Iron deficiency anaemia

[ALLAN HUGHES]

I am 76 yrs old and was diagnosed with C.D. at 42 but apparently had symptoms from an early age. One of the signs that led to diagnosis was when I went to donate blood and was said to be anaemic. I ended up with quite severe symptoms most of which improved by following a strict gluten free diet. I have however been diagnosed with chronic iron deficiency anaemia. I recently had a full gastroscopy, colonoscopy and capsule endoscopy and no abnormalities were detected.

I have been treated with iron infusions and now a series of injections of Mircera. This seems to improve my Hb levels but the effect does not last. I am concerned that I will need to be treated for the rest of my life and would like to know if there is anything that can be done which might give a more permanent solution to the low haemoglobin levels.

Any advice would be appreciated. 

[trents]

Welcome to the forum, @ALLAN HUGHES!

Have you been checked for a special kind of anemia known as pernicious anemia? It results from the destruction of the autoimmune destruction of the parietal cells that line the stomach which produce an enzyme known as "intrinsic factor" needed to absorb vitamin B12 which, in turn, is necessary to the assimilation of iron from our diet.

[plumbago]

@ALLAN HUGHES

For me, learning about iron in the body is difficult and complicated because it has different forms and purposes, binds to one protein for transport, and is stored bound to another. Also, there are different components involved in the measurement of iron in the body, which mean different things. Finally, anemia does not just mean iron-deficiency anemia; there are other kinds of anemia and so it is important to find out what kind of anemia it is. However, you say you know you have iron deficiency anemia.

There are a few conditions that can cause iron deficiency anemia - apart from celiac disease. First though it is important to ask if your celiac disease is well-controlled?

Otherwise, anemia can be from

• Loss (bleed - upper or lower GI including hemorroids),
• destruction (hemolysis, can be auto immune. Inflammation),
• problem with production

You have gotten scoped, so presumably, the medical team has eliminated bleed as a cause of the iron deficiency. Do you feel confident in that decision?

Do you know what stage or classification your anemia is?

The Key Question
Basically, is the iron deficiency producing the overall anemia, or is the anemia causing iron deficiency? It's complicated!

What is your hemoglobin level on average? Do you have symptoms? Is the anemia leading to complications?

ETA: I looked up the med you take for the low iron and see it is used for people with kidney disease. Do you have CKD? "Patients with chronic kidney disease may not produce enough erythropoietin, a hormone that stimulates the production of red blood cells." Do you think this is applicable to your situation?

 

 

Edited March 10, 2024 by plumbago

[ALLAN HUGHES]

Thank you for your interest Plumbago. In answer to your questions:

1. Firstly, it seems I have been mistaken in calling it Iron Deficiency Anaemia - I note that my Path report calls it "Normochromic Anaemia".

2. I am confident that my Coeliac Disease is very well controlled.

3. I am also confident following my scopes by my gastroenterologist that there are no issues with my G I tract and no bleeding was detected.

4. My latest Hb. reading was 103g./L

5. Symptoms - Although I am normally quite fit and well, about 3 months after treatment, I start noticing that I get fatigued quite easily and do not have my normal energy levels.

6. Apparently I do not have any signs of Chronic Kidney Disease.

 

[ALLAN HUGHES]

4 hours ago, trents said:

Welcome to the forum, @ALLAN HUGHES!

Have you been checked for a special kind of anemia known as pernicious anemia? It results from the destruction of the autoimmune destruction of the parietal cells that line the stomach which produce an enzyme known as "intrinsic factor" needed to absorb vitamin B12 which, in turn, is necessary to the assimilation of iron from our diet.

Thanks for your interest Trent.

It seems I have been mistaken calling it Iron Deficiency Anaemia and now note that my Path report calls it "Normochromic Anaemia"

[knitty kitty]

@ALLAN HUGHES,

Are you taking any nutritional supplements?  

Several of the B vitamins are needed to make red blood cells.  Celiac and aging can affect our ability to absorb nutrients from food.  Supplementing with a B Complex may help.

Riboflavin B 2 has been shown to promote erythropoiesis.  Niacin B 3, Thiamine B1, Vitamin D, and Pyridoxine B 6 are also required, in addition to Folate and Cobalamine B12.  Copper is needed as well as iron.  

Talk to your doctor about boosting your ability to absorb nutrients by taking a B Complex, Vitamin D and copper.  

Hope this helps!

[plumbago]

Hi again @ALLAN HUGHES

You should definitely ask your medical doctors exactly why you are taking this medication and what is the exact source of the anemia. That will be step one, and will help immensely.

Have you had any labs for inflammation levels? If so, what did they show?

Systemic inflammation that results in immune cell activation and formation of numerous cytokines can lead to decreased absorption of iron, restricted iron trafficking and interruption of release of iron required for RBC production. In addition, there are other reasons chronic inflammation can lead to anemia such as less erythropoietin activity.

Check in with your doctors, I say! And thank you for responding back to the forum - so few do.

Take good care.

[Scott Adams]

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