Chronic Anemia

[trents]

Okay, I was diagnosed with Celiac disease about 2 1/2 years ago and a recent antibody test showed that I am being successful at gluten-free compliance. I was mildly anemic at time of diagnosis so the GI doc put me on an iron supplement for a couple of months and that brought my hemaglobin/hematacrit nicely up into the middle of normal range. A year after that my iron levels had slipped back to slightly under normal. Since that lab work was done only a week after donating blood I attributed it to that. Got another CBC about a week ago which showed the H&H were still a tad under the normal range. By the way, I get a free CBC every yeare as part of my employment benefits.

I'm considering putting myself back on iron supplementation for a couple of months. I don't want to risk iron over load but I don't think supplementation for a couple of months would hurt. I'm thinking that this may be something I have to do now and then to keep those iron stores up to snuff. I'm coming to the conclusion that going gluten-free doesn't completely fix damage done to the mucosa in every case and that some of these absorption problems associated with the disease can persist even with compliance. I am a 55 year-old male.

I'm thinking I won't go to the doctor for an iron supplement prescription, just get some over the counter product. I know the doc will balk at this as the anemia is very slight. H&H are 13.4/39.7. Reference values are: hemaglobin (13.7-16.7) and hematacrit (40-50).

Any input?

[plantime]

I recommend you check the maximum dosage allowed for a male of your age and size, and supplement daily with half of that. That is what I was told to do by my doc years ago to treat my anemia. He said that way, I wouldn't overdose, but could still have the benefits of iron all the time. As long as you are careful about the daily dosage, you should be able to take iron all the time. I am a 41 year old female, by the way!

[jenvan]

How high did your iron ever get? Since it is so mild, seems chronically so, that perhaps focusing on getting iron via diet might even be enough. It seems like you responded fairly quickly. I was also anemic...for years. My numbers were frighteningly low, so I had an infusion in Feb 05. (After months and months--never responded to iron supplements.) I've been normal since but the #s have been on a steady decline. I am actually getting it tested tommorrow. I may end up with another infusion eventually. Healing is an interesting thought... Techinically my SI is "normal" now, no atrophy, mosaic etc. HOWEVER, the typical folds found in the SI have not returned in my case, via last biopsy, and as GI says...may never. That is not an issue as far as cancer rates, active disease etc, the biopsy is still negative for Celiac, but I feel that it would put me at a slight continued absorptive disadvantage b/c of loss of surface area etc...so, that could be a factor in returning or continuing anemia. Just some thoughts...

[trents]

You ask how high my iron ever got? Two or three months after my diagnosis and the initial iron supplementaion I spoke of, the Hemaglobin was 15.0 and Hematacrit was 45.1. That was in January of '04. That held steady for about a year and a half. I started donating blood again sometime after that as the blood center finally cleared me as a doner. (My liver enzymes had normalized after Celiac diagnosis and going gluten free.) I think I donated twice in several months and the next time I got my CBC done I noticed the iron levels had dipped slightly below normal. I decided not to give blood any more until I could get more labs done. They have not returned to normal and it has been about four months since I last donated. I would have thought the iron level would have rebounded by now. Maybe that tells me I'm still not absorbing dietary iron very well and I had siphoned off the iron I had replenished through supplementation.

I don't want to run the risk of damaging organs through excessive iron build up if I supplement on an ongoing basis. Plantime, if you are a 41 year old female, I assume you are still experiencing mensus and losing some iron through that pathway on a regular basis. Men are in more danger of iron overload when supplementing because they don't lose it through mensus.

Steve

[jennyj]

My iron levels will drop suddenly also. I have had three iron infusions and one blood transfusion-

( hemoglobin was at 6 and by the time I got to the hospital it had dropped). I can not take supplements so I just have to plan on every 6 months to spend the day at the hospital and get an IV infusion. Wish I could do something different.

[plantime]

I don't want to run the risk of damaging organs through excessive iron build up if I supplement on an ongoing basis. Plantime, if you are a 41 year old female, I assume you are still experiencing mensus and losing some iron through that pathway on a regular basis. Men are in more danger of iron overload when supplementing because they don't lose it through mensus.

Steve

That's why I suggested taking half of what is recommended. Iron overdoses can be fatal. Talk to your doctor, see what he suggests.

[jenvan]

My iron levels will drop suddenly also. I have had three iron infusions and one blood transfusion-

( hemoglobin was at 6 and by the time I got to the hospital it had dropped). I can not take supplements so I just have to plan on every 6 months to spend the day at the hospital and get an IV infusion. Wish I could do something different.

How long have you been gluten-free? And you've been doing the infusions for a year or two but are still not remaining at normal levels?