Are my hb and iron results dropping because of increased inflammation?

[Moomin8]

Evening peeps☺

I am beginning to think that my iron (which is down to around 4 (should be 9) and my hb is around 10 (should be around 12) is down to my inflammation: esr 120 and crp 114. I'm soooo tired what with still flaring after 9 months. I take ferrous fumarate 3 x a day. I'm off to the docs in the tomorrow to ask what I can do. I'm taking prednisolone now (into my 2nd week of 30mg) and I don't look so inflamed even though I'm still very sore. Will my hb/iron increase ? Trouble is the docs don't really know what to do.

[Beaches2]

Hi

I've been through this. I was anaemic for almost a year when things first kicked off. My GP said probably just because of the inflammation, gave me iron tablets. I was eating as much iron rich food as I could, did lots of reading online to try and understand why inflammation can cause anaemia. It seems it is complicated, but basically when you have inflammation you can't absorb/use iron properly. Anyway, once the inflammation was brought under control, the anaemia vanished.

There was a suggestion that I might need an endoscopy to check for any bleeding, but my levels increased and I didn't need it.

I don't think GPS do know what to do to help because it's down to getting the inflammation controlled and that's down to finding the right drug combination.

It's so horrible and miserable being tired all the time isn't it? I hope you find some relief soon.

[medway-lady in reply to Beaches2]

It could be Pernicious Anaemia also auto immune and I have that its not really a problem just a jab every 3 months now. Thats what they may be testing for as no amount of swallowed iron will improve it. Its down to absorption and jabs.

[Moomin8 in reply to medway-lady]

Thanks medway-lady. I've had my b12 checked. At first it was low but I take cyanocobalamin daily- just one a day now for maintaining my levels as I'm on 2 omeprazole daily, so hopefully all's well there?

[medway-lady in reply to Moomin8]

Not necessarily I used to take the blue capsules 3 day it made little difference so another test and PE was diagnosed. I don't know why Omeprazole as I only take this as well as the Riveroxaban can thin the stomach lining its not to do with the RA meds. I also have Celiac it again is not a problem just part of the auto immune spectrum. My RA is very well controlled and really no problem I take Arava (leflodamide) but do think be careful as sometimes its easy to make a link which may or may not be right. xx

[Moomin8 in reply to Beaches2]

Thank you Beaches2. That explains why my consultant wasn't too happy that my gp initiated an endoscopy! However, that revealed an hiatus hernia for which I've doubled my omeprazole -which helps. The trouble is with the RA and the anaemia, I'm double tired! How did you cope? I'm way off my RA being under control and have had to take a course of prednisolone about 4 times since January. The doses have to be increased each time before my inflammation gets anywhere near to decreasing. I'm into my 2nd week of 30mg and it still kills😯I've got jaw and toothache and a sore throat on top now!!! Arghhhh! !!

[Beaches2 in reply to Moomin8]

It's not easy coping with it all. To be honest I don't know how I did but we have no choice do we? I just kept hoping things would improve? My GP sent me to the anaemia clinic and I had to be screened for coeliac first......it was negative. But as I said,just before my appointment my bloods shot up into normal range 😊.

I think the worst thing is thinking that you are always going to be feeling like that. I'd read about anaemia of chronic disease ......horrible term.....and thought maybe that was how everyone with RA felt......but I heard others on here saying they had been out and about doing "stuff" so tried to believe it would get better once things got controlled.

It has and now, although I don't have the energy I had before RA, I feel fine. Talk to your GP just to make sure you've covered anything else it could be and then it's a case of keeping on at your rheumy team to try and get a treatment that works.

[earthwitch]

When I had constantly low iron, folate and Hb it was just before I got diagnosed with coeliac disease. If you are eating a normal diet but still deficient, then it might be worth asking your doctor to screen you for coeliac disease as that is a common cause of malabsorption problems that lead to things like low iron, etc.

[Moomin8]

Thanks earthwitch. My folates are always really high- mainly, I think, because I take 4 days of folic acid? My endoscopy revealed, apparently, that there's no problem with my absorbtion?

[Kariss]

I think that for some it can take a long time to rebuild normal red blood cell level after anaemia has set in, especially if it is constantly being wasted in the body by inflammation present. I've read that it is badly absorbed and you can also get bleeding into the joints if you have RA or inflammatory arthritis. My sister who was vegetarian and going through the menopause at the time took two years to get back to normal - she eventually went back to eating meat to achieve this, couldn't seem to manage on diet or supplements alone. This probably isn't much help to you, but my point is that other outside factors could be contributing to the aneamia (my sister doesn't even have RA!) so might be worth looking at your general lifestyle.

Best of luck, being tired all the time is so debilitating!

[NicolaP]

I've been told by a couple of GPs at my surgery that inflammation markers can affect iron absorption levels showing in HB results. However, unfortunately other things including PPI tablets such as Omeprazole can also affect them too. My HB have consistently been low for some years to the extent I'm now having to take ferrous sulphate regularly and they've only just gone up a little in 6 months. I suspect in my case its a mixture of both. My ferritin levels have been apparently normal all along.