Borderline Anemia? Thyroid?

So I've been feeling like crud lately (fatigue, constipation, cold hands, reduced appetite, general sense of malaise) and my doctor ordered the usual blood tests since it sounded like hypothyroid, which I am already treated for.

I noticed on the test that my red blood cell count has been right at the low end of normal the last two years. Doctor didn't think it was worth noting and just jacked up my thyroid dose a little even though my TSH was only 2.5 (looking for a new doc), but I'm wondering if persistently being right on the border of low red blood cell count could account for some of my issues. Anybody have any experience with that?
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Replies

  • WBB55
    WBB55 Posts: 4,131 Member
    Do you also have any odd pain or discomfort after eating? In your back or right side of your front? Especially after eating fatty meals? Do you have a family history of gall stones? I'm not a doctor, I can't diagnose you. I would get gall bladder "attacks" occasionally, but would also experience the kind of symptoms you describe 24 hours per day for the last 6 months or so before it was removed. All of which, except for the cold hands, went away after my gall bladder was removed.

    Totally just throwing that out there.
  • fittocycle
    fittocycle Posts: 824 Member
    Did your doctor also include a ferritin test as part of your blood work? The only reason I ask is that I had very low ferritin (iron stores) but my hemoglobin was always in the normal range. And yes, it made me very tired. My normal workouts left me exhausted. I would be breathless going up stairs and I was losing more hair than normal too. Once my doctor added an iron pill into my diet, I was fine. But please do not take an iron supplement unless your doctor recommends it. Too much iron in the body can be very dangerous.

    Take care and I hope you feel better soon!
  • williams969
    williams969 Posts: 2,528 Member
    Did your doctor also include a ferritin test as part of your blood work? The only reason I ask is that I had very low ferritin (iron stores) but my hemoglobin was always in the normal range. And yes, it made me very tired. My normal workouts left me exhausted. I would be breathless going up stairs and I was losing more hair than normal too. Once my doctor added an iron pill into my diet, I was fine. But please do not take an iron supplement unless your doctor recommends it. Too much iron in the body can be very dangerous.

    Take care and I hope you feel better soon!

    +1 I had the same symptoms. RBC normal (low normal, but nothing noteworthy). Add'l ferritin testing showed I have iron deficiency. OP--if you're concerned, request the ferritin testing. And, as an extra note (for those who didn't hear fittocycle when she said)--DON'T self-diagnose low-iron, nor supplement w/ iron pills unless Dr. prescribed. They will tell you what dose, if any, you should take.:flowerforyou:
  • fittocycle
    fittocycle Posts: 824 Member
    williams-I'm surprised you had the same thing happen to you. From what I've learned, doctors won't routinely screen ferritin. If they would include the test, I would certainly help a lot of people!
  • Espressocycle
    Espressocycle Posts: 2,245 Member
    Interesting, he didn't do a ferritin, but I'll ask about that when I find a new doctor. No reason I'd be low on iron really, but you never know.
  • earth_echo
    earth_echo Posts: 133 Member
    Do you consume coffee, dairy, soy or eggs often (daily)? If so, all those foods interfere with iron absorption. If you do end up taking an iron pill, I'd suggest you take it before bed. I drink coffee all day and this was the only way that worked for me to get enough/absorb enough iron.
  • Espressocycle
    Espressocycle Posts: 2,245 Member
    Do you consume coffee, dairy, soy or eggs often (daily)? If so, all those foods interfere with iron absorption. If you do end up taking an iron pill, I'd suggest you take it before bed. I drink coffee all day and this was the only way that worked for me to get enough/absorb enough iron.

    I drink a big cup every morning, sometimes a smaller cup in afternoon. I consume plenty of dairy too. Wondering if I might be a little low on vitamin C though, which I know can hinder absorption.
  • Vune
    Vune Posts: 669 Member
    Interesting, he didn't do a ferritin, but I'll ask about that when I find a new doctor. No reason I'd be low on iron really, but you never know.


    I just got bloodwork back showing rather severe anemia (low rbc count, hemoglobin, hematocrit, and a rather disturbingly low platelet count). They're checking for internal bleeding. I have an rx for ferrous sulfate in the meantime. I'm not sure why I would be bleeding internally, but I'm also not going to be putting it off when it could be something serious. Is your doctor really that bad?
  • MeganAnne89
    MeganAnne89 Posts: 271 Member
    Make sure your doctor tests for BOTH ferritin and iron. They're two different things. You can have symptoms of anemia yet you can have something called haemochromatosis (I've posted about this before - it's what I have). Haemochromatosis is iron overload which can lead to symptoms such as extreme fatigue, joint pain, stomach pain, fogginess, and the list goes on.

    A person who has iron overload can have a regular blood test (which can includes an iron level test) that shows that their iron level (in their bloodstream - which is what the iron test checks) is low. When you have low iron in your blood, you have less red blood cells. At this point, most doctors make the mistake of diagnosing you with anemia. Bad bad bad. You can be anemic yet also have haemochromatosis and if you do, dear god, never take any kind of supplement with iron in it.

    What happens with haemochromatosis is that your body is stealing the iron that you're ingesting from food/ would be in your bloodstream and just holding it inside of you around your organs and not ridding itself of the iron as it normally would. Iron overload is extremely dangerous when it's not treated.

    And in response to an earlier comment, no, doctors do not (for some idiotic reason) regularly test for iron and ferritin. Iron overload shows up in about 1 in every 200-300 people around the world.
  • williams969
    williams969 Posts: 2,528 Member
    williams-I'm surprised you had the same thing happen to you. From what I've learned, doctors won't routinely screen ferritin. If they would include the test, I would certainly help a lot of people!

    I lost a lot of blood (just short of needing a transfusion) birthing my last child. They did the "full" standard panel two days post-natal, then again 2 weeks later, including the ferritin, for whatever reason (CYA, maybe). They found it then, and they same 6 months later.

    I do find it interesting that others here have said that coffee and eggs interfere with iron absorption. Unless I missed it (I could have), my Dr. never mentioned I should limit those, and they're definitely a huge part of my diet. I do make sure to take my Vitamin C w/ my iron, though, always. Oops! I will put a call in today. I'm "better" now, but it can't hurt to check with him.
  • neandermagnon
    neandermagnon Posts: 7,436 Member
    are you vegetarian or vegan? If not then low iron in men warrants further investigation. It's common in women because women lose iron through menstruation, pregnancy and breastfeeding... but men don't, and men need a lot less iron than women, and meat will provide enough, so if a man's eating meat yet still has low iron, there's something more going on than mere dietary deficiency, hence the need for further investigation.

    If you're vegetarian or vegan then you need to take iron supplements and that's the most likely cause, although it's not that hard to get enough iron as a male vegetarian/vegan.... but if you're also not eating vegetables that contain iron it could result in iron deficiency anaemia. But I still think a 2nd opinion wouldn't be a bad idea even if you're vegan/vegetarian.
  • MeganAnne89
    MeganAnne89 Posts: 271 Member
    are you vegetarian or vegan? If not then low iron in men warrants further investigation. It's common in women because women lose iron through menstruation, pregnancy and breastfeeding... but men don't, and men need a lot less iron than women, and meat will provide enough. I think a second opinion might be in order. Although if you're vegetarian or vegan then you need to take iron supplements and that's the most likely cause. But I still think a 2nd opinion wouldn't be a bad idea.

    Yes please, second opinion. Never take iron supplements unless BOTH ferritin and iron have been tested to rule out haemachromatosis (mentioned in my above-post).

    I also realized above OP that someone mentioned taking vitamin c supplements? I think I read that. Anyways, if you have iron overload, that's a bad thing to do as Vitamin C makes you absorb more iron. So I never recommend taking vitamin c supplements unless you have had full blood work done.

    Also, in response to another post, coffee does inhibit iron absorption. I've been told by my hematologist that that can be beneficial for me to drink with meals.
  • neandermagnon
    neandermagnon Posts: 7,436 Member
    are you vegetarian or vegan? If not then low iron in men warrants further investigation. It's common in women because women lose iron through menstruation, pregnancy and breastfeeding... but men don't, and men need a lot less iron than women, and meat will provide enough. I think a second opinion might be in order. Although if you're vegetarian or vegan then you need to take iron supplements and that's the most likely cause. But I still think a 2nd opinion wouldn't be a bad idea.

    Yes please, second opinion. Never take iron supplements unless BOTH ferritin and iron have been tested to rule out haemachromatosis (mentioned in my above-post).

    I also realized above OP that someone mentioned taking vitamin c supplements? I think I read that. Anyways, if you have iron overload, that's a bad thing to do as Vitamin C makes you absorb more iron. So I never recommend taking vitamin c supplements unless you have had full blood work done.

    Also, in response to another post, coffee does inhibit iron absorption. I've been told by my hematologist that that can be beneficial for me to drink with meals.

    ^^^ this - and quite a few other possible conditions. Healthy men don't lose very much iron, hence the risk of iron deficiency anaemia being really low. Male athletes have slightly higher needs (due to iron being needed to build muscle) but even male athletes should get enough iron from an omnivorous diet, or on a vegetarian diet if they take care to get vegetable sources of iron.

    The above also applies for women who are not menstruating, pregnant or breastfeeding (e.g. post-menopause or on birth control that stops periods) for the same reason - if you're not losing iron you don't need lots of it in the diet.

    People who are in the above categories should be careful re taking supplements that contain iron, because too much iron can be toxic.
  • redheadmommy
    redheadmommy Posts: 908 Member
    As pp said, get your a ferritin level tested. I got anemic during extended Brestfeeding both times and my hemoglobin was normal , but my ferritin level was almost non- existent.
    If you are anemic and you dr makes you take iron pills, make sure your dr do follow ups. Many iron pill is really hard to digestion system and only a fraction of the iron gets absorbed. Hemagenics is a good one, because most of the iron actually gets absorbed not like the others. Always take your iron pill with high vitamin c food/ drink, and at least 2 hr apart from dairy .

    However red meat and liver is better than any iron pill ever will be. I did't like red meat before , but I forced myself to eat at least. Twice a week and now I actually start to like it.

    I also agree with pp, do not take iron ( or any other for that matter) pill unless you know you actually need to take it. Get you dr test all kinds of mineral and vitamin deficiency and take what you actually need. Lots of people have vitamin d deficiency and do not know about it and that also can cause fatigue.

    EDIT: I just realized OP is a young healthy male. I doubt you are anemic unless you have extensive bleeding, some chronic condition that interfere with iron absorption or gave blood more frequently then every two month. Instead of trying to figure out what is wrong with you by yourself, get a better dr or push your current one to do more test and find out what actually is wrong with you.
  • lindsey1979
    lindsey1979 Posts: 2,395 Member
    Interesting, he didn't do a ferritin, but I'll ask about that when I find a new doctor. No reason I'd be low on iron really, but you never know.


    I just got bloodwork back showing rather severe anemia (low rbc count, hemoglobin, hematocrit, and a rather disturbingly low platelet count). They're checking for internal bleeding. I have an rx for ferrous sulfate in the meantime. I'm not sure why I would be bleeding internally, but I'm also not going to be putting it off when it could be something serious. Is your doctor really that bad?

    When you have a really low platelet count, you can begin to bleed internally.
  • lindsey1979
    lindsey1979 Posts: 2,395 Member
    I'm surprised that they didn't do a full iron/ferritin work up. Hopefully, that will help.

    Have you had Vitamin D, iodine and magnesium checked as well? Low numbers on both of those can cause a lot of similar symptoms and throw off the effectiveness of your thyroid meds (or sometimes, make you feel worse depending on other factors). Same with adrenals --- DHEA specifically from what I remember.

    What are your Free T3 and Free T4 numbers?

    If you have Hashi's, you may just need to be in a higher part of the "normal" range. For example, I don't get symptom alleviation until I'm in the top third of the "normal" range for Free T3 and Free T4. If I'm in the low range of normal, I still have horrible symptoms -- and some docs won't do anything about this so long as you're still "within range". My doc said that's because when you have Hashi's (the most popular hypothyroid condition), there is no way of knowing how effective your antibodies are at binding up and rendering inactive the Free T3 and Free T4. They could be blocking 2% or 80% -- and this can vary depending on how much you trigger the autoimmune function (like they believe certain foods do -- gluten is an issue for me). So he treats me based on symptom management and blood tests -- if I'm still creating TSH, then I'm not over medicated since my thyroid is still making up the difference.

    Do you have a T3 medication or just T4? Synthroid is just T4 and some fair better with a medication that uses T3 as well -- either one of the natural dessicated thyroids like Nature-throid or Armour as they already have all the thyroid hormones in them or additional script for cytomel (T3 only).
  • Vune
    Vune Posts: 669 Member
    Interesting, he didn't do a ferritin, but I'll ask about that when I find a new doctor. No reason I'd be low on iron really, but you never know.


    I just got bloodwork back showing rather severe anemia (low rbc count, hemoglobin, hematocrit, and a rather disturbingly low platelet count). They're checking for internal bleeding. I have an rx for ferrous sulfate in the meantime. I'm not sure why I would be bleeding internally, but I'm also not going to be putting it off when it could be something serious. Is your doctor really that bad?

    When you have a really low platelet count, you can begin to bleed internally.

    Time to read up on thrombocytopenia! And here I've been wasting my time on my high parathyroid hormone/normal blood calcium combo...
  • Espressocycle
    Espressocycle Posts: 2,245 Member
    I'm surprised that they didn't do a full iron/ferritin work up. Hopefully, that will help.

    Have you had Vitamin D, iodine and magnesium checked as well? Low numbers on both of those can cause a lot of similar symptoms and throw off the effectiveness of your thyroid meds (or sometimes, make you feel worse depending on other factors). Same with adrenals --- DHEA specifically from what I remember.

    What are your Free T3 and Free T4 numbers?

    If you have Hashi's, you may just need to be in a higher part of the "normal" range. For example, I don't get symptom alleviation until I'm in the top third of the "normal" range for Free T3 and Free T4. If I'm in the low range of normal, I still have horrible symptoms -- and some docs won't do anything about this so long as you're still "within range". My doc said that's because when you have Hashi's (the most popular hypothyroid condition), there is no way of knowing how effective your antibodies are at binding up and rendering inactive the Free T3 and Free T4. They could be blocking 2% or 80% -- and this can vary depending on how much you trigger the autoimmune function (like they believe certain foods do -- gluten is an issue for me). So he treats me based on symptom management and blood tests -- if I'm still creating TSH, then I'm not over medicated since my thyroid is still making up the difference.

    Do you have a T3 medication or just T4? Synthroid is just T4 and some fair better with a medication that uses T3 as well -- either one of the natural dessicated thyroids like Nature-throid or Armour as they already have all the thyroid hormones in them or additional script for cytomel (T3 only).

    They had me at 3.8 TSH forever and I felt like crud for YEARS until Doc added cytomel to get me to stop bothering him. TSH came down to 1.5, I felt better. It's back up to 2.5, hence additional thyroid. Lower end of normal on free T3/T4. He's never run tests for vitamins and minerals at all, I'd think he would have this time, but he is a lousy doctor who never takes my complaints seriously, hence looking for a new one.
  • Espressocycle
    Espressocycle Posts: 2,245 Member
    EDIT: I just realized OP is a young healthy male. I doubt you are anemic unless you have extensive bleeding, some chronic condition that interfere with iron absorption or gave blood more frequently then every two month. Instead of trying to figure out what is wrong with you by yourself, get a better dr or push your current one to do more test and find out what actually is wrong with you.

    Yeah, although I seem to have the health of a menopausal woman - hypothyroid diagnosed at 22, bum knee despite having never played sports or injured it, GERD, depression, etc. But yeah, I eat meat, not to mention fruit and dark leafy vegetables - there's no way it's diet. I wouldn't worry about it since it's in the normal range (barely) if I didn't have symptoms. It's been low for years, so I doubt I have internal bleeding, so if anything, it's probably malabsorption. My platelets are normal. In fact, the only things in my test that aren't in the normal range are sodium and glucose, which are rather low.
  • lindsey1979
    lindsey1979 Posts: 2,395 Member
    I'm surprised that they didn't do a full iron/ferritin work up. Hopefully, that will help.

    Have you had Vitamin D, iodine and magnesium checked as well? Low numbers on both of those can cause a lot of similar symptoms and throw off the effectiveness of your thyroid meds (or sometimes, make you feel worse depending on other factors). Same with adrenals --- DHEA specifically from what I remember.

    What are your Free T3 and Free T4 numbers?

    If you have Hashi's, you may just need to be in a higher part of the "normal" range. For example, I don't get symptom alleviation until I'm in the top third of the "normal" range for Free T3 and Free T4. If I'm in the low range of normal, I still have horrible symptoms -- and some docs won't do anything about this so long as you're still "within range". My doc said that's because when you have Hashi's (the most popular hypothyroid condition), there is no way of knowing how effective your antibodies are at binding up and rendering inactive the Free T3 and Free T4. They could be blocking 2% or 80% -- and this can vary depending on how much you trigger the autoimmune function (like they believe certain foods do -- gluten is an issue for me). So he treats me based on symptom management and blood tests -- if I'm still creating TSH, then I'm not over medicated since my thyroid is still making up the difference.

    Do you have a T3 medication or just T4? Synthroid is just T4 and some fair better with a medication that uses T3 as well -- either one of the natural dessicated thyroids like Nature-throid or Armour as they already have all the thyroid hormones in them or additional script for cytomel (T3 only).

    They had me at 3.8 TSH forever and I felt like crud for YEARS until Doc added cytomel to get me to stop bothering him. TSH came down to 1.5, I felt better. It's back up to 2.5, hence additional thyroid. Lower end of normal on free T3/T4. He's never run tests for vitamins and minerals at all, I'd think he would have this time, but he is a lousy doctor who never takes my complaints seriously, hence looking for a new one.

    Do you know if it's Hashi's? Have you had your antibodies tests (TPO, Tg)?

    And I feel your pain. Sadly, your experience with thyroid issues is shared by MANY of us. It can be very difficult finding a doc that will address it fully. I finally went out of pocket to an expert and finally got it taken care of.