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Iron deficiency anemia and RA
srk316 posted:
I was diagnosed with RA 5-6 years ago. Went the usual route; short-term prednisone, methotrexate, plaquinil. Nothing seemed to really work great for the inflammation or pain. Meds made me very nauseous and I didn't tolerate them well. Once the pain was manageable with ibuprofen instead of vicodin I stopped all other treatments. My Sed rate have remained high, like 56+. I have just recently been diagnosed with anemia. My hemoglobin is very low and my reserves are low too.

Can you tell me the best course of action to get this reversed? There is no initial indication that I have blood in my stool, signs of bleeding or stomach ulcer. However, I do take Prilosec otc due to ibuprofen use.

I think my gp is barking up the wrong tree with sending me to a gastroenterologist while I continue to struggle with rapid heart rate, shortness of breath, weakness and generally feeling tired and yucky.

I have heard about some other blood test for people with chronic inflammatory diseases and was curious if I should approach my rh dr. or gp to run some more tests before we pull out the big invasive procedures that will tax my HSA account with my high deductibles.

Any suggestions?
Scott Zashin, MD responded:
Anemis can be due to a number of causes. RA is one and can cause anemia as a result of the body's inability to utilize iron.Low B12 is another possible cause. You mention
GI causes of anemia. Despite the lack of blood in the stool, .low iron can be an indicator of a gastrointestinal cause. In my patients who have significant anemia and it is not from the GI tract, I will often refer them to a hematologist to help with diagnosis and treatment. There are newer treatments out for certain patients that help build up the red blood cell levels.
srk316 replied to Scott Zashin, MD's response:
Thank you for your response. Due to my SOB I was sent to the ER by my gp. I was given a blood transfusion and have some energy back along with the ability to breath better, still tachy at 100 bmp. I will pursue the GI doc and hematologist routes. Merry Christmas!

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