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  #1   ^
Old Sat, Oct-13-07, 11:57
xerref xerref is offline
New Member
Posts: 22
 
Plan: CKD
Stats: 150/150/138 Male 175cm
BF:
Progress:
Default 21y/o need advice on blood work

hi,
my recent lab results revealed that i have anemia.
however, according to the results, my macrocytes are up, indicative of megoblastic anemia. BUT my b12 levels are 583pmol/L and folic acid levels are 53.5nmol/L and my ferritin levels are 56 and potassium levels of 4.0mmol/L

so my GP says i need a iron and potassium supplement, whereas my endo says i shld be supplementing with a b-complex.
who is right in this case and what is causing the increase in macrocytes exactly? both of my doctors could not give me a definite answer, which is just highly suspect :/

i also had my thyroid checked:
Free T4 : 11.3pmol/L
tsh : 2.55 uIU/mL
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  #2   ^
Old Mon, Oct-15-07, 04:51
kebaldwin kebaldwin is offline
Thank you Dr Atkins!
Posts: 4,146
 
Plan: Atkins induction
Stats: 311/250/220 Male 6 feet
BF:45%/20%/15%
Progress: 67%
Location: North Carolina
Default

I can't answer your question specifically ... but that has never stopped me before :-)

What is your diet like?

Most low carbers need potassium supplements - which usually means buying "salt substitute" (main ingredient will be potassium) at your grocery store. You might want to add potassium and salt to your food - or I think Morton has something also found in most grocery stores called "half salt" which is half sodium and half sodium. I prefer 2/3 potassium and 1/3 salt - but whatever.

Normally if your electrolytes are out of balance you get cramps and constipated.

Most low carb diets are naturally high in iron from all the meat - so therefore most low carbers avoid iron in their supplements.

Most people have problems related to nutrition and don't realize it. I am not one that likes for people to take just B12, or C, or D, - i.e. one vitamin here and one vitamin there.

IMHO people need to take a "mega" high quality multivitamin (6 to 8 capsules per day) plus about 4 grams of fish oil per day. It will give you optimal dosages of most of the vitamins and minerals you need. If you have regular nutrion problem - this should resolve most nutritional problems.

Do this for 3 months and then go back to your doctors. If you still have a problem - then address it.

Eating low glycemic foods is half of fixing people's nutritional problems - supplements are the other half.
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  #3   ^
Old Mon, Oct-15-07, 07:35
cs_carver cs_carver is offline
Senior Member
Posts: 4,629
 
Plan: Generic LC with tweaks
Stats: 204/178/165 Female 72 inches
BF:
Progress: 67%
Location: NC
Default They're both right

Quote:
Originally Posted by xerref
so my GP says i need a iron and potassium supplement, whereas my endo says i shld be supplementing with a b-complex.
who is right in this case and what is causing the increase in macrocytes exactly? both of my doctors could not give me a definite answer, which is just highly suspect :/


There are few definite answers in medicine once you get out of the realm of CSI and House. Once you're dead, it's sometimes possible to give a definite answer as to what killed you, esp. when there's a knife in your back. But most of the time, problems are multi-determined. Far too many variables.

You're of childbearing age, and as such, your folic acid status is critical, whether or not you are planning to get pregnant any time soon. If there's any chance you might carry a baby to term, folic acid levels are critical and by the time you know you're pregnant, most of the folic-acid-related decisions have been made by the baby. So Bs matter.

And I'd wonder if you have a history of abundant iron in your diet. If not, then yes, take the supplement, esp. if you tend to heavy periods. They can be WAY draining on a body. LC will tend to help iron levels, but I've never seen mine rise significantly so I take a supplement with iron, and am always at the low end of the Red Cross donor scale.

You might could do some googling on your condition and see what the common risk factors are and maybe you lived next to a factory when you were growing up, or you live downwind from something now, or maybe your mother did and it simply takes 20 years to show up. It only gets more complicated from here on out.

Good luck.
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  #4   ^
Old Mon, Oct-15-07, 07:41
TarHeel's Avatar
TarHeel TarHeel is offline
Give chance a chance
Posts: 16,944
 
Plan: General LC maintenance
Stats: 152.6/115.6/115 Female 60 inches
BF:28%
Progress: 98%
Location: North Carolina
Default

Quote:
If there's any chance you might carry a baby to term, folic acid levels are critical and by the time you know you're pregnant, most of the folic-acid-related decisions have been made by the baby


Plus, as a male, you'll be famous.

Kay
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  #5   ^
Old Mon, Oct-15-07, 08:33
Didy's Avatar
Didy Didy is offline
Senior Member
Posts: 1,057
 
Plan: Low carb
Stats: 136/118/115 Female 5' 2"
BF:
Progress: 86%
Location: Washington
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Quote:
Originally Posted by TarHeel
Plus, as a male, you'll be famous.

Kay


Okay, now I splurted coffee out of my nose and it's all over my keyboard! Thanks alot Tarheel!
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  #6   ^
Old Mon, Oct-15-07, 08:33
Didy's Avatar
Didy Didy is offline
Senior Member
Posts: 1,057
 
Plan: Low carb
Stats: 136/118/115 Female 5' 2"
BF:
Progress: 86%
Location: Washington
Default

Quote:
Originally Posted by TarHeel
Plus, as a male, you'll be famous.

Kay


Okay, now I splurted coffee out of my nose and it's all over my keyboard! Thanks alot Tarheel!

Dang it! And I even double posted!!!
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  #7   ^
Old Mon, Oct-15-07, 10:33
cs_carver cs_carver is offline
Senior Member
Posts: 4,629
 
Plan: Generic LC with tweaks
Stats: 204/178/165 Female 72 inches
BF:
Progress: 67%
Location: NC
Default Oops... forgot to check

Not too many 21-year olds get to doctors, when you think about it.

In that case, ++1 on the prior eating habits, and the anemia is a different degree of problem.

Truth is, the B status probably affects fetal health almost as much when it's the sperm's contribution. Just infinitely harder to monitor...
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  #8   ^
Old Mon, Oct-15-07, 13:00
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 25,843
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

Quote:
Originally Posted by TarHeel
Plus, as a male, you'll be famous.

Kay

THREAD of the CENTURY!

Ok, but humour aside.

Is this macrocytic anemia? Pernicious anemia? Or iron related anemia? Low iron can be caused by microscopic bleeding and one cause of that is intestinal trauma caused from food intolerances. You could get checked for Celiac it is a bunch of nasty testing and often misses the other diagnosis of gluten intolerance, which is just as bad, IMHO. I wouldn't rely on conventional celiac testing but would use a fecal test which Enterolab.com has available. You can test for other food intolerances too. If you do find out you're gluten intolerant, treat it with the same respect as you would celiac disease.

Macrocytic anemia is caused by low folate levels or low b12 levels. Your B12 levels are ok, but it doesn't hurt to raise them. Low thyroid can also cause that sort of anemia. Pernicious anemia can be caused by intestinal troubles, lack of an enzyme you need to process B12 called Intrinsic Factor. Iron anemia can be caused by microscopic bleeding or not absorbing iron properly... think intestines again, although you can lose blood in other ways too.

Do you have any intestinal issues? Irritable bowels, diarrhea, that sort of thing?

Ok, I just looked up macrocytes, those are abnormally large blood cells which indicates macrocytic anemia or pernicious anemia. Checking blood folate levels doesn't help because, according to my rhuemy, the folate is where it can't really be measured. I have macrocytic anemia from a drug I take and I'm taking LOTS of extra folate. Hopefully that will help my red blood cell size, I haven't heard yet from my latest blood test.

You should probably try to figure out why you have this sort of anemia. I'm betting you're taking a drug that interferes with folate absorbing or you've got some intestinal issues or a diet seriously lacking in folate.

If you want to dispense with all this testing nonsense, just follow the paleo diet and see if that helps your bloodwork, and whatever symptoms you might have.

Last edited by Nancy LC : Mon, Oct-15-07 at 13:12.
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  #9   ^
Old Fri, Oct-19-07, 07:03
xerref xerref is offline
New Member
Posts: 22
 
Plan: CKD
Stats: 150/150/138 Male 175cm
BF:
Progress:
Default

hey
i used to suffer from an eating disorder about 3 years back.
undereating and over-exercising is a bad combination, resulted in my cortisol skyrocketing and my body basically ceased almost all production of my growth hormones and testosterone. i have since gained abt 40lbs with a good diet and weightlifting. could my previous bad eating habits be the cause of all this?
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  #10   ^
Old Fri, Oct-19-07, 07:11
kebaldwin kebaldwin is offline
Thank you Dr Atkins!
Posts: 4,146
 
Plan: Atkins induction
Stats: 311/250/220 Male 6 feet
BF:45%/20%/15%
Progress: 67%
Location: North Carolina
Default

Quote:
Originally Posted by xerref
undereating and over-exercising is a bad combination, resulted in my cortisol skyrocketing and my body basically ceased almost all production of my growth hormones and testosterone. ... could my previous bad eating habits be the cause of all this?


I wouldn't know about under eating and over exercising :-)

I do know about over eating high glycemic foods and under exercising - and know that can screw you up really bad - because of bad nutrition - so why wouldn't under eating and over exercising cause problems from bad nutrition?
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  #11   ^
Old Fri, Oct-19-07, 08:29
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 25,843
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

I have macrocytic anemia too. It can be caused by a number of things, I suggest you google it. Alcoholism, taking certain drugs (I'm taking one that causes it, sulfasalazine), B12 deficiency, folate deficiency, maybe some other things.

You really need to go to a doctor and figure it out. If you're deficient in one of the vitamins, find out why. You might need injections of B12 or sublinqual tablets.
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  #12   ^
Old Sun, Oct-21-07, 20:14
Citruskiss Citruskiss is offline
I've decided
Posts: 16,864
 
Plan: LC
Stats: 235/137.6/130 Female 5' 5"
BF:haven't a clue
Progress: 93%
Default

I'd definitely add the b-complex supplement, and it wouldn't hurt to take a separate B-12 supplement. Get the B-12 in the sublingual tablet form, rather than just trying to get it from the b-complex or multi-vitamin. The sublingual tabs absorb much better. While your b-12 seems fine, I don't think it would hurt to take a little more, in addition to a really good b-complex.

With regard to iron - I'd suggest asking about getting an iron panel done first before adding in iron supplements. Ferritin is just one aspect of the whole 'iron' picture, and you might want to follow up and find out your serum iron, total iron binding capacity, tranferrin saturation (also known as iron saturation) etc. in addition to that ferritin number you already have - this will shed more light on whether there's an iron deficiency, or possibly even an iron overload.

Here's a blurb on the iron panel test:

http://www.med.umich.edu/1libr/aha/aha_ironstud_crs.htm

PS - edited to add: iron issues also affect MCV. (macrocytes). You haven't gotten a definitive answer because you might need some more tests run to get to the exact cause of the elevated MCV.
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  #13   ^
Old Sun, Oct-21-07, 20:24
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 25,843
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
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I think I found I wasn't taking enough folate to resolve my macrocytic anemia. The doctor had said 1000 mg but I saw somewhere that said 1000-2000 mg. So I've bumped it up and I'm feeling MUCH better.
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  #14   ^
Old Sun, Oct-21-07, 22:33
southbel's Avatar
southbel southbel is offline
Carolina Girl
Posts: 1,161
 
Plan: Atkins
Stats: 244.5/131.8/120 Female 5' 4"
BF:
Progress: 91%
Location: Charleston, SC
Default

If you do find the root cause for your anemia and low potassium, please share, as I have the same issue. I have low folate, B-12, iron, and potassium. Thus far, I have been treated for symptoms but not been given a root cause although I do have other issues. So, I am finding this thread very interesting. Although, I am following up on Nancy's prior suggestions of gluten intolerances since I do have intenstinal issues as well.

xerref, your TSH suggests a sluggish thyroid too and since I have hypothyroidism, I wonder if this is a connection? Anyway, if your doctor finds a connection for all of these, please share.
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  #15   ^
Old Wed, Oct-31-07, 05:46
xerref xerref is offline
New Member
Posts: 22
 
Plan: CKD
Stats: 150/150/138 Male 175cm
BF:
Progress:
Default

hi all.
thanks for the informative replies.
i have taken some of the advice given and it has paid off. i seem to have more energy after taking a b-complex and potassium supplements. my next visit to my endo would be in dec, but i might bring it forward if im still having problems. thanks again everybody.
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