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Can Ferro Grad C Be Taken When Suffering From Polycythaemia Vera?
Question: Hi, Today my Doctor prescribed Ferro-Grad C for treatment of iron deficiency. I believe iron is essential in the production of red blood cells, however I have been diagnosed with Polycythaemia Vera where my bone marrow produces too many red blood cells. I have been confused to some extent by statements from my Haemotologist and my Doctor with regard to the relationship between iron and red blood cell production. Does an increased intake of iron have an adverse effect on the Polycythaemia.. I have been blaming my symptoms (aching joints, shortness of breath, lethargy) on PV, whereas iron deficiency could be the culprit.
Any advice would be appreciated.
Thanks
XXXX
Any advice would be appreciated.
Thanks
XXXX
Brief Answer:
Should not take iron.
Detailed Answer:
Hi XXXXXXX
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Looking at the clinical history and present query, my opinion is as follows:
1. In polycythemia vera, one of the goal is to induce iron deficiency through phlebotomy or venesection.
2. If your hemoglobin has fallen below the critical limits of 10g%, then I would think about advising iron therpay. What is your hemoglobin level at present?
3. Routinely, I would have thought of anemia, and advised Iron. However, in polycythemia vera, maintaining a iron deficiency state is very helpful limiting red cell production.
4. Increased intake of iron, will accelerate the production of RBCs.
5. Aching joints, shortness of breath and lethargy could be symptoms of anemia, however, age related degenerative changes in joints, malnutrition can also cause similar symptoms.
6. Unless you hemoglobin is below 10g%, do not take. Do attach reports of serum ferritin, (serum iron studies ) and complete hemogram, if you have further doubts.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Should not take iron.
Detailed Answer:
Hi XXXXXXX
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Looking at the clinical history and present query, my opinion is as follows:
1. In polycythemia vera, one of the goal is to induce iron deficiency through phlebotomy or venesection.
2. If your hemoglobin has fallen below the critical limits of 10g%, then I would think about advising iron therpay. What is your hemoglobin level at present?
3. Routinely, I would have thought of anemia, and advised Iron. However, in polycythemia vera, maintaining a iron deficiency state is very helpful limiting red cell production.
4. Increased intake of iron, will accelerate the production of RBCs.
5. Aching joints, shortness of breath and lethargy could be symptoms of anemia, however, age related degenerative changes in joints, malnutrition can also cause similar symptoms.
6. Unless you hemoglobin is below 10g%, do not take. Do attach reports of serum ferritin, (serum iron studies ) and complete hemogram, if you have further doubts.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank you for your quick response.
I have typed recent blood test results from 12/08/2014
Haemoglobin 158
MCV 72
RDW 18
MCHC 322
Platelets 492
White Cells 13.3
Neut 70%
Lymph 18%
Mono 8%
Eosin 4%
Red cells are moderately mocrocytic and showq several elliptocytes, Whit cell and platelet morphology is unremarkable.
IRON STUDIES
Iron umol/L 3
Trasferrin umol/L 41
TFN Satn 4
Ferritin Ug/L 10
0000 Still iron deficient but ferritin and red cell indices are improving, Consistent with iron deficiency.
Dr XXXXXXX XXXX
Apologies, I missed several readings in my previous response.
Routine Haematolgoy
RCC 6.8 x 10 12/L
PCV 0.490
Neut 70% 9.3
Lymph 18% 2.4
Mono 8% 1.1
Eosin 4% 0.5
Red cells are moderately mocrocytic and show several elliptocytes, Whit cell and platelet morphology is unremarkable.
Regards
XXXX XXXXXXX
I have typed recent blood test results from 12/08/2014
Haemoglobin 158
MCV 72
RDW 18
MCHC 322
Platelets 492
White Cells 13.3
Neut 70%
Lymph 18%
Mono 8%
Eosin 4%
Red cells are moderately mocrocytic and showq several elliptocytes, Whit cell and platelet morphology is unremarkable.
IRON STUDIES
Iron umol/L 3
Trasferrin umol/L 41
TFN Satn 4
Ferritin Ug/L 10
0000 Still iron deficient but ferritin and red cell indices are improving, Consistent with iron deficiency.
Dr XXXXXXX XXXX
Apologies, I missed several readings in my previous response.
Routine Haematolgoy
RCC 6.8 x 10 12/L
PCV 0.490
Neut 70% 9.3
Lymph 18% 2.4
Mono 8% 1.1
Eosin 4% 0.5
Red cells are moderately mocrocytic and show several elliptocytes, Whit cell and platelet morphology is unremarkable.
Regards
XXXX XXXXXXX
Brief Answer:
do not start iron therapy
Detailed Answer:
Hi XXXXXXX
Thanks for asking again.
Your hemoglobin is well above the normal limits. Not necessary to start iron therapy.
Refrain now from starting. Your polycythemia will shoot once you start iron therapy and will complicate things.
Any further queries, happy to help again
Dr. Prakash HM
do not start iron therapy
Detailed Answer:
Hi XXXXXXX
Thanks for asking again.
Your hemoglobin is well above the normal limits. Not necessary to start iron therapy.
Refrain now from starting. Your polycythemia will shoot once you start iron therapy and will complicate things.
Any further queries, happy to help again
Dr. Prakash HM
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Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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