Doc prescribe Iron Supplements & Vitamin D + Calcium and Centrum *_* too much?

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Dear Dr. Andy
 
Hi everyone!

I'm a newbie! Joined Yesterday!  :biggrin So nice to be here! I'm so glad to come across your website!  :wink Every time I have a blood test, my OB/GYN (also my main doctor) prescribes me Iron supplements. Again, this year she prescribe Iron supplements plus Calcium + D vitamin (which seem to cancel out each other?) though she did not do lab test on my Iron levels. I'm afraid she may be over-prescribing me.  :huh Also, I exercise and bike/hike and feel great, but she thinks I'm severly anemic and wants to force me into an endometrial biopsy though my pap was normal (last week!) and no heavy bleeding/cramps, and my cycles are very regular. Should I do the invasive biopsy anyways, or change a doctor (since she won't discuss my uterine ultrasound with me until 5 min. before the biopsy she's insisting on). Thanks SO much, you really give me hope in this confusing situation! :rolleyes
 
Sincerely,
Sophie from California

« Last Edit: October 31, 2010, 06:04:42 PM by Andy »

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Offline Andy Battaglia

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Hi Sophie,

Do you have any of your blood test results? What is your Hb level? The calcium and D are very important and calcium is not well absorbed without adequate D levels, but iron is not likely to help you and will hurt your organs if taken long term when not needed. You should tell your doctor you will not take iron unless a panel of tests called iron studies verifies that you are iron deficient. Iron can help anemia caused by iron deficiency but is useless against any other type of anemia and specifically thalassemia minor.
Andy

All we are saying is give thals a chance.

Dear Dr. Andy :hugfriend

Thank you so much for taking the time to review my thasslanemia! Here are my blood test results and flags:

RBD 5.22 (high)
Hemoglobin 8.9 (low)
Hematocrit 32.7 (low)
MCV 63 (low)
MCH 17.0 (low)
MCHC 27.2 (low)
RDW 21.2 (high)
Calcium 9.2 (normal)
Vitamin D, 25 hydroxy 30.0 (low)

So should I keep taking Centrum and Caltrate and hold the SlowFe until I get blood test for Fe levels?  ???Thanks SO much!

Sophie :biggrin

Oops, I meant "RBC" 5.22 (high)

I don't have any Fe results....Thanks so much!  :bighug :bighug

Sophie

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Offline Andy Battaglia

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Hi Sophie,

The only reason I could see that your doctor would want to do the endometrial biopsy is that she is looking for an explanation for your low hemoglobin level. Even though you have no sign of bleeding, your doctor thinks bleeding could be a possibility.

I don't have enough of your background to be certain, but if your Hb level has typically been around 9, then there is no reason to look for bleeding as an answer. If your Hb has suddenly dropped, then exploring a bit might make some sense, but ONLY after iron studies have been done. If your doctor wants to do an invasive biopsy before doing iron studies, it's time to get another doctor. All of your blood counts point to thal minor as the cause. Iron deficiency does remain a concurrent possibility but this cannot be assumed in thalassemia minor. An iron panel is necessary to diagnose iron deficiencies in thal minors. This is thal 101 and if your doctor can't bother to check out what I am saying, then you need a doctor that will recognize at least the very basics of thal minor.

Your vitamin D level is marginal. 30 is the lowest to be considered normal, but bumping it up would be a good idea. You have good habits that are keeping you more fit than would be expected for your Hb level, so do keep up the exercise. It does wonders for optimizing the oxygen level.
Andy

All we are saying is give thals a chance.

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Offline Andy Battaglia

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And yes, I would say don't take iron unless you know you're deficient. A balanced diet is usually all it takes to have a normal iron level.
Andy

All we are saying is give thals a chance.

Dearest Dr. Andy  :cheer

[bgcolor=#00ff7f][bgcolor=#00ff7f][/bgcolor] Thank you so much for your detailed and wise advice! Yes, you are definately right on the target when you describe my concerns about biopsy, iron levels, etc. The doc doesn't even ask about the iron panel but wants to go into the biopsy. So I will change another doctor. If I just take a few days of SlowFe during my period (5 days a month) will that boost my system a bit, or just not take iron at all except for Centrum?  :dunno Thanks again for ALL your help! I will keep on exercising!

Gratefully,
Sophie[/bgcolor]  :yahoo :clap

 

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