After a year and a half of lupron and zytiga i ended up with anemia. Colonoscopy and endoscopy came out clear and really clean so we attributed it to iron deficiency.
Currently iron is at 20 compared to a range of 50-175 and ferritin is at 3 compared to a range of 8-388. I changed my diet to include lots of spinach, broccolu, etc and started an iron supplement. After 3 months iron numbers did not move. I'm told i need to get IV iron. My question is does anyone have experience with IV iron and what can be expected? I wasn't thrilled when i looked up possible side effects.
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michael00
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Iron supplements such as ferrous sulfate usually work well specially if taken with a glass of lemonade or orange juice. Or Vitamin C 500 mg tab. Vit C increases the absorption of Iron in intestines
If you want to further confirm its really Iron deficiency anemia...get microscopic exam of your blood smear on the glass slide, Under microscope, if your red blood cells show smaller diameter (MCV) and less Hb per cell (MCHC), then it is 100 % Iron deficiency anemia.
But bigger question still remains WHY ? Are you losing Iron due to some slow bleeding somewhere or are you not getting enough Iron thru food ? Or some other reason.
Whatever be the reason. it still need to be treated by standard therapy. If that does not work, you may go for I V Iron.
My husband is going through the same thing. He got a transfusion last week. His hemoglobin was at 6.8 before and 9.1 after. Our GP told us to take iron and B12 supplements. The hospital told us to see our cardiologist (he could hardly walk 12 feet and was extremely out of breath)but cardiologist said nothing has changed from a year ago and that my husband needs to make sure he is getting plenty of protein. The pharmacy suggested ANEMIA Essentials. It has
Iron (Ferous aspartame ionized) 25
Vitamin c100mg
Folate 400mcg
Niacin 20 mg
Vitamin B6 5mg
Vitamin B12 100mcg
Copper 1.5 mg
Magnesium 5 mg
Vegetable fiber 269 mg
Says it is a complete energized ferrous iron formula.
I was looking for something he could take without causing stomach problems.
Nothing, it was just from my experience of taking iron supplements. It always gave me heartburn. I was afraid if it gave him any problems like heartburn, he wouldn’t take it.
Interestingly my wife just had two infusions of iron due to her low iron. Virtually no side effects and it brought her iron up to the high end of the spectrum. Her hematologist suggested a complete scope from both ends to look for a source of bleeding which can deplete iron. They found nine polyps some of which were bleeding which the doctor believed was the cause of her low iron. They said it could be an early sign of leukemia if her iron didn’t go up after the infusions and that her radiation from previous breast cancer increases the odds of leukemia.
Schwah
I am on the other end of the scale, i.e. 160-180 for the last 25 years that I have data. One month ago it surged to 217. I took immediate counter measures:
1) Stopped daily 1000 mg vitamin C supplement.
2) Reduced by, at least, half consumption of citrus fruits, kiwi an such that I like very much and may be overdoing.
3) During high iron content meals I eat along some feta cheese, as I have read that the calcium intake limits the iron absorption.
I visited a hematologist and took a list of blood tests.
Now the iron in the blood went down by 50% to 108!!!
Asking the dr how can this be possible, he replied: "Iron has a high variation during the day"
Just try the reverse of what I did and see how it works.
Have not but. My father was on zytiga and prednisone. His iron was extremely low, even had to get a transfusion to bring his blood back up, didn’t help much. Finally had to take him off of the zytiga and prednisone.
Still waiting to see what the doctor puts him on . Doctor said his enemia was caused by the drugs. Good luck with the monster 🙏🙏🙏
I had the same issue, MO prescribed iron supplements and they worked like a charm. It took a couple of months but iron levels are back to normal and anemia is gone. I get my iron levels checked regularly to be sure that they don’t go too high which can cause problems. The brand of supplements I use and my MO recommended are called “Ferro-Sequels” they come in a green box and are available on Amazon.
BTW my wife had iron IVs and she reported that it’s no big deal.
Interesting comments - husband's iron has been on the lower end of the scale but beyond being out of breath has not cause any major problems. He's been on Lupron for 3 years in January, Zytiga 2 years in December. His oncologist (hematology specialist) said that taking iron supplements wouldn't help as it's the cancer and the ADT that's causing the problem. I'm going to have to do some research on it.
My dad struggled with iron deficiency and anemia for the majority of the 5 years he was on Zytiga. We did various iron supplements, which for a bit, but the next thing they were gonna do was the IV iron. Scopes did not show any obvious loss of blood, and they didn't think he was developing anemia - so it was a bit of a mystery that was ultimately attributed to the combined effects of his long-term ADT.
5 months into Lupron, hubby was short of breath, could not walk on flat ground more than 10 or 12 feet without resting. His blood count was so low that general practice doctor hospitalized him and he got 2 pints of blood and IV iron. All scopes swallowed camera turned up negatively for a specific bleed. Gastrointerologoist told him to eat meat. His crits are improving but he is like a new man. More energy, can walk without stopping. My disappointment is that none of the doctors he saw, attributed any of those issues to Lupron. Even the radiation oncologist who prescribed the Lupron did not think his low counts were due to Lupron!
I was on Lupron (Eligard) for 6 1/2 years. I had low Iron levels, but it was from my kidney disease. I was stage 4 kidney disease. All the iron supplements in the world did not raise my ferritin levels. I had 5 iron I.V.'s of ferrous succrate in 6 weeks and my iron went from 9.4 to 10.0 . The kidney gives off a hormone called Erythropoietin that tells your RBC's to mature and enter the blood stream. Without this hormone all the iron in the world will not help. The cells just sit there in the bone marrow and need the hormone to mature (loose their nucleus) and enter the blood stream. The spleen kills off any RBC's that are over 4 months old so that is how anemia occurs with kidney disease. I get a shot of synthetic hormone about every 2 months called Procrit. I go to an anemia clinic and they really know how to control your hemoglobin levels. I was tired and had low energy for years and it is not worth it to try and find supplements. I wish you luck with your anemia.
A comment. Sounds as thought Fe supplementation may be beneficial. However, much of the anaemia due to ADT is likely to be due to direct effects of testosterone, not Fe, lack.
do you just take one 18mg iron per day? and one methyl folate per day?
Are you taking doxycycline? If so, I've read that vitamin C is the second "punch" in the studies that were done about doxycycline's effectiveness against cancer. So how much vitamin C do you take and does it need to be taken at the same time as the doxycycline?
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Looks like a bit of ADT induced anemia
High Ferritin level, low iron, 
Anemia related to bone marrow 
Iron storage and use
PSA woes paired with anemia and high alk phos
