Iron levels up dramatically but Liver enzymes down

[Deades]

After going to my doctor yesterday, he felt the doctor who performed by endoscope was premature in diagnosing celiac.  My iron levels went from 30 something to 147 in 3 months of being gluten free.  At the same time, my B12, folate and liver enzymes went down dramatically.  I am scheduled for a liver ultrasound Friday and more blood work on other minerals.  Has this happened to any one else?  It seems fixing one problem led to others.

[cyclinglady]

During this time did you stop taking supplements?  My body can not process the usual supplement forms (non-methylated) of b12 or folate.  It caused my blood levels to be extremely elevated (above range).  When I stopped taking a multi-vitamin, my folate and b12 went back into the normal range.  

Celiac disease can impact your liver as well and can resolve in a gluten-free diet.  Of course it could be something else not related to celiac disease.  

I am sorry that your case is not clear cut.  Whatever the outcome, find out what caused the villi blunting!   That is NOT normal.  If you need a second opinion, get one from a another GI.  NONE of my primary care physicians had a clue about celiac disease.   Great doctors, but unless they see it on a regular basis, forget it.  

Your first GI messed up.  When he saw the villi blunting, he should have ordered the celiac antibodies panel that day.  Assuming you have celiac disease is reasonable as it is one of the main causes of villi blunting.  It was the only way to diagnose celiac disease prior to the invention of the antibodies tests, along with improvement in a gluten-free diet and other health markers.

 

 

[ironictruth]

  On 9/14/2017 at 1:52 PM, cyclinglady said:

During this time did you stop taking supplements?  My body can not process the usual supplement forms (non-methylated) of b12 or folate.  It caused my blood levels to be extremely elevated (above range).  When I stopped taking a multi-vitamin, my folate and b12 went back into the normal range.  

Celiac disease can impact your liver as well and can resolve in a gluten-free diet.  

 

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To add to that, good about your iron and enzymes! 

 The gluten-free diet is naturally deficient in B vitamins.  They have a tendency to hide in your standard loaf of bread but not in the gluten free stuff.  Did they also happen to prescribe you a PPI or acid reducer? Because those can interfere with absorption as well.

 How drastically did your B12 drop? If not a huge decrease and you're still within normal range my suggestion would be to try to find foods that are higher in B and folate naturally. 

 

[cyclinglady]

If you do not have celiac disease, then all of these (see link) should be investigated and ruled out.

Open Original Shared Link

Medications can also cause villi blunting:

Open Original Shared Link

 

[knitty kitty]

Here's a previous thread discussing hemochromatosis which may be connected to Celiac Disease.  In hemochromatosis,   the body stores too much iron in the liver and other organs.  B12 and folate can become deficient because they are integral in red blood cell production.  Symptoms of hemochromatosis don't usually appear until middle age.  

 

https://www.celiac.com/forums/topic/93392-in-the-process-of-diagnosishigh-iron/

 

Hope this helps.

  On 9/14/2017 at 1:06 PM, Deades said:

After going to my doctor yesterday, he felt the doctor who performed by endoscope was premature in diagnosing celiac.  My iron levels went from 30 something to 147 in 3 months of being gluten free.  At the same time, my B12, folate and liver enzymes went down dramatically.  I am scheduled for a liver ultrasound Friday and more blood work on other minerals.  Has this happened to any one else?  It seems fixing one problem led to others.

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[Deades]

The only supplements I was taking were 325 iron, calcium, 2,000 vit. D and 500 magnesium.  Since my appointment on Wednesday, the iron and magnesium are stopped.  I have not been prescribed a PPI or acid reducer.  My husband has hemochromatosis so I am aware of that and do not have it.  My labs are:  I went gluten free June 1, 2017.  The changes are from only 3 months gluten free.

 

.                               Sept 2017.            Nov. 2016

iron.                            147.                         37

Ferritin .                       86.1.                       10.2

Calcium.                        9.2.                         9.1

Vit. D.                            54.9.                       43.7

B12.                               261.                        306

Folate.                             3.6.                         9.9

[ironictruth]

  On 9/15/2017 at 2:02 PM, Deades said:

The only supplements I was taking were 325 iron, calcium, 2,000 vit. D and 500 magnesium.  Since my appointment on Wednesday, the iron and magnesium are stopped.  I have not been prescribed a PPI or acid reducer.  My husband has hemochromatosis so I am aware of that and do not have it.  My labs are:  I went gluten free June 1, 2017.  The changes are from only 3 months gluten free.

 

.                               Sept 2017.            Nov. 2016

iron.                            147.                         37

Ferritin .                       86.1.                       10.2

Calcium.                        9.2.                         9.1

Vit. D.                            54.9.                       43.7

B12.                               261.                        306

Folate.                             3.6.                         9.9

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That seems consistent to me of someone with celiac whose damage was not so severe or long that they could not respond to iron. I have Marsh II-3A damage and my ferritin went from in the 70's prior to my first gluten challenge to 20. After 3 months of iron it was back up to the 30's.

Being on iron btw can give the ACTUAL SERUM iron read a FASLE high level. But your ferritin is nice so likely that is NOT the case with you. I literally became mildly anemic in 24 hours once while in the hospital with no food and no iron pills. I eat a lot of high iron foods. So it would be good for you to keep on top of it once you quit the iron supplement. Maybe incorporate a gluten free protein drink with added vitamins and minerals. They have a few which re even certified gluten free. Your ferritin is lovely. I would love mine to get back up above 50!

Your b12 is low. Not horrendous, but low. You may want to consider supplementation and/or as I mentioned, watch for foods that contain b12 and folate as a lot of gluten free foods, such as bread, really do not contain it. So if you were "challenged" to begin with in getting these nutrients and vitamins, you are certainly NOT getting them easily on a gluten free diet unless you make sure you incorporate them.

A good nutritionist should have your history and current labs to help you develop a plan.

I do not know your history, who was this doctor who felt the diagnosis was premature and more importantly, why? A GI? A primary care? I was told by a few different types of docs I did not have celiac. I finally went to one of the best celiac specialists in the states.

Good to explore the liver regardless with a history of elevated enzymes. But, as cyclinglady mentioned, that is a common finding in celiac as well.