HGB HEMOGLOBINE

I START AT 16 , NOW IS 14 , DC SUGGEST TO TAKE SOME IRON  , I M SO HAPPY RIGHT NOW OCTOBRE 1 I WILL HAVE MY 12 WEEK SETST AGAIN   HOPE AT THE TIME WILL BE CLEAR   COMPLETELY . CIAO EVERYBODY LOVE YOU ALLLLLL

[copyman]

DO NOT TAKE IRON !!!!! Hepatitis loves iron. Iron is almost as bad as alcohol.

[Bill1954]

Baloney.

If your doctor suggested you take supplemental iron, you may be deficient. Blanket statements such as the one above are not only misleading they are irresponsible. Adequate iron is necessary for the development of heme and the subsequent delivery of oxygen to the body's tissue. Listen to your doctor--

Bill

[portann]

Many heppers have too much iron but it's simply not true for everyone. Typically, we have enough iron and don't need extra.

If you have HCV, extra iron is usually a bad idea but - and big but - if your iron is insufficient, then supplemental iron could be necessary.

Some people with HCV need phlebotomies to reduce iron but others need iron supplements. The point is don't assume and make sure your doc runs an  iron panel.

The iron study blood test is what measures iron and ferritin levels and is what tells you and your doc whether you need extra.

So did your doc run TSAT and ferritin tests before advising you to take supplements?

If your TSAT is below 20 percent or your ferritin is below 100, you'd require supplemental iron (I think).

The majority of men and post-menopausal women have enough iron and don't need iron supplements but if you've been found to have low iron stores, listen to your doc.

My hope is your doc is on top of this, though it  wouldn't hurt to double-check.

Susan

P.S. Mostly I've heard of supplemental iron on tx when related to supporting procrit-stimulated RBC production. There were a couple of people here, though, who took it during tx due to low iron stores.

[copyman]

not baloney.... FACT. Even though you think you know everything about HCV you are wrong this time. You failed to to your homework on this. Do some research and report back. Besides the original poster said their HGB dropped from 16 to 14. Not a significant drop at all.  They are no where near anemic so why would they want to take a chance supplementing iron. I would question any doctor suggesting that!

There is study after study suggesting iron should be avoided with HCV. When ever I read something like " In fact, increased iron has been shown to enhance hepatitis C virus (HCV) replication in vitro "  plus Dr Afdhal advising his patients not to take iron is enough for me to warn others to AVOID IRON. I will continue to give this warning.

I have included a few studies that I found after 1 min of searching, there are many:

Serum iron markers are often elevated in hepatitis C virus infection, particularly in African-American persons, although the clinical significance of this finding remains unclear. Although hepatic iron is usually only mildly elevated in hepatitis C virus, iron overload is associated with more advanced disease, nonresponse to interferon monotherapy, and increased risk of hepatocellular carcinoma. Iron status does not predict response to interferon and ribavirin combination therapy. Most studies indicate that HFE mutations are associated with increased iron stores and advanced fibrosis. Iron depletion therapy may delay disease progression.

Introduction
Iron homeostasis is critical for all multicellular organisms because iron is an essential element necessary for many basic biological processes; however, excess iron may also be highly cytotoxic. Mammals do not have an active mechanism to excrete excess iron and, therefore, have evolved a tight regulatory mechanism for the absorption and storage of iron. The liver is the main iron storage organ and it plays a fundamental role in iron metabolism. The iron transport protein, transferrin, and the major iron storage protein, ferritin, are both synthesized in the liver. Given this iron-rich environment of the liver, it seems likely that hepatotropic viruses would evolve a means to use this essential nutrient to their advantage in patients with increased hepatic iron stores. In fact, increased iron has been shown to enhance hepatitis C virus (HCV) replication in vitro [1], possibly by upregulating cellular translation factor eIF3 [2]. Although there are limited data suggesting a direct role of iron in HCV infection, cellular processes like respiration and energy metabolism are dependent on iron and are required for virus replication and persistence. Thus, iron load may have a profound indirect effect on HCV infection, and in turn the HCV may alter regulation of iron homeostasis. In this article, we describe the current understanding of the relationship between hepatic iron, serum iron indices, and HFE mutations in relation to HCV infection and treatment.

[spectda]

My doctor has had me taking iron supplements for the past 10 days because of my low hgb. I have not had a test to determine if I am low in iron. I hope it doesn't adversely effect my und status. I can't take procrit and we are trying to keep me from reducing my riba any further.

[Bill1954]

Oh, brother....

[pcds]

I love the passion of some of the people on this site.  Copyman, Potann, Bill, all are this forums giants and others.  It's nice you have the back and forth with so much knowledge really from each.  A regular smorgasbord of information.  What would all  us newbies do without you!!
Love you all,
Judy

[portann]

It comes down to Bruno's iron stores. Maybe he can post if his TSAT is below 20 percent or his ferritin is below 100.

It's surprising that his hemoglobin is still so relatively high, although he dropped two points, which is a good sign. ????


Bruno, do you smoke?

[Trinity4]

I don't think iron supplements are necessary with an HGB of 14 either.  That number is within the normal range for men.   When I had phlebotomy for PCT, my starting HGB was almost 17 and my ferritin level was around 900.  If my HGB dropped below 12, I had to skip the phlebotomy session that week.  They reduced my ferritin to 17 prior to starting treatment but my HGB remained at 12.

Trinity

[nygirl7]

AGree his hemo is too high for iron especially since he is NOT undetectible even at this point.  It seems a risk I would not consider personally.  I would ask the doctor what his logic on this is.........perhaps he doesn't realize the viral replication effect at all.

[portann]

Bruno,  I suggest you phone your doctor to ask specifically why he thinks you need iron.

It's important to understand the basis of his decision. It's one thing to have problems with high iron storage, as people with HCV can have,  but another if you're deficient.

The point is, iron is not necessarily 'bad', flat out.  It's essential in hemoglobin's oxygen-binding function. Without a certain level of circulating iron, we're caput.

There are many kinds of anemia aside from hemolytic anemia (which you don't have), iron-deficiency anemia, aplastic anemia, pernicious anemia, folate deficiency anemia, beta thalassemia anemia, sickle cell anemia.

Iron tests are serum Fe, total iron-binding capacity (TIBC) and transferrin saturation.

Without these tests, I don't see how he could know that you're iron deficient. :(

I'm personally confused because of the nice hemoglobin you still have.

Trish took iron but that was only when her hemoglobin sunk and she needed Procrit along with iron. I think Geterdone was also on iron supplements for a while. If you take Procrit with low iron stores, Procrit would be useless. (And yes, I know you're not even close to Procrit territory but just saying.)

I think I once read that vegetarians can sometimes have normal hemoglobin and low iron stores. Are you a vegetarian?

Get your blood drawn, if you haven't already, find out from your doc what's going on and let us know.  

TTYL and congrats again on your nifty four week PCR result.

Susan

[spectda]

Congrats on your results, you are doing great mr bruno! good advice from those who know!
- Dave