Iron Deficiency

[MAGSWAT]

I was just wondering if there is any connection between RA or similar diseases and iron deficiency anaemia.

I have my first appointment with my Rheumy on Monday, my GP suspecting I may have RA or something similar. When he did a blood test 2 months ago he said my red blood cell count was slightly low and put me on iron tablets for 2 months. I had another blood test on Friday once I'd finished the tablets and have just had a call from the surgery saying my GP wants me to take iron tablets for anote 3 months, so my red blood cell count is obviously still low. My GP nurse also told me my white blood cell count after the first test was sligtly high.

I'm sure I've heard somewhere that high white and low red cell counts can be another indiciation of RA.

Does anyone know if this is correct?

[earthwitch]

If there isn't any reason for you to be getting low in iron (losing too much blood, or poor diet) then you should ask your GP to check for coeliac disease, as that causes malabsorption problems. However, inflammatory disorders can also cause all sorts of things to go out of balance in your blood so controlling your RA is important. I didn't think it was so much straight anaemia though, as things like eosinophils and basophils (other types of blood cells) that went with RA. If two months of iron tablets didn't get you back to normal though, I'd definitely want to be checked out for coeliac, and also to do one of the poo tests for hidden blood to see if there was any bleeding from your gut.

[Hidden]

Actually if you google RA it almost invariably lists amaemia as one of the more common symptoms associated with this disease so it could well be connected. It would probably be useful for your consultant to see all your blood test results in printed form anyway so it would be a good idea to get your GP surgery to do a print out for you to take with you. If you do this then photocopy it for your own record too so you can see how things are changing once you are diagnosed and put on treatment. Good luck - let us know how you get on! Tilda xx

[MAGSWAT]

Thanks guys. I have just found some info on anaemia that says once the levels are back up to normal most docs like to put you on 3 months more of iron tablets to give your system a boost and ensure the levels don't drop too low again. Just wish the surgery would tell you these things when they phone!

Will let you know how I get on on Monday. Kind of dreading it and looking forward to getting some answers all at the same time!

[Hidden]

Hi there,

I was anaemic when my illness first flared i.e. before the drugs and when my ESR was high. I was then put on steroids for 3 months, ESR dropped to virtually nothing and anaemia went too. Now that I'm off steroids my ESR is up to 70-ish again and I'm more anaemic than ever. For me there is a straight correlation between high inflammation levels as measured by ESR and anaemia. (I've never suffered from anaemia before, ever, and I'm 56.)

A Rheumy nurse told me that RA patients (I have PsA but they thought it was RA then) tend to 'permanently run a little low' when I mentioned anaemia. I think that's a bit complacent.

Some sources of information about PsA list anaemia as a symptom, too. Do you happen to know what your ESR or CRP are? Might be worth tracking them to see if anaemia links to inflammation levels with you.

Christina

[hamble99b]

some anti - inflammatory drugs can cause stomach problems. I had to stop taking meloxcam/mobic

because my iron levels dropped.

sandra.

[oldtimer]

I had quite severe anaemia about six years ago. I had loads of investigations (so I know I haven't got all sorts of things!) and a bone marrow showed that my bone marrow just wasn't doing anything. The rheumatologist sighed when everything came back normal(ish) and said it was probably the RA - and stuck me on high dose steroids for a bit. This did the trick although I'm still on a much lower dose of steroids and I'm still running at "low normal" or just below. If I get an infection or any other stress it seems to affect it again.

It can't help that we often need to take anti-inflammatory drugs as well that can cause bleeding from the gut, but it appears that chronic inflammation can suppress the blood count all the time.

But definitely get checked out for coeliac disease as that can often be in the background of chronic anaemia.