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I Am Suffering With Very Low Energy, Muscle Cramps Everywhere( Hands Legs Neck Arms), Shortness Of Breath, Crumbling Of Nails And Dizziness.Recent CBC Showed Low Hemoglobin, Hemocrit, Rbc And Ferritin. My Dr Said I'm Anemic But Only Said To Drink Green Smoothies To Flush My Kidneys. Should I Be Concerned ?
Question: I am suffering with very low energy, muscle cramps everywhere( hands legs neck arms), shortness of breath, crumbling of nails and dizziness.
Recent CBC showed low hemoglobin, hemocrit, rbc and ferritin. My dr said I'm anemic but only said to drink green smoothies to flush my kidneys. I also had a egfr reading of 56.
Recent CBC showed low hemoglobin, hemocrit, rbc and ferritin. My dr said I'm anemic but only said to drink green smoothies to flush my kidneys. I also had a egfr reading of 56.
Brief Answer:
anemia?
Detailed Answer:
Hello,
My first comment is that anemia requires investigation unless the cause is already known. Lack of iron in particular may be caused by inadequate iron intake or absorption and increased iron requirements (due to blood loss usually but also due to skin disorders, etc). If you already know why your iron stores are depleted then that's fine and you should only receive supplementation to get the iron stores back to normal levels (your ferririn levels that is). Low iron in the body may cause many of your symptoms.
If you don't know why your ferritin levels are low then an investigation should be carried out starting with gastrointestinal tract tests. Colonoscopy and endoscopy of the upper gastrointestinal tract are the first two tests to order in such cases since many individuals have lesions that result in blood loss. I usually start with the test that would address the patient's complaints. For example for a patient with recurrent burning pain of the stomach I would start with an upper gastrointestinal endoscopy.
If you're a vegetarian then you be taking less iron than needed, so this is something else to consider. Inadequate absorption of iron may occur due to celiac disease but it's not very likely to be diagnosed at your 65 - it should have been diagnosed earlier I mean. Surgery in the stomach may impair iron absorption. The same applies for surgery in the lower part of the small instestine.
Regarding your low eGFR, this is not very worrisome at least with the currently provided information. You should check with follow-up testing whether your creatinine tends to rise and an ultrasound scan may exclude obstruction of the urinary tract (an enlarged prostate?). This reading cannot explain any of your symptoms.
I hope I've answered your query. Let me know if you need further assistance.
Regards!
anemia?
Detailed Answer:
Hello,
My first comment is that anemia requires investigation unless the cause is already known. Lack of iron in particular may be caused by inadequate iron intake or absorption and increased iron requirements (due to blood loss usually but also due to skin disorders, etc). If you already know why your iron stores are depleted then that's fine and you should only receive supplementation to get the iron stores back to normal levels (your ferririn levels that is). Low iron in the body may cause many of your symptoms.
If you don't know why your ferritin levels are low then an investigation should be carried out starting with gastrointestinal tract tests. Colonoscopy and endoscopy of the upper gastrointestinal tract are the first two tests to order in such cases since many individuals have lesions that result in blood loss. I usually start with the test that would address the patient's complaints. For example for a patient with recurrent burning pain of the stomach I would start with an upper gastrointestinal endoscopy.
If you're a vegetarian then you be taking less iron than needed, so this is something else to consider. Inadequate absorption of iron may occur due to celiac disease but it's not very likely to be diagnosed at your 65 - it should have been diagnosed earlier I mean. Surgery in the stomach may impair iron absorption. The same applies for surgery in the lower part of the small instestine.
Regarding your low eGFR, this is not very worrisome at least with the currently provided information. You should check with follow-up testing whether your creatinine tends to rise and an ultrasound scan may exclude obstruction of the urinary tract (an enlarged prostate?). This reading cannot explain any of your symptoms.
I hope I've answered your query. Let me know if you need further assistance.
Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Due to an accident I had. Look supply loss to my colon. So I had a stomach for a year. March 2018 I had the stoma take down. Because of accident I only have 12" of large colon. Everything seems to be working good. I don't see blood in stool. I think only a minor trim at end of small intestine was lost. My vitamin B12 numbers were at the low end of normal.
Should I ask my Dr for an iron injection so I don't pass out and fall until we figure out why low iron RBC?
Should I ask my Dr for an iron injection so I don't pass out and fall until we figure out why low iron RBC?
I apologize for auto correct.
I had an accident that prevented blood supply to my colon. I had a stoma for a year. Take down March 28, 2018.
I had an accident that prevented blood supply to my colon. I had a stoma for a year. Take down March 28, 2018.
Brief Answer:
Please read the complete answer
Detailed Answer:
Thanks for the additional information.
The large intestine is not important for iron absorption. The stomach, first and last part of the small intestine are important. If your diet is not adequate in iron then you should increase iron intake (meat mostly).
Otherwise checking both the intestine and the stomach would be required.
Kind Regards!
Please read the complete answer
Detailed Answer:
Thanks for the additional information.
The large intestine is not important for iron absorption. The stomach, first and last part of the small intestine are important. If your diet is not adequate in iron then you should increase iron intake (meat mostly).
Otherwise checking both the intestine and the stomach would be required.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Prasad
My final question on previous post was not addressed.
Would it be wise to ask my primary Dr to administer an iron injection to help until a diagnosis regarding low iron, RBC, Hemodrit and Hemoglobin is completed. I am faint and suffering from muscle spasms/cramps all over my body.
Would it be wise to ask my primary Dr to administer an iron injection to help until a diagnosis regarding low iron, RBC, Hemodrit and Hemoglobin is completed. I am faint and suffering from muscle spasms/cramps all over my body.
I sense you feel you answered question in your original reply.
You said:
If I know why - then supplementation
If I do NOT know why - investigative testing.
The Referal process and testing can take a month or more in our market.
I am very much non functional and getting weaker.
Is it ok to supplement prior to appointment Referal for testing?? i.e. Would an injection or transfusion be approiate until a diagnosis can be made?
You said:
If I know why - then supplementation
If I do NOT know why - investigative testing.
The Referal process and testing can take a month or more in our market.
I am very much non functional and getting weaker.
Is it ok to supplement prior to appointment Referal for testing?? i.e. Would an injection or transfusion be approiate until a diagnosis can be made?
Brief Answer:
Yes, supplementation can be started immediately
Detailed Answer:
Welcome back,
You can start taking supplements right away if the time to complete the investigation would be that long. You can use tablets or liquid formulations of iron. Intravenous iron can also be used but keep in mind that the intravenous route comes with some risk for serious adverse events.
Regarding the cramps, it is possible that iron correction won't eliminate them. Checking the electrolytes and muscle enzymes (CPK) might provide helpful clues.
I sincerely hope to have addressed all the issues now. Please let me know if you have more questions.
Kind Regards!
Yes, supplementation can be started immediately
Detailed Answer:
Welcome back,
You can start taking supplements right away if the time to complete the investigation would be that long. You can use tablets or liquid formulations of iron. Intravenous iron can also be used but keep in mind that the intravenous route comes with some risk for serious adverse events.
Regarding the cramps, it is possible that iron correction won't eliminate them. Checking the electrolytes and muscle enzymes (CPK) might provide helpful clues.
I sincerely hope to have addressed all the issues now. Please let me know if you have more questions.
Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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