Low iron

Hi all, I was diagnosed with PA about 8 months ago. I'm having injections but feel no better and now have very wiered feeling in my head and regular headaches. My iron level is now very low at 14 although that was over 3 months ago and dr thinks it will be much lower now. He thinks I might have some internal bleeding as can't explain why it's so low so now I have to have an endoscopy and colonoscopy but as I am in Portugal for the next 4 weeks I'm wondering if anyone knows of a good place in Portugal to have it done or even if the low iron count could be down to something else ?

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  • If your low B12 is caused by Pernicious Anemia then it's likely that you have low stomach acid. This can make it difficult to absorb iron. You could try to find somewhere that sells iron as the bisglycinate, fumarate or. Anything described as 'chelated iron'.

    If all you can find is iron sulfate then you could try taking those with citric acid and vitamin C.

  • Thank you. The Dr has prescribed me iron supplements now. Along with laxatives! Will the endoscopy show the low stomach acid ?

  • My husband has PA and low iron , ( 11) , he's just been prescribed iron tablets . he recently had an endoscopy and colonoscopy which where clear so in his case I agree with Fbirder , prob due to PA , ( although his GP said not connected !) learning so much from this forum , thank you everyone πŸ˜€πŸŒŸ

  • Thank you for replying . I'm so confused with it all at the moment 😩 Just want to find a way of feeling normal again. Has the iron helped him ?

  • Hi Lifegems , he only started on them yesterday , but will let you know in a few weeks . He has neurological symptoms and has been refused more frequent injections 3 times by GP . It is very confusing , I hope you get some answers soon , I'm not very up on it all but I hope someone gives you a better answer soon , good luck , and I hope the wrather is sunny in Portugal , at least you'll get some vit d 🌞

  • Ah yes vit D no problem! I self injection occasionally but then I feel it has a really bad impact on my skin.. acne for first time at 49 is not great ! Really trying to get a grip on everything but it feels really depressing at times 😩 Your husband is lucky he has a supportive wife πŸ˜€

  • Just wondering is it rocasia as it is one of the symptoms of PA , similar to acne , ? I hope your iron levels improve soon and you start to feel better asap , . Take care

  • Partly Rosacea but more like blooming boils ! Anyway thanks for replies and good luck to you guys too 😁

  • Ferrous sulfate works okay, immediate release better than time release. Take with vitamin C and plenty of fluid on an empty stomach, or with food if empty stomach is irritating. Avoid caffeine for 2 hours before and 1 hour after. Iron loss/blood loss needs to be ruled out eventually, but above will solve if just malabsorption. 130 mg elemental iron per day should get you back to normal, maybe less after caught up. 200mg ferrous sulfate is 65 mg elemental iron.

  • Thanks Brian. So the Dr has me on 600 Mg a day of ferrous surface. Why no caffeine?

  • Caffeine decreases the absorption of iron....

  • Ah thought you might say that ! Thanks

  • What was your hemoglobin? I have atrophic gastritis, PA. After improving on B12 shots then oral B12, I started losing exercise tolerance, and my Hgb fell to 12.6, low Fe. Became 14.8 after 6 weeks of 400 ferrous sulfate per day. Now taking 200/day with vitamin C. I already had upper GI scope, and was caught up re lower GI. Occult blood test was also negative.

  • I'm not sure I really understand all that 😩 Still trying to get my head around everything plus there seems to be different names for the same thing which adds to the confusion 😩😩 but thanks for the info .. need to look up what your referring to 😁 When you say exercise do you mean like normal exercise? I've always been really fit but struggling big time now which upsets me

  • I had a haemoglobin count of 6 (or for some its 60) and had to have an immediate blood transfusion. Also had endoscopy and colonoscopy. Are you suggesting trying to have them in Portugal, I would have them near home as the prep for a colonoscopy is not nice and requires being 2 ins from a loo for several hours. I was diagnosed as having mild gastritis, which they put down to having Naproxen anti inflamatory for arthritis. I gather they frequently don't discover the cause. I took iron sulfate for 9 mths as they wanted my ferritin levels up to 100. Along with other suggestions about what to avoid before and after, tea, coffee, also need to avoid antacids lansaprazole or similar.

  • Hi Chris

    Yes I understand the prep ain't great ! Hoping some weight loss counteracts downsize 😁 I've actually just booked for both here in Portugal and seems really straightforward and I get a general so don't need to be awake for either plus I'm in and out same day and the cost is less than 300 euros for a private hospital which is cheaper than my flights to the uk so I'm just hoping all goes well (plus I get a time that suits me) just hope it's all clear! Iron supplements have helped already .just second day today and my head is already better.. just wish my skin would clear up !

  • I just had a sedative which worked fine. Can't remember any of it. I assumed that the two procedures would sort of meet in the middle and cover the whole of the digestive system, apparently not. There is a curly bit in the middle which they can't reach. It very rarely causes a problem, but if they suspect something you have to swallow a little camera which takes pictures as it goes through and comes out the other end!!!!! Great fun. I didn't have to have it thank goodness. Glad you're feeling better. I ended up with 2 transfusions, and it's amazing how quickly it made me feel better. You don't realise how bad you felt until you feel better.!!

  • Hi Chris

    Yes you kind of get used to the lethargy and brain fog but the headaches and dizziness were just too much ! I'm reading the book at the moment which talks about the benefits of vitamin transfusions which sounds fab. Might price it up in Portugal! Likely to be cheaper than ukπŸ˜€

  • Low iron leads to low hemoglobin, essentially smaller red blood cells with less hemoglobin in each one. Lower Hgb lowers oxygen carrying capacity, which lowers exercise tolerance. The scopes are to check for sources of blood loss. Iron works if just malabsorption, but hard to catch up if ongoing blood loss.

  • Hi Brain

    Thank you. I think that's why the dr has requested I have the tests to check for internal bleeding. What I don't understand is if iron deficiency is in connection with smaller red blood cells yet I thought PA which I have is larger red blood cells? Exercise is definitely more difficult. I still mountain bike and walk but it s so much harder now 😩

  • Two separate problems from autoimmune gastritis. Parietal cells are destroyed leading to a nearly complete failure of B12 absorption. Shots work, or tremendous over dose on oral B12 lets enough be absorbed later in the intestine. B12 deficiency causes large red cells, and blocks some metabolic pathways, causing extreme exercise intolerance, among other problems. Iron absorption is impaired also, to different degrees in different people. Iron deficiency can cause anemia, with smaller cells and less hemoglobin per cell.

    I had large cells on average, started B12. Months later iron deficiency remained, small cells and high variability of cell size as I had some large cells, some medium, and some small. Now on B12 and iron, better hemoglobin, back to normal exercise tolerance, I expect cell variability to fall as my old PA cells and my iron defficient cells die off. Red blood cells live around 120 days, though large PA cells live shorter, so any blood count is a timed average of last 4-5 months of production and destruction...

  • Whatch out for nitrous oxide with general anethetic as could depleat vit b12 . I've read on here , my husband had a local for those tests and was painless , also quicker recovery . The prep not too bad if you start it well in advance ( day before ) and avoid fibre , residual food such as sweet corn , nuts etc . Wishing you all the best and glad iron tabs starting to take effect , πŸ‡§πŸ‡«πŸ’‰πŸ˜€πŸŒž

  • Thank you so much ! Will definitely watch out for the nuts lol. 😜

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