iron low

[virgocharm]

my  gp says my hemoglobin is 9.8 and she wants me to take iron 3 times a day. i know this is a no- nohavent started tx yet, waiting to august to see my hep doc what should i do?

[medicmommy]

Do you know why your hemoglobin is so low? What is your hematocrit? Do you have a condition other than the hep C that can explain the anemia? Are you symptomatic? (Fatigued, short of breath, cold, weak?)...Have you had an event (eg surgery, childbirth, illness) that has caused recent blood loss? If the answer to these is no, get your blood redrawn. Something's not right...as in a possible flaw with the blood draw...or you have a slow active bleed (as in bleeding into your gut)..
As we know, there are several different kinds of anemia, caused by different things...during treatment, we commonly see hemolytic anemia (where the blood cells are destroyed faster than the body can replace them)..people with crohn's disease or diabetes often have anemia caused by poor vitamin B absorption (pernicious anemia), and yet others have iron deficiency anemia (most common) which is from not enough iron in your diet...(there's hemorrhagic anemia caused by blood loss also) If you don't have an explainable reason for your low labs, I'd ask for a redraw...Too much iron can be very hard on the liver and spleen...But not enough can be damaging as well...~MM

[Bill1954]

I think it’s important to understand what she based her decision on. If iron studies have been performed, and she understands the dynamics of iron and HCV, then by all means follow your doctors advice.

If you don’t know already, HCV treatment (the ribavirin component most importantly) can cause sever *hemolytic* anemia in a percentage of patients; I’m not sure you would be allowed to begin Tx until this is resolved.

However, it’s also important to understand that iron is essential for the transport of oxygen, and is sometimes necessary; if you listen to some people on this forum, they will flatly tell you that iron + HCV is bad; not necessarily so. A complicated balancing act exists; a full iron studies should probably be performed prior to treatment, along with an explanation of why it is reduced in the first place. A Hemoglobin result of 9.8 is precariously low, and should definitely be resolved, HCV, HCV treatment or not. Remember that there are dozens of types of anemia, with different causes; the anemia commonly associated with HCV treatment is hemolytic anemia.

There was a brief thread recently on this topic:

http://www.medhelp.org/posts/show/564722?post_id=post_3132118

Additionally, look through this site and bookmark for future reference; it might provide a little more insight for you:

http://www.labtestsonline.org/

Good luck to you—

Bill