I am a patient of young onset Parkinson’s; currently 40 yrs old. On Levodopa and dopamine agonists like ropinorole and pramipexole. Lately hemoglobin levels has fallen quite a lot from 11.1 gm% in Jan 2024. Restless legs increasing too. have terrible constipation; my gut muscles slower than an Aged tortoise 🐢
Because of menstruation, currently feeling very weak and tired. I am wondering if I need Esophagogastroduodenoscopy with biopsy and iv iron; also colonoscopy.
oral iron may increase constipation.
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Divii
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I have not tried them, but understand topical patches can work well if anemia's not too severe. I think this is the best known brand; amazon.com/PatchMD-Iron-Top...
If you decide to get IV iron, maybe you could use these afterwards to "top up" iron stores.
For constipation we find avoiding meat and dairy and eating beans, chickpeas or lentils every second day helps. Also not sitting too long. By keeping regular walking around the legs help the bowel move it on through.
A high fiber morning planet-based protein shake might help you avoid meat and dairy yet start the day and stay regular. Try the brand Garden of Life on Amazon.
you ferritin is extremely low along with your heamoglobin and total red blood cells.. you also have other markers that are critically low ie; all those highlighted in red are critically low. What did your doctor say? Did they test you for pernicious anemia? Did they test to see if you have intrinsic factor? Without intrinsic factor your stomach does not absorb B12, it affects red blood production and you become anemic… when this happens people have severe fatigue along with other symptoms like tingling in hands or feet, nausea, racing heart, etc… look it up. My brother has it…. This may not be your issue but looking at your lab work your doctor needs to do further tests to find out what’s wrong with you…?I am NOT a doctor but based on your results and my brothers diagnosis you need help from a doctor that knows what he/she is doing…
"The probiotic strain Lactobacillus plantarum 299v (Lp299v) significantly increases intestinal iron absorption in meal studies. The present study was conducted to explore the effects of 20 mg of iron with or without Lp299v on iron status, mood state, and physical performance. Fifty-three healthy non-anemic female athletes with low iron stores (ferritin < 30 μg/L) were randomized, and 39 completed the study. Intake of Lp299v with iron for four weeks increased ferritin levels more than iron alone (13.6 vs. 8.2 µg/L), but the difference between the groups was not significant (p = 0.056)."
I know this is late, but WOW - what an eye opener about iron levels and PD. Thank you. My HWP has been slightly anemic for several months and after a long hospital stay for pneumonia in April, his levels were still low, so I fed him grass fed beef liver 5x in 2 weeks and started him on the bovine liver pills from Dr Mercola (Ancestral Supplements looks great as well). His blood levels are now good, I only dose him with about 20% of the liver pills now as a precaution, However, now that I looked up information on iron and PD, am at a loss for what is best for him! Here is an article that some may find useful - BUT - it has no conclusions, just says what Thal says, its a delicate balance and there are two totally opposite opinions on it. Very confusing for sure especially when serum blood levels and brain levels do not seem to correlate. Lots of good info here on this thread, just makes me feel a bit lost on what is best to do. Of course, our neurologist doc has Never mentioned anything about this.....This disease is tricky.... here is the article: sciencenews.org/article/evi.... Bless us all on this journey!
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Parkinson’s disease and iron
Iron deficiency anemia
High levels of iron 
Excess iron in the brain contributes to neurodegeneration. How do we reduce this? Iron chelator? Oxalates? 
