Iron RDW

[Ithinkimdying]

I was told with my RDW being 12.7 that my iron is low. My only question is how often should I take iron if I only do 1 injection per week right now? When I did it daily I took iron daily sometimes two daily when it was a daily shot. But if I'm doing once a week I don't want to end up getting it to high if I take an iron daily?!

[fbirder]

Your Red Cell Distribution Width is in range. Normally iron deficiency anaemia would be indicated by small cells, so a low value for the MCV. But your MCV appears to be in range as well.

The big tell, however, would be your ferritin level. Do you know what that was.

If you do have an iron deficiency then you need to supplement to fix that. The amount of B12 you're taking will have little to no influence on how much that is.

What does your doctor recommend?

[Ithinkimdying in reply to fbirder]

Not sure yet I see him this week and will be asking for a ferretin test. I'm just going to lie as usual and tell him the ER recommended it since no one does what I say unless I claim another doctor says to do it.

[Bodil333]

If iron is low (numbers?) and MCV is normal, yo are very likely to be B12 deficient. With low iron, you get MICROcytes. With low B12 (and Folate), you get MACROcytes. MCV = average size/diameter of cells. With only low iron, your cells should be small, they are not, as fbirder mentions. Please also note that the range for B12 is far too low. I have seen patients who have been vegan (NO B12 in diet) for decades and their B12 has been within range. In my opinion, B12 lower range should start at 600ng/L. In Japan it starts at 500ng/L. Agree with everything fbirder says, get Ferritin (iron storage) done.

[fbirder in reply to Bodil333]

Yes a combination of iron deficiency and B12 deficiency can cause both microcytic and macrocytic anaemia, with the possibility of the average cell volume being normal.

However, in that situation the distribution of cell widths (RDW - which is a measure of the difference between the largest and smallest red cells) would be much larger than normal, which it isn't in this case.

[helvella in reply to fbirder]

What you have posted is exactly as I understand things are. But as I read the description, I started to ask myself (yet again), why?

If inadequate iron means that cells don't grow to full size, and inadequate B12 means cells grow too large, why do we end up with a population of some under-size cells and some over-size cells? Why don't they all end up more or less the same size?

It is as if some cells are affected by the inadequate iron, and some by the inadequate B12, but none by both.

[fbirder in reply to helvella]

Yes, that does sound feasible.

Unfortunately, I don't know why iron deficiency causes microcytosis, so I'm going to have to research that.

[Ithinkimdying in reply to helvella]

I was told try to take iron three times a week if I do weekly injections. But I just started doing more shots yesterday and today because I felt like I was back sliding some

[Ithinkimdying in reply to Bodil333]

I had been doing daily injects the first two months. Then downed to 3 x now I was down to 1x a week. I'm starting to feel crappy so I've upped them back up and have had two days in a row. I'm going to take iron daily and ask for ferretin this week. My b12 was 190 and im not a vegan that was 8 months ago.i have bad stomach issues.i asked for my b12 to be retested on month 6. It was 1200 which still didnt seem high with as much as i inject.

[fbirder in reply to Ithinkimdying]

It's quite possible that 1200 is the highest that particular assay can measure. It's why mine is always 5999.

[Ithinkimdying in reply to fbirder]

Wow! Yours test at 5999?! I've seen 2000 but never over that.

[PAS-admin Partner]

Have seen 67000 in medical literature

And the Cyano-kit (hydroxo as cyanide-poisoning antidote) : 'The serum value of B12 can rise to an average of 560 000 000 pmol/L within 50 minutes'

so 2000 is not that much