Very new to this

[Classicmichael]

Hi, for some time now l have been coming down from breakfast about 8 am and about two hours later l have been so exhausted that l just have to go back to bed again and just curl up and fall asleep and wake up about a hour and a half later.

I received a call from my Doctors surgery asking me to make an appointment following a routine blood test because l take warfarin, and the doctor told me l was suffering from anaemia.

I now take one ferrous fumarate 322mg per day plus folic acid and despite awful side effects l am still extremely tired most of the time.

Although l am a pensioner l did have reasonable health before this and l now can't guarantee how l am going to be from day to day, can anyone offer any advice.

[clivealive Forum Support]

Hi Classicmichael was your Vitamin B12 level measured along with your iron and Folate?

There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another so the three must always be in balance. Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body.

Iron deficiency Anaemia is quite different from Pernicious Anaemia which is a form of B12 deficiency and given that you say you are a pensioner I wonder if your doctor had had it tested.

I'm not a medically trained person but I have had P.A. for more than 45 years.

[Classicmichael in reply to clivealive]

Hi Clivealive, No l don't think my doctor tested me for B12 deficiency and l am therefore not taking it.

I am going to make an appointment with the Doctor to look into this further as l have just been told to take one tablet of ferrous fumarate 322mg a day which after a month did no good so two days ago it was increased to two tablets a day, along with one folic acid tablet.

Thank you for your advise, this is obviously not a straightforward illness as l thought.

[GavinUK]

Hi Classicmichael,

How long have you been taking the medication? It is possible that there may be a delay before things improve - in fact sometimes things get worse before getting better.

As already mentioned, B12 deficiency could certainly cause the tiredness, but it is a symptom common to folate deficiency and iron deficiency too, so it can be difficult to pin down - but that is why generally all 3 should be tested.

Do you have copies of your blood test results? If not you are entitled to ask for a print out of them, and that may help shed some light on things, if your doctor is not doing a good job of explaining it.

If your folate was tested, I would have expected your B12 to be too. There is guidance that if you are given treatment for folate deficiency, B12 should be tested first as the folic acid can mask the symptoms of B12 deficiency and inhibit diagnosis/treatment which can lead to nerve damage.

This page has a good break down of the symptoms of B12 & folate deficiency - do you see ones on there that you recognise?: nhs.uk/Conditions/Anaemia-v...

There is also the possibility that your B12 level was in theory within the 'normal' range, but at a low enough level to cause you some of the symptoms. The more recent guidance recognises that people can have the symptoms and effects, while still having what some doctors would consider a 'normal' level.

Unfortunately, the level at which you are considered deficient seems to vary across the country.

There are things that you may well be able to do to improve your situation, and it does sound like you are experiencing more than could be put down to 'old age'.

Is your GP approachable? If you have been on the tablets for a little while now then it is reasonable to see him/her again and seek further assistance - or a review of your medication to see whether referral to a haematologist or similar may be in order.

It may help if you keep a symptom diary for a period, so that you can show the GP how your day is being affected, as that may help persuade them that you are not just suffering from the natural process of time...

I wish you luck in finding some way to improve things - there are people on this forum who will be able to answer many of your questions so welcome.

Gavin

[Classicmichael in reply to GavinUK]

Hi Gavin, l look good for my age, but must admit this is the first summer that l have noticed that my legs have been so white despite wearing shorts and my energy levels are really low especially in the mornings when l have on some days had to go back to bed to sleep for an hour.

That said l wasn't prepared for this,l thought that Anemea meant that l would just take a couple of iron tabs and bounce back to my old self and it now seems l was wrong.

I will ask for a printout of my blood results and ask the Doctor about the vitamin B12 as she did not prescribe this.

It seems that there is a lot to learn about treating this illness and l am even wondering if this could be a long term thing which l hope it is not.

Thanks for your help

Mike (only just a pensioner)