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Wednesday, April 16, 2014

Iron Deficiency

As many of you probably know, I have been anemic for quite a while now, long before my MM diagnosis.  I first noticed my weakness and shortness of breath on our family vacation in Switzerland in December 2008.  I could barely ski, and I found myself lagging the rest of the family walking up the hill to our rented condo.  After that, I saw my PCP, who prescribed iron pills.  After about 6 months, I was still anemic and I was referred to a hematologist, who prescribed Vitamin B12 instead of iron.

All of this persisted for another couple of years, during which I was often tired.  I finally got diagnosed with Lyme disease, and after several months of high-dose antibiotics, I felt better.  But my anemia never went away.  My hematologist never figured out the source of my anemia.  When I was diagnosed with MM in July 2011, I exhibited only one of the four standard CRAB symptoms (elevated Calcium, Renal problems, Anemia, or Bone lesions).  In my case, it was anemia.

I am recounting this background to put my current situation into perspective.  In January, I was found to be iron deficient, so I have been taking Ferrex iron pills since then (250 mg, 2x a day).  In March, my iron levels were about the same, which puzzled me.  After 300 mg/day of iron pills for two months, shouldn't things have gotten better?  I don't know, I'm not a doctor.  I brought this up to Dr. Richardson's nurse, Mary, at my last visit and told her I was a bit concerned about it.  She didn't think it was anything to be concerned about, but she agreed to bring it up with Dr. Richardson.  I also agreed to have a fecal occult blood test done with my PCP to see if there was any internal bleeding.

On Tuesday, Mary called me to say that Dr. Richardson had no explanation for the results, so he suggested that I get checked out by the Benign Hematology Group at the Farber.  So I now have an appointment in June to meet with one of their physicians during my normal monthly visit.

In the meantime, I obtained a fecal occult blood test kit from my PCP, Dr. Guidi,  and sent it in early this week.  I just got a call from Dr. Guidi's nurse today saying that the results were normal.  Phew!  That's good news.  I was concerned that there might be a source of bleeding somewhere in my digestive system that was depleting my iron level, but that seems to be ruled out now.

Maybe I'm supposed to just keep on taking iron pills for an indefinite period and hope everything is OK, but that just doesn't seem right to me.  There must be some underlying cause, and I would like to get to the bottom of it.  Maybe I'm being overly concerned, but I want to take control of my situation and not just let things dawdle along.  I'm happy that Dr. Richardson suggested getting another hematologist involved.  I'm also glad that I am being proactive in pushing for answers.  After being anemic for over 5 years, I'd really like to know why.  Maybe it has to do with the MM or the Revlimid side effects, but then again, maybe not.  I'm looking forward to finding out. 



6 comments:

  1. Have you tried the floradix?

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  2. No, I am not using over-the-counter iron. I'm taking ferrex as a prescription from Dr. Richardson, so I assume he has his reasons.

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  3. I hope this anemia doesn't have to do with the MM. How low is your hgb and hct with the iron supplementation?

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  4. Hi Elizabeth. Over the last year, my HCT has been hovering between 34 and 37. After 3 months on the iron pills, it went up to 37.9. My Hgb, which had been averaging about 11.5, went up to 12.3 in April. These numbers are still low, but definitely improved over past history. Thanks for asking.

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  5. You’ve been in that predicament for quite a long time. It must have been terrible not getting to the bottom of it. I hope you’ve found the answers to your questions by now, and that it isn’t as serious as it seemed. Take care and I wish you all the best!

    Cody White @ Dr. Chris Fraser's Clinic

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    1. Thanks, Cody. I seem to be doing fine now, so maybe the problem has been solved, at least for now.

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