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Anemia of unknown orgin?

ekay03

My dog has hands!
I saw my gp yesterday and he said that I am anemic again :eek2: Ordinarily this would not seem like a big deal, but I am on Iron supplements along w/ folic acid and 2 different kinds of multi vitamins. Doc really didn't explain much but I think he this it must be my crohns becoming active. So I guess the next step is the always fun colonoscopy. And here I thought my crohns would stay in remission forever! Still I can't complain since my last major flare was in 2000.
 

vonfunk

Bourbon Bandito
Location
Toronto,
Last year my colitis had been quietly active for a long time before it was noticed, blood work came back and my RBC count was low enough to require a transfusion. Even with the scope they couldn't pinpoint an area, all they saw was that some of the polyps were red and inflamed looking.
 

David

Co-Founder
Location
Naples, Florida
That's you're anemic while taking ferrous sulfate is interesting and makes me think something may be going on with your iron metabolism. I notice you're on Nexium (I assume for GERD). The problem with proton pump inhibitors is they reduce stomach acid (like they're designed). Gastric acid lowers the pH in the proximal duodenum, enhancing uptake of iron. When gastric acid production is reduced, iron absorption is substantially reduced as well.

Problem is, it's a double edged sword as iron pills often cause GERD :(

How do you feel about liver or liverwurst? :)
 

ekay03

My dog has hands!
Thanks for the info David! You gave me a lot of info I didnt know! I dont really have GERD. My gp put me on it about 6 months ago. His reasoning at the time was it might help w/ stomach upset. Now at my last visit he changed me to Dexilent instead of Nexium. I did not ask why. Upon reading about Dexilent, it too appears to be a proton pump inhibitor also. My stomach upset was never a big complaint. In fact I was hesitant to add another drug to my already long list of stuff, but my gp pretty much insisted I take it! And yes! I do like liver and liverwurst.
 

David

Co-Founder
Location
Naples, Florida
I'd of course discuss this with your doctor first (maybe your GI) but see about getting off the PPI and eat liver or liverwurst more often. You can see the nutritional benefits of calfs liver here. Much more vitamin A than I'd like a Crohnie to have unfortunately, but everything else is amazing.

If you don't NEED the PPI, I'd really try hard to get off of it. Reducing stomach acid has a whole host of negative affects as our entire digestive system is tooled to having a very acidic stomach.
 

ekay03

My dog has hands!
Again thank you and I absolutely will discuss that w/ him when I go back in January! I dont think I need it. I dont currently have a GI! When medicaid switched providers I GI opted out. As did every GI In Dallas county! This is no Joke. I have asked my pcp to send a referral to Parkland Memorial GI dept. I am still waiting to hear from them. So A question to you. What would happen if I just stopped taking them? I know some meds that is really bad and others not so much. Where do proton pump inhibitors fall? Im not gonna just quit (not today anyway)
 
David is so right about the PPI's. They are widely over prescribed. They also inhibit absorption of B12 which could be causing the anemia. They should be weaned off (try half dose for a few days) to prevent a rebound effect of over acid production.
 

ekay03

My dog has hands!
rebound effect doesn't sound especially pleasant. And the pills I have are capsules. I will wait and let the doc get me off. My b12 is fine. He made a point of sharing that w/me.
 
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