I'm a 32 year old female with chronic anemia. I have both b12 deficiency and iron deficiency. I am taking b12 injections monthly now and my levels have been in the 200's at last count. I've noticed very little improvement even after a blood transfusion last May when my Hgb was an 8 and my ferritin level was a 2. Presently I have a Hgb of 11.2 and a ferritin count of 3. I have tried unsuccessful iron transfusions which resulted in allergic reactions to Infed (hives) and Vonifer ( severe nausea, fever, chills, all over body ache, etc). I have been given Repliva from my second hematologist and rather than improving, my ferritin count has dropped a full point in a month's time despite the gained point in my Hgb. I have a lot of tightness in the left side of my chest, palpitations, and audible murmur contributed to a mitral valve prolapse diagnosed by my cardiologist. He wasn't concerned at the time (Aug. 08) but the symptoms have gotten more continuous and tougher to ignore. I am so fatigued that daily personal hygiene and moderate housework wipe me out. I have had issues with ulcer like pain since I started taking the Repliva and am concerned that continuing with it might lead to worsening of the anemia. I am on 40mg of Nexium and do space the taking of the iron atleast 2hrs from the time I take this medicine. I should mention that I've had Roux-n-y gastrc bypass so the absorption of iron is reduced and impaired. Are there other options besides further blood transfusions or risking the attempt to transfuse the third form of iron? Why would it be advisable to continue on the Repliva since there was a decline in ferritin and no recordable evidence of it working? The stomach issues are so severe while taking it that I don't know how long I can continue. I am taking 1/2 tab every 2-3 days now since I'm so sensitive to it. I do get blotchy and itch while on it, but it is controllable with benadryl. Any advice would be greatly appreciated.