Hyperglycemic and Severely Anemic

Good to hear that you’re getting appropriate medical care.
Just a thought though. Have you had your anaemia looked into? As in, do you know what’s caused it? It isn’t always as simple as a lack of iron intake…

My anemia is caused by extremely heavy menstrual bleeding due to large uterine fibroids, so I am answering from that point of view. I am not familiar with anemia due to other causes.

When I had the following counts June 2020, my doctor sent me to the ER that day for a *blood transfusion*:

Crit: 21
Hemoglobin: 6
Ferritin: 1.7

Since then I have been getting *iron infusions* about once per quarter. I was no longer officially anemic per my blood test in Dec., but my next test, which was right after my period, had (unsurprisingly) lower numbers again, so I had another round in March or April, and then a recent uterine MRI showed a bone marrow issue that made my doctor order another round of infusions.

I still take supplements, but no longer worry too much about getting iron from food. I had been eating liverwurst and red meat during my period, but it turns out fat and saturated fat increase my fibroids, which make the bleeding worse. So now I have decreased my fat (and increased fiber) which has the nice side effect of helping me stay in a calorie deficit, as I don't find fat especially filling, and those calories are better spent on protein and carbs containing fiber. As of today, I've lost 30 pounds since Jan 2. The last 3 or so pounds are really just water weight due to my cycle, so let's call it 27 pounds, which is a pound a week, right where I'm supposed to be. (I almost never hit exactly a pound a week weekly, and sometimes not 4 pounds monthly, but over time it has averaged out.)

Don't listen to anyone who tells you that spinach is a good source of iron, without also telling you just how many grams of spinach you have to eat to get X RDA % of iron and including a caveat about the bioavailability of heme vs non-heme iron (meat vs plant sources). I do eat spinach and other leafy greens on a daily basis, but not due to their iron content.

If anyone mentions cooking with cast iron pans I will scream.

If anyone mentions cereal, be aware that cereal grains are not naturally super high in iron. When the label has high iron counts, that means it was FORTIFIED, and you'd probably be better off just taking a supplement, rather than whatever cheap iron the manufacturer dumped into the cereal just to hit an iron count.

There are many forms of iron, and some are more easily absorbed by the body than others.

The 2-3 forms of iron I've received from my doctors over the years did not get both my energy and iron levels back up.

Something to keep in mind when looking at supplements is that some list iron in terms of *elemental* iron and others have a higher mg count, the meaning of which is unknown to me.

For example, my primary care doctor gave me ferrous gluconate (which sent me to Urgent Care with excruciating abdominal pain) which says 324 mg but the elemental iron is 36 mg. She wanted me to take three pills a day. Then I saw a hematologist who said I should be taking one pill, every other day. I did this for 6 months and then switched back to iron bisglycinate daily, which gets both my iron AND energy levels up. (The study that showed every other day use was better for absorption was not for iron bisglycinate, which is in general better absorbed.)

If you do not have fibroids, and your anemia is not as severe as mine, the Mayo Clinic list of foods is good, with the exception of "Iron-fortified cereals, breads and pastas", for the reason I gave above. But if you truly do have SEVERE anemia, you really should be seeing a hematologist and getting infusions rather than relying on food and supplements to turn this around.

https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034

Foods rich in iron include:

• Red meat, pork and poultry
• Seafood
• Beans
• Dark green leafy vegetables, such as spinach
• Dried fruit, such as raisins and apricots
• Iron-fortified cereals, breads and pastas
• Peas

Your body absorbs more iron from meat than it does from other sources. If you choose to not eat meat, you may need to increase your intake of iron-rich, plant-based foods to absorb the same amount of iron as does someone who eats meat.