nrdsb4-- iron supplements can indeed mess pretty badly with the gi tract. Given Emily’s anemia is mild, I think dietary changes could help. Iron infusions are very helpful to severely anemic people. The infusions bypass the stomach and are not that frightening. Large doses of oral iron can really ruin the digestive tract and can cause long lasting issues. More severe anemia should be evaluated by a hematologist and the pros and cons of oral supplements should be evaluated and compared with infusions. I’m not a doctor, but I wouldn’t be at all concerned if my hemoglobin and hermatocrit were slightly below normal unless I had other things going on.
I think Nrdsb4 was referring to her doctor threatening a blood transfusion, not an iron infusion.
@peacefulmom, you misunderstood my post. @VeryHappy is right.
I’m not sure if anyone has mentioned that consuming excess amounts of calcium products can
effect iron absorption. If you are consuming lots of milk and or eating lots of dairy products including TUMs then it cause anemia.
Men (and post-menopausal women) have lower iron requirements. Men also tend to eat more meat than women. Excess iron can damage various organs, though that tends to mainly be an issue if one has a gene for heightened iron absorption (hemochromatosis, see http://www.mayoclinic.org/diseases-conditions/hemochromatosis/basics/definition/con-20023606 and http://www.hemochromatosis.org/ ).
Hi- I understood about the blood transfusion. I was trying to caution that in many cases oral iron can be extremely harsh on the stomach, whether it is slow release or not. I would just be careful to monitor that the iron tabs are not causing other issues. In cases of extreme anemia (not like the OP) I would choose iron infusions over oral iron if they upset my stomach in a debilitating way. In the case of the OP, I personally wouldn’t be concerned with the slight changes and I would try to increase my intake via food.
“Not to worry you further, but iron supplements can be very harsh on your stomach and can cause other problems.”
Not really the right thing to say to a hypochondriac.
If it was low last year and is lower this year, odds are it isn’t something so serious that your health is at immediate risk, seems to me. Disclaimer: not a doctor, don’t even play one on TV
"I logged into the electronic system and was able to see that my hemoglobin levels have dropped 1.5 points within the last two years so there is a clear downward trend here. What really bothers and concerns me is that during the visit with him I asked specifically if these low numbers could indicate a serious health issue and he said no. "
Well, yes, any bad anything could indicate a serious health issue. My slight cough could be the beginning of tuberculosis, or it could just be … a slight cough. My tummy trouble could be the beginning of dysentery, or it could just be … too much greasy food last night. My headache could be an inoperable brain tumor, or it could just be … a normal headache.
A doctor who tells me I had tuberculous, dysentery or an inoperable brain tumor just based on those things is a bad, bad doctor. There are protocols to follow. He’s following the protocols.
You know you’re prone to anxiety and hypochondria and overreaction - and yet you want him to overreact, too. Does that make sense?
“VeryHappy, yes, I know that’s what he is doing but aren’t we losing time and opportunity to figure out what is causing the anemia instead of guessing by doing it this way?”
But that’s the protocol. Just like you don’t give someone a CT scan / MRI based on a mild headache, even though technically there could be a brain tumor there. If you are unable to relax and accept things, and you continue to catastrophize, then you need to seek professional help.
Maybe you do have something terrible like a lymphoma or colon cancer (and I’m not scaring you here, I know it’s what your searches of “low hemoglobin causes” will have turned up). Like I wrote before, if its taken 2 years and hasn’t dropped into the “we’re putting you in the hospital for a transfusion” stage, seeing if an iron supplement resolves things sounds like good medical practice.
Aside from the fact that the tests you seem to want are not fun, they carry real risks called iatragenic effects – a fancy way of saying testing & treatment might injure or kill you. If every worried middle-age person with a slowly declining hemoglobin level got the full barrage of tests to check for these conditions the deaths and serious injuries caused by the testing (perforations when they scope to look for cancer from mouth and other end, bleeding or infection from the bone-marrow biopsy, etc) would far outnumber the lives saved by diagnosing a serious problem 3 months earlier. So if you’re one of the people who’s cancer is caught 3 mos earlier, it was worth taking the chance. If you’re one of the people seriously harmed or killed by checking for a disease you don’t even have, probably not so happy.
Right now there’s no way to tell if you’ll fall into one of those 2 camps, or a 3rd one of “no cause found” after these tests. You seem to be assuming all testing is benign and simply gives “an opportunity to figure out what is causing the anemia”. That’s unfortunately not the case.
“Right now there’s no way to tell if you’ll fall into one of those 2 camps”
This comment wasn’t helpful at all considering how worried I already am and yes, I fully realize that physicians are in the business of “population health” but I am in the business of worrying about my own health, that’s the problem.
So have any strategies been tried earlier?
I guess your only option is to go doctor-shopping then, and find a doctor who doesn’t practice good medicine who will acquiesce to the dozens of tests you apparently want now even if your symptoms don’t call for them.
Patients like this are a doctor’s nightmare, since nothing they do will suffice to assuage their fears. Since they aren’t rational.
They are a good doctor’s nightmare. They are a mercenary doctor’s annuity.
And they are part of the reason for the growth in medical care costs (excessive tests cost money, and if they are of the types that have risks of causing additional medical problems, those additional medical problems cost money as well).
^^ @ucbalumnus, I don’t have any data to back this up, but my inclination is to believe that patients who are frequent fliers probably also are above average in seeking legal recourse.
I assumed that you would understand that the population outcomes are the best (and only) way of estimating your outcome probabilities. Apparently I was mistaken…
OP. I have no advice,but wanted to let you know I’m sorry you are struggling with this. The unknown in any medical situation is scary.
The tough thing about treating anxiety disorders is that the behaviors and the problematic thinking is deeply entrenched. And often patients can be invested in their belief system, and discount alternative explanations or interventions. Cognitive behavioral therapy can be very beneficial, if the patient is truly bothered enough by the symptoms that they are willing to let them go. Sometimes the secondary gain outweighs the displeasure of the anxiety. Old joke: (q) How many psychologists does it take to change a lightbulb? (a) Only one- but the lightbulb has to really want to change.