High Hemoglobin and Small Veins (hernia, reflux, leg, nodes)
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Its never seen hypothesized that such infections cause iron deficiency. Anemia of chronic disease lowers iron levels that one might not respond to indicating it isn't a lack of iron but the body shutting down free iron. There is a difference in iron studies in those cases.
Quote:
Recent studies have suggested a link between iron-deficiency anemia and Helicobacter pylori infection. In the current study, strains of H. pylori derived from patients with iron-deficiency anemia showed enhanced Fe ion uptake and Fe ion-dependent rapid growth compared with those from patients with non-iron-deficiency anemia. H. pylori with enhanced Fe ion-uptake ability may be a causative factor for iron-deficiency anemia.
I'm familiar with PPIs, and how commonly they are used.
Don't know about the cause and effect between bleeding ulcers/bleeding cancerous tumors and anemia? In my experience, when my own issues with these items were discovered and fixed, my hemoglobin and other red cell indices went back into the normal ranges and I was no longer anemic. With some help from an oral iron supplement, that is. Guess my issues aren't iron malabsorption, even though the treatment I had for the ulcers ( a couple years before the cancer) included PPIs.
That suggests a cause and effect relationship to me.
Adenomas are different, you bleed a lot more. We're talking about the more common form of bleeding, from a peptic ulcer, and why it's assumed that minor level of bleeding is enough to cause anemia. I'm pointing out that it's likely the bacterium responsible for the ulcer causing the iron deficiency, not the minor bleeding.
Of course, this is the entire claim behind GI bleeds being the #1 source of anemia in adults, due to peptic ulcers.
For those interested in maximizing iron absorption:
Quote:
There are multiple variables that may enhance or inhibit the absorption of medicinal iron (Table 4A). Differences in absorption are most likely due to the requirement of acidity in the duodenum and upper jejunum for iron solubility. For iron released beyond these sites, the alkaline environment reduces absorption.13 Ideally, patients should not take iron supplements within 1-2 hours of antacids. The inhibition of iron absorption by other medications that reduce stomach acid like H2 blockers may be even more prolonged.Absorption is also delayed with tetracyclines, milk, and phosphate-containing, carbonated beverages such as soft drinks. Even the calcium, phosphorus and magnesium salts contained in iron-containing multivitamin pills impair absorption of elemental iron.14 For this reason, multivitamin preparations should never be recommended as a sole therapy for iron deficient anemia. Iron tablets are recommended between meals or at bedtime to avoid the alkalinizing effect of food and to take advantage of the peak gastric acid production late at night.
Iron is not readily absorbable, and a bad diet combined with medications could see the amount of iron you absorb to be even less, if then presented with a stressor, you may find yourself sub-clinically anemic.
This study (meta analysis) was used to assess when to switch patients from oral iron to IV iron. For our purposes, it shows a significant percentage of people who don't respond to oral Iron, and that would be likely due to malabsorption in the gut.
Quote:
Responders, compared to non-responders, were younger (32.9 vs. 39.7 years), had lower BMI (27.9 vs. 31.1 kg/m) and a lower base-line Hb (9.1 vs. 9.8 g/dL). Treatment compliance with oral iron was reported in four trials and ranged from 83.9% to 98.5% (Table 1). At day 28, the number of patients with an Hb increase of 1.0 g/dL or more from baseline was higher for responders than non-responders (100% vs. 46.8%) and at day 42-56 the number of patients with an Hb increase of 2 g/dL or more was higher for responders than non-responders (92.9% vs. 27.4%) (Figure 1).
"However, the relationship between H. pylori and the etiology of IDA remains obscure. In the present study, we compared the Fe ion-uptake ability of H. pylori strains recovered from patients with IDA and patients with gastroduodenal diseases without IDA (non-IDA)."
They took a culture and looked at the bacteria in culture.
"Most of the strains recovered from patients with non-IDA showed a similar growth rate under Fe-restricted and Fe-sufficient conditions.
Discussion. Although epidemiological and clinical evidence of the relationship between H. pylori infection and the incidence of IDA has been accumulating, the etiology of H. pylori– associated IDA is not clear."
I agree it isn't clear.
Are you suggesting that they have H pylori causing the iron deficiency? What symptoms justify testing for H pylori infection?
Are you suggesting that they have endoscopy of the upper GI in addition to a colonoscopy?
One takes a piece of tissue and places it in a CLO test media capable of detecting urease. Positive pink color Bingo!!
So it's ok to screen for H pylori but lets not screen for colon cancer.
Let me play your role when you state that viruses are good for you.
With regard to H pylori,
"The infection has classically been associated with different gastro-intestinal diseases, but also with extra gastric diseases. Despite such associations, the bacterium frequently persists in the human host without inducing disease, and it has been suggested that H. pylori may also play a beneficial role in health.
Despite the existence of such associations, these diseases occur only in a small percentage of infected people, suggesting that the bacteria frequently persists in the human host without inducing any obvious signs of disease, and it has been suggested that H. pylori may also play a beneficial role in human health[9-14]. Indeed, recent studies indicate that the decreasing incidence of H. pylori in the developing world is paralleled by an increase in the incidence of allergies and autoimmune diseases[15]. Furthermore, the absence of H. pylori has been linked to elevated incidence of diseases, such us multiple sclerosis and celiac disease, among others[16-18].
" H pylori infection is inversely associated with the development of some diseases, suggesting that the presence of these bacteria may also be beneficial to the host, as is the case for reducing the risk of obesity, childhood asthma, inflammatory bowel disease and celiac disease among others.Jul 28, 2018"
Are you suggesting that they have H pylori causing the iron deficiency? What symptoms justify testing for H pylori infection?
No, we're not discussing Crazy Cat Lady at all, just if blood loss from peptic ulcers is the cause of anemia as is assumed.
Crazy Cat Lady should re-do the test in 2-3 months after supplementing with iron/vit z and avoiding antacids .
As for tests for H pylori, you can do a simple antibody test from blood or antigen test from stool. Not as accurate as scraping the stomach, but less invasive.
I'm linking to a widely used medication and its role in Iron malabsorption.
PPIs (like household names Prilosec) are routinely used.
Also, GI bleeding from a peptic ulcer does not imply the bleeding was the cause of the anemia. See my post right before yours to Hoonose.
Last summer I started taking OTC Prilosec daily (I felt I was using too much regular antacids.) I have to take some kind of antacid though my acid reflux is horrible.
Oh no, just looked at a chart and my Hematocrit has had a huge decrease since 2019. Yikes.
It was even high in July of 2019. Even I know that looks bad. Gosh, I hate the idea of a colonoscopy.
No need to fear colonoscopy. The procedure itself is painless (you're unconscious, for practical purposes). The prep just involves repeated loose BMs for a few hours. Big deal....Your blood tests show a classic pattern for GI bleeding/ Fe deficiency-- a fall in Hb & Hct with small, pale RBCs (low MCV & MCH). Get it checked soon- panendoscopy.
Re- dietary Iron-- there is no "good" source once you get deficient. Luckily, we've evolved to be very good at retaining & recycling Fe, so no evolutionary need to be good at absorbing it, and we have a built in saturation point for absorbing Fe from our diet so we don't get over-loaded....Malabsorption of Fe is limited to those for whom we can predict it-- after extensive GI surgery, etc- virtually never seen in otherwise normal people.
Re- peptic ulcers & H.pylori-- over-rated. The bacteria does not "cause" ulcers, but once you get an ulcer, it takes longer to heal if it gets infecteed. Cf- when you skin you knee playing tackle football in the alley-- it heals quickly unless it gets infected......Early studies done once flex endoscopy came into general use was that peptic ulcers heal remarkably fast by themselves (24-48 hrs) most of the time. That makes it hard to really evaluate treatments. The ones that last longer tend to be the ones infected with H.pylori, leadng to the false conclusion that they are etiologic agents. I don't believe Koch's Postulates have ever been tested & confirmed for H. pylori in humans.
Last summer I started taking OTC Prilosec daily (I felt I was using too much regular antacids.) I have to take some kind of antacid though my acid reflux is horrible.
Oh no, just looked at a chart and my Hematocrit has had a huge decrease since 2019. Yikes.
It was even high in July of 2019. Even I know that looks bad. Gosh, I hate the idea of a colonoscopy.
Yeah, looks like a pretty good drop over a three year period, and the latest MCV ( mean cell volume) especially suggests it might well be an iron deficiency. But that's verified/diagnosed with iron study testing, so hopefully that's done or is in progress ( involves a blood draw, hopefully before you've started the oral iron supplement).
If the iron test results show an iron deficiency, there is some likelihood it could be from blood loss ( bleeding over time), if that's the case it'd most commonly be from the GI tract. Serial fecal occult blood testing ( say times 3 over several days, for example) would verify GI blood loss. If it's slow blood loss from a gastric ulcer or erosion(s), blood might be detected in some but not all stool samples, that's the reason for multiple samples. That's a noninvasive test that while it's not fun with the "honeydipping", to obtain a sample you smear on occult blood cards, you send or drop those off for testing and that is the extent of your involvement.
If all or some of the occult blood testing comes back positive, that's when your doctor would most likely suggest perhaps both upper and lower endoscopies, to find where that blood is coming from. The upper endoscopy ( EGD) would look for bleeding sources from your esophagus down through the portions of your stomach into your duodenum- indicated especially with your history of reflux, possibly other GI symptoms. Often gastric ulcers are associated with NSAID ( such as over the counter Motrin, Aleve type use. In any case should you have ulcers they'd be treated, they'd look for a possible cause, ie, reviewing life style causes, NSAID use, testing for the presence of H. pylori bacteria in tissue samples obtained from the stomach during the EGD. Ulcers are treated with- more antacids, avoidance of foods that can cause more irritation- kinda what you can tolerate. If the bleeding is heavy or ongoing, that may be treated during the EGD to stop the bleeding, but that may or may not be needed.
The colonoscopy would also look for bleeding, polyps, masses ( as is routinely done). You'd be sleeping during both these
procedures, so no pain or discomfort there. They say the colonoscopy prep is the worst part, but even still the preps that have come out more recently don't involve as much of the liquid you have to drink as the earlier ones.
In any case, following up with your doctor and going from there is your best bet. I think it was you, wasn't it, who said she "freaked out" when she saw your results? If so, I'd bet it was because she wasn't expecting those and they came as a surprise ( putting results like that in a serial chart form will do that). A reaction like that from a doc is scary, but she will have her act together, and will have a good plan going forward to get to the bottom of your dropping CBC results. It'll be ok!
No need to fear colonoscopy. The procedure itself is painless (you're unconscious, for practical purposes). The prep just involves repeated loose BMs for a few hours. Big deal....Your blood tests show a classic pattern for GI bleeding/ Fe deficiency-- a fall in Hb & Hct with small, pale RBCs (low MCV & MCH). Get it checked soon- panendoscopy.
Re- dietary Iron-- there is no "good" source once you get deficient. Luckily, we've evolved to be very good at retaining & recycling Fe, so no evolutionary need to be good at absorbing it, and we have a built in saturation point for absorbing Fe from our diet so we don't get over-loaded....Malabsorption of Fe is limited to those for whom we can predict it-- after extensive GI surgery, etc- virtually never seen in otherwise normal people.
Re- peptic ulcers & H.pylori-- over-rated. The bacteria does not "cause" ulcers, but once you get an ulcer, it takes longer to heal if it gets infecteed. Cf- when you skin you knee playing tackle football in the alley-- it heals quickly unless it gets infected......Early studies done once flex endoscopy came into general use was that peptic ulcers heal remarkably fast by themselves (24-48 hrs) most of the time. That makes it hard to really evaluate treatments. The ones that last longer tend to be the ones infected with H.pylori, leadng to the false conclusion that they are etiologic agents. I don't believe Koch's Postulates have ever been tested & confirmed for H. pylori in humans.
I've had some ongoing issues with iron deficiency anemia since they discovered my colon cancer last summer and after the colon resection, and at this point I fear I may be a lifer on oral iron supplementation- that or occasional IV iron infusions which I would prefer to avoid. I will have repeat endoscopies this summer as part of the cancer surveillance so will see about any ongoing bleeding ( history of gastric ulcers as well).
So in trying to maximize iron absorption from the supplement, I've been taking a product called Vitron C which contains 65 mg iron and also Vitamin C. The vitaminC is intended to enhance the absorption of the iron. I take it at about 5AM, ( have to get up and go to the john anyway) about 3 hours before any of my other meds and on an empty stomach. Then I go back to bed and sleep off any possible side effects of the iron supplement. I haven't noticed any untoward side effects they often report for these supplement.
Sometimes you gotta do what you gotta do. I do feel lousy ( tired) when the hemoglobin gets down below 9 grams.
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