drops in hemoglobin and hematocrit for animals with similar conditions than are ER physicians and even primary care, even with cancer patient (oncologist) orders. in the area of "Cadillac" veterinary care, they often surpass those of us in human care. Seriously. I am sad to admit.

It is the case that a human patient may be allowed to be far lower in their hematocrit and hemoglobin before a transfusion is ordered than a canine patient with cancer or autoimmune condition. As one with colleagues in both fields, I can attest to this. You MUST advocate for the care. I'm sorry to say this, but I've observed it firsthand.

the supplement but we havent had the GP follow up yet.

The cause is bleeding sometimes I guess and if not bleeding from abdomen where else could it be, I wonder. Or it is just a condition that has no acute cause like that.

for which SOME are almost useless given the lack of absorption. Really. Do your own homework and be an aggressive advocate.

This is an area for which I get VERY antagonized by my colleagues and thus have ZERO problems pointing out that the best in veterinary medicine often have it ALL over us in terms of standard of care for those conditions.

My score is twenty, though, not as bad.

Not looking forward to any pill that makes me feel bad.

That has been a problem lately.

if she’s not already seeing one

Physician here. With no history of anemia, and given IV iron and discharged on iron supplements, I must assume your SO’s bloodwork was consistent with iron deficiency. They must have checked stool guiac for occult blood in hospital and should arrange a colonoscopy pronto if they haven’t already, unless there is some other reason for chronic occult blood loss - upper GI bleeding/ulcer/gastritis from regular NSAID use, chronically heavy menses, renal or bladder cancer, other…

Poor absorption from proximal GI tract (duodenum, jejunum) is an uncommon cause and would primarily occur in setting of previous upper GI surgery or chronic inflammatory conditions, which I’m sure they asked about and you would have been aware of.

They did an abdominal scan in hospital last week and nothing.

Could the colonoscopy have started a bleed during the process of that, and it could still be bleeding and if so how would they check that? Yes all bloodwork is consistent with iron deficiency, i posted some of it here and I have tons other that I could post but I dont know what to post to show you, but yes.

Below numbers were after first test in hospital beginning of last week, then the last test before they sent her home:

RBC 3.29 L (went up to 3.67 after hospital visit and transfusion and iron IV)

Hemoglobin 7.1 (went up to 8.4, normal for her in the past 14.0)

Hematocrit 25.6% (went up to 28.6% post hospital)

Ferritin 3 (no further testing)

NT-proBNP 567 (went down to 426)

Not even a month ago.

that would be the most common source of bleeding post colonoscopy. The dramatic symptoms - severe shortness of breath - does in part suggest acute/sub-acute blood loss, as slower blood loss over say 6-18 months would give a person time to adapt physiologically.

If she had GI losses post colonoscopy, she would have noticed reddened stools, somewhere between bright red and dark maroon. For the hospital to test for various forms of anemia, however, would suggest that the cause of anemia was not clear.

The BNP is a typically an adjunctive measure of heart failure, used in conjunction with the chest X-ray to determine if someone’s shortness of breath is caused by cardiac decompensation. Sounds like the value was normal, so not sure it was rechecked. Low hemoglobin can stress the system since she has markedly decreased oxygen carrying capacity, causing heart attack (MI) or congestive heart failure (CHF), but this usually happens in the setting of pre-existing heart disease.

Ferritin stores are very low, suggesting the process has been going on for more than just a few weeks though. If there is no reason for iron malabsorption - precious upper GI surgery/resection, chronic GI inflammatory condition - you’re looking at finding the reason for insidious blood loss.

Often, anemia is multi-factorial, so for example, it is incumbent on your docs to determine if the anemia is a combination of iron deficiency and anemia of chronic disease (acd), and find the reason for this.

What are your docs thinking is the cause of her iron deficiency?

They dont know, I dont think, but I was not there the day she had her last visit with the attending physician before discharge and she doesn't remember everything. Tuesday she sees her GP and they will have the notes and tests from the hospital as it is all the same system, so will find out more then.

I wondered if the CLN itself could have caused bleeding (had 2 polyps removed) that resulted in this since it was only a month ago, but if she was bleeding from the colon it would be in her stool AND would it have shown in the abdomen scan? I dont know if that would be visible or WHERE else could she be bleeding NOW that causes this that could be screened by another CT if anywhere?

Thanks again...

(I dont think she has noticed red or black or blood in stool between CLN (3-22) and hospital visit (4-11 to 4-13.) And as to now, or since hospitalization, she doesnt know because she has been plugged up which is common for her.

Which reminds me, we read that someone who uses stimulant laxatives on a regular basis, and we both do, can develop this issue as a result of the lack of absorption of the iron.