Iron deficiency anemia without an apparent cause

Posted by ellie0989 @ellie0989, Aug 18, 2023

I'm a 21-year-old female. Last year, after a routine trip to my primary care physician, I received alarming blood test results and was sent to a hematologist who diagnosed me with severe iron deficiency anemia. Initially, the anemia was thought to be caused by heavy menstrual bleeding, and so in addition to being given two iron infusions, I was also put on an oral contraceptive that has halted the heavy bleeding entirely. Over the course of the last few months, the typical symptoms of iron deficiency anemia began to return (dizziness, fatigue, restless leg syndrome, headaches, etc.) and after another trip to the hematologist, I was once again diagnosed with anemia and have at this point received the first of two more iron infusions. After consulting with my hematologist, he recommended that I take another trip to see my primary care physician who can hopefully run some more tests to try and determine the cause of the anemia. Does anyone know of any other common causes of iron-deficiency anemia or has anyone had a similar experience?

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I had gastric bypass in 2000 and was told then that if I didn't take my vitamins I could become anemic. For the last 4 years, my blood work would show that I was anemic and then the next time I wasn't. Finally, last year, my PCP had me have a colonoscopy and endoscopy to determine where I was losing blood. Everything turned out OK. That's when I was sent to an oncologist and was found to have MGUS with anemia deficiency. My journey began then.

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Thanks so much for your insight!

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Vit C can play a role in the absorption of oral iron in foods. Aspirin over a long period can cause anemia too. There may be a genetic component you have that effects your absorption and metabolism of iron too. Just some possibilities to check out. Best of luck. Have you been checked for Thallasemia ( minor)??

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No, I have not, but I will be sure to bring that up with my hematologist. Thanks so much!

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A year and a half ago, I presented a hemoglobin of 7g with no evidence of bleeding in upper or lower GI as per scans. The referral to a Hematology/ Oncology doctor revealed an iron deficient anemia. She ruled out a multitude of other diseases that could cause this. I received two separate iron infusions which brought my hemoglobin to 13.5. Since then, I’ve had two six month follow ups. My hemoglobin is now dropping a little,12.3g but I still have a reserve of iron.
The recent batch of testing revealed that I have a JAK2 mutation with a low hemoglobin, slight increase in WBCs and elevated platelets 545. I’m labeled as having PV and have been put on hydroxyurea. I haven’t found anything in the literature about anemia with PV.
Guess I’m in denial.
Ironically I started my career in Hematology before I specialized in genetics. So, I understand the values and symptoms.
I can’t find any information that says you can have polycythemia with a low red count.
Be sure your heme/onc doctor tests for a JAK2 deletion.

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@cindyem

A year and a half ago, I presented a hemoglobin of 7g with no evidence of bleeding in upper or lower GI as per scans. The referral to a Hematology/ Oncology doctor revealed an iron deficient anemia. She ruled out a multitude of other diseases that could cause this. I received two separate iron infusions which brought my hemoglobin to 13.5. Since then, I’ve had two six month follow ups. My hemoglobin is now dropping a little,12.3g but I still have a reserve of iron.
The recent batch of testing revealed that I have a JAK2 mutation with a low hemoglobin, slight increase in WBCs and elevated platelets 545. I’m labeled as having PV and have been put on hydroxyurea. I haven’t found anything in the literature about anemia with PV.
Guess I’m in denial.
Ironically I started my career in Hematology before I specialized in genetics. So, I understand the values and symptoms.
I can’t find any information that says you can have polycythemia with a low red count.
Be sure your heme/onc doctor tests for a JAK2 deletion.

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Thanks so much for the insight! I really appreciate it!

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There is a very long discussion about anemia after Covid vaccinations. If you are vaccinated I would read this thread.

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@av8r525

There is a very long discussion about anemia after Covid vaccinations. If you are vaccinated I would read this thread.

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Thanks so much! I will look into that.

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@ellen0989 Welcome to Mayo Clinic Connect!

You have had some great responses here, and here is what Mayo Clinic has to say about it all: https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034

Back in the late 90s, I developed severe anemia. Went through endoscopy, colonoscopy and many tests. They determined it was my large fibroid tumors and extremely heavy periods caused by them, as the reason. I took oral iron supplements, and was put on Lupron shots prior to a hysterectomy January 1999. While that stopped the heavy periods and fibroids, it did not cure my anemia! In fact, the doctor told me to drive carefully, if I got in an accident I would probably bleed out before help could arrive!

What I will say is that underlying medical conditions could be a factor, it's trying to nail everything down. You may have a genetic component that does not allow you to absorb iron. Have they done a ferritin test, Total Iron Binding Capacity [TIBC]? From Wikipedia: https://en.wikipedia.org/wiki/Total_iron-binding_capacity. I have this test done routinely due to my end stage kidney disease, and being on dialysis. I take a chelated iron capsule each night, which is easily tolerated by my system, and eat a healthy diet.

I'll be curious to hear what they find out.
Ginger

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@gingerw

@ellen0989 Welcome to Mayo Clinic Connect!

You have had some great responses here, and here is what Mayo Clinic has to say about it all: https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034

Back in the late 90s, I developed severe anemia. Went through endoscopy, colonoscopy and many tests. They determined it was my large fibroid tumors and extremely heavy periods caused by them, as the reason. I took oral iron supplements, and was put on Lupron shots prior to a hysterectomy January 1999. While that stopped the heavy periods and fibroids, it did not cure my anemia! In fact, the doctor told me to drive carefully, if I got in an accident I would probably bleed out before help could arrive!

What I will say is that underlying medical conditions could be a factor, it's trying to nail everything down. You may have a genetic component that does not allow you to absorb iron. Have they done a ferritin test, Total Iron Binding Capacity [TIBC]? From Wikipedia: https://en.wikipedia.org/wiki/Total_iron-binding_capacity. I have this test done routinely due to my end stage kidney disease, and being on dialysis. I take a chelated iron capsule each night, which is easily tolerated by my system, and eat a healthy diet.

I'll be curious to hear what they find out.
Ginger

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Hi Ginger! I have had both of those tests a couple times now. Before the first round of infusions last year, my ferritin was at a 6 and my TIBC was very high. My most recent blood work showed a TIBC in the normal range but another low ferritin level of 10. Thanks so much for the insight!

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