Wednesday, April 4, 2018

Anemia in the Gastric Bypass World

I don't even know where to start with this one.  I guess we start with today and then I'll work my way backwards.

I'm anemic.  My ferritin is extremely low.  The "healthy" range is 22 to 250.  Mine is 7.  (I am low in several other areas as well, but am going to save everyone the gritty details.)  I have been overly exhausted lately (for probably close to six months), but it was easy to blame getting older and continuing to be too busy (hey, I calmed down for like two months, then suddenly my life ramped back up).  I had my 14th surgery anniversary on March 17, so it was time to do blood labs.  I wondered if possibly I was low in iron.  My nurse practitioner emailed me to say, "hey, you're right, you're anemic, take some iron!"  Ellen explained it's not that simple.  The numbers I am low in do indicate anemia but apparently it can be a deficiency of iron (which most people associate anemia with) or with folate, a B vitamin.  

I am sure I did a blog on this years ago, but I can't find it right now.  I'm probably just too tired and frustrated to look for it.  

I am bummed because I feel like my vitamin levels have been pretty good since I started working with Ellen in 2014.  I take a lot of expensive supplements.  I did struggle with some liver issues a couple of years ago, but those seem to have resolved.  I let some vitamins go, thinking I was eating better and I would get my nutrition from food.  I think this is a reminder that I have surgically altered my body and I literally can't get all of my vitamins out of the food because part of my intestine has been bypassed.  

I also have to admit that when I heard "anemia" can also refer to a B vitamin deficiency, I was taken back to when my doctor told me that B vitamin deficiencies can be related to alcohol consumption.  It is no secret that I have been drinking a lot more lately.  I am definitely drinking less now than I was last year, but I do enjoy going out for a drink (or five).  I guess I would have to categorize myself as a binge drinker.  I don't need to drink every day.  Or even every week.  But if I do happen to go out, I am more likely to drink to excess and act stupid (I mean, fun stupid, for the most part).    

I just worry.  I feel like everything is connected and I don't want to start circling the drain.  My body jumped up about 6-7 pounds about two months ago for no good reason.  None of my old tricks are taking the weight off.  I have stabilized so I am not stressing about it too much.  Potentially, it was a reaction to letting a couple of my supplements go while trying to save money.  I did recently have a break-through on my psoriasis and I cured a flare-up without medication.  However, I have had what feels like a cold for almost two weeks, and now I'm wondering if it is allergies.  I stopped having to take daily allergy pills after I went gluten-free last year.  I am not militant about gluten.  I choose not to eat it but I don't stress if I get a bite in here or there.  In fact, I kind of feel like having small bites on rare occasions will help me not get super sick rather than if I cut it completely and it accidentally gets into my system.  (I do pay a price for eating it.  My wrists and fingers get super sore if I have more than a bite.)  Also, I can admit I've been eating candy at work lately, so sugar is sneaking back in.  

I mean, even with these issues, mentally I feel great!  My depression and anxiety are under control (so the sugar intake isn't anywhere close to my previous levels).  And, although I am fairly tired, I otherwise feel good physically.  I am doing yoga three to four days per week.  I have been more spotty on lyra and pole (at night, I am ready to rest, not go to class).  I hang out with my family and play hard with toddlers at least once a week.  I try to walk around more at work.  (And once I get this exhaustion under control, I will return to my early morning mini workout at home.)  I am in a good place.  

So, I am going to increase my vitamins for the next two months to see if I can get my levels back up.  This is just another reminder that I am, first and foremost, a gastric bypass patient.  I need to put my supplements and vitamins first, food second.  I know I often lament the fact that I don't get to be a "regular" person who just gets to eat normally and not think about food and vitamins every day.  I'm not that person.  I made that choice 14 years ago and the best thing I can do is own that decision and move forward.

If I don't get my levels up, I will have to go to my doctor for weekly iron infusions for five weeks.  I am trying to avoid that.  I do remember being told that anemia after gastric bypass is very common, and that I would most likely never be able to donate blood again.  But I am hoping I can get my numbers up to acceptable levels, and get my energy back.  I'm tired of being tired.  


  1. Holy moly, that sounds overwhelming. Iron infusions sound scary. I could probably google it and be relieved, but it just sounds awful.

    It's wonderful that your mental health seems to be in check. I find that the hardest to regulate on my end. I don't have any food allergies, but my best friend is painfully gluten intolerant. Can't even have trace amounts.

    Sounds like you have a decent handle on it and a plan. Good luck! Especially with the drinking part. I bet I could lose these darn last 20 lbs if I quit drinking. But that life sounds miserable.

    1. They sound scary to me too, which is why I asked if I could try to fix myself with vitamins first. But I am so, so exhausted. Maybe I should have opted for the quicker fix. :-/

      I do a lot to keep my mental health issues in check without medication. Keeping my sugar consumption down helps a lot. I also use yoga and meditation to keep myself in a good place. Some days it works, some days it doesn't. Last night was a rough night for me, but I saw someone from my past that I probably shouldn't have.

      I really like to remind myself that my first world problems aren't that bad. I have a place to live, food to eat, a job that pays well, clean water, a car to life is just fine. I don't have to dodge bombs just to go to the market. However, when I'm in the middle of a meltdown, try telling my brain that. :-/

      Anyway, thanks...I do feel like I have a decent handle on it more days than not! Now today, I am just getting myself back on track. Last night had the potential to derail me for days, instead of hours. So I'm doing better. :)

  2. For those who have asked, the iron I am using is Floradix. It's a liquid that I take 30 minutes before breakfast and dinner. (Remember you can't mix calcium, and other minerals, with iron, so you need to take it alone, but taking it with Vitamin C will help with constipation.)