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Greetings all,
It's been awhile since I posted but I need some guidance and I knew this would be just the place to get it. The issue is that I am anemic and iron deficient and have been for about a year. I have had all the typical tests and then some, to rule out a GI bleed.
Today I saw a hematologist and he wants me to start taking iron. I was expecting this but I'm hesitant to take iron orally because of the GI implications. I've been doing pretty well with my GI symptoms (mastocytic enterocolitis diagnosis) and I'm afraid the iron will set me back.
The hematologist said I could go with the iron infusion option if I wanted to, but he suggested I try the oral iron first. He was going to consult with my gastro on this, but he felt pretty confident that I would be OK with the oral iron. I'm not so convinced based on past experience.
So, two questions; first, what are your thoughts/experience regarding oral iron use when colitis is present and second has anyone had iron infusion and if so, what was your experience?
The doctor is leaving the decision up to me and I'm really not sure which option to go with, which is why I welcome your thoughts.
Thanks in advance,
Julie
Anemia...oral iron or iron infusion?
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Hi Julie,
It's good to see a post from you again, and it's great to see that you have been able to keep your mastocytic enterocolitis symptoms well controlled, but I'm sorry that you're faced with an iron dilemma. If you're not bleeding, wouldn't the problem have to be due, (by default), to pernicious anemia, (IOW, insufficient production of intrinsic factor in the stomach)? Or am I overlooking something?
Isn't the standard treatment for pernicious anemia simply supplementation with vitamins B-12 and folic acid? Has your B-12 level been checked? Has your blood been analyzed for the markers of pernicious anemia? (For starters, pernicious anemia is characterized by a complete blood count result that shows a high MCV and a normal MCHC, and there are other markers, of course). Many of us with MC tend to have a B-12 deficiency issue, due simply to malabsorption, but we have several members with MC who actually have pernicious anemia.
Unfortunately, I haven't had any experience with iron supplements. I've been anemic several times, (earlier, due to malabsorption caused by gluten sensitivity, and recently, due to a bleeding issue), but I've never taken an iron supplement. Hopefully, someone else can share their experience taking an iron supplement.
Tex
It's good to see a post from you again, and it's great to see that you have been able to keep your mastocytic enterocolitis symptoms well controlled, but I'm sorry that you're faced with an iron dilemma. If you're not bleeding, wouldn't the problem have to be due, (by default), to pernicious anemia, (IOW, insufficient production of intrinsic factor in the stomach)? Or am I overlooking something?
Isn't the standard treatment for pernicious anemia simply supplementation with vitamins B-12 and folic acid? Has your B-12 level been checked? Has your blood been analyzed for the markers of pernicious anemia? (For starters, pernicious anemia is characterized by a complete blood count result that shows a high MCV and a normal MCHC, and there are other markers, of course). Many of us with MC tend to have a B-12 deficiency issue, due simply to malabsorption, but we have several members with MC who actually have pernicious anemia.
Unfortunately, I haven't had any experience with iron supplements. I've been anemic several times, (earlier, due to malabsorption caused by gluten sensitivity, and recently, due to a bleeding issue), but I've never taken an iron supplement. Hopefully, someone else can share their experience taking an iron supplement.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Tex and Julie,
I would imagine Julie's tests are showing a hypochromic, microcytic anemia, which does respond to iron therapy. Pernicious anemia would show up under the microscope as a macrocytic anemia, which does not respond to iron. Usually the former is caused by blood loss, which is why they did those tests to rule out a GI bleed.
I really don't have an answer. My own preference would be to try the oral iron first.......but Julie, it sounds as if you may have had trouble with this in the past? How about taking half the recommended dose over a longer period of time? That might be less corrosive on the gut. Iron often causes constipation, which may or may not be a "side benefit". Let us know what you decide.
Love,
Polly
I would imagine Julie's tests are showing a hypochromic, microcytic anemia, which does respond to iron therapy. Pernicious anemia would show up under the microscope as a macrocytic anemia, which does not respond to iron. Usually the former is caused by blood loss, which is why they did those tests to rule out a GI bleed.
I really don't have an answer. My own preference would be to try the oral iron first.......but Julie, it sounds as if you may have had trouble with this in the past? How about taking half the recommended dose over a longer period of time? That might be less corrosive on the gut. Iron often causes constipation, which may or may not be a "side benefit". Let us know what you decide.
Love,
Polly
Blessed are they who can laugh at themselves, for they shall never cease to be amused.