Iron based anemia

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Ok guys....here are the numbers from my blood work.
Iron Screen FERR (showing low, "L") 3ng/ml; normal is 10-170

IRON/TIBC
UIBC (showing high, "H") 371 ug/dL; normal is 92-365
Transf. % Sat. (showing low, "L") 8%; normal is 15-55
TIBC (in normal range) 402ug/dL ; normal is 229-429
Iron (showing low, "L") 31ug/dL; normal is 35-160

CBC
Hemoglobin (showing low, "L") 10.8g/dL; normal is 11.5-15
Hematocrit (showing low, "L") 33.9% ; normal is 34.0-46
MCV (showing low, "L") 77fL ; normal is 80-100

Now, something that my DR told me was that some cyclists got into lots of trouble because they we loading up on hemoglobin(?) before meets in order to boost up their performance, so I do know that this is important for strenious workouts. As a painting contractor when my iron levels drop, I notice a big reduction in my ability to put in a full days work. And the DR said that it would of course affect my ability to work. If I was just a sit down desk worker, it won't be noticeable.

So......watcha think??????

Thank you for contradicting yourself and backing up what I said.

The following are from your Merck Manual (which is very 'junior' compared to proper reference textbooks such as Harrison's Principles and Practice of Internal Medicine):

"Classically, the term pernicious anemia defines B12 deficiency caused by loss of intrinsic factor secretion"

"Less common causes of decreased B12 absorption include chronic pancreatitis, malabsorption syndromes, certain drugs (eg, oral calcium-chelating drugs, aminosalicylic acid, biguanides), inadequate B12 intake (usually in vegans), and, very rarely, increased metabolism of B12 in long-standing hyperthyroidism"

"Pernicious anemia is a megaloblastic anemia caused by B12 malabsorption. In this condition, atrophy of the gastric glands is severe, with loss of parietal cells and an inability to secrete intrinsic factor, a necessary cofactor in B12 absorption"

So once again:
There are many causes of B12 deficiency. All of which can cause anaemia.
Pernicious anaemia, which is an auto-immune condition leading to inadequate intrinsic factor, is the most common cause of B12 deficiency but is not the only cause!

Please stop repeating the same error ad nauseam.

Your results do point to an iron deficiency picture with mild anaemia.
The fatigue level tends to progressively increase the lower the haemoglobin and a level of 10.8 is only mildly reduced.
I hope your doctor is looking into the cause of your iron deficiency!

An extra recommendation if you are on iron tablets - take them away from food (2 hours before or 4 hours after) as many foods contain things that will impair iron absorption.

Patch:

Refer to your earlier post. This is what you said:

"...There are many causes of B12 deficiency and 'pernicious anaemia' is only one of them - and it is due to a lack of intrinsic factor."

As I said, contrary to what you said, P.A. is not a cause but the result of B12 deficiency.

For the umpteenth time:

B12 deficiency from any cause leads to anaemia.
This is called megaloblastic anaemia.

Pernicious anaemia is an auto-immune condition that leads to a lack of intrinsic factor.
This leads to impaired B12 absorption and low B12 levels.
This leads to megaloblastic anaemia.

Then please show me a specific reference where it states that PA leads to a lack of intrinsic factor.

From your Merck Reference:

"Pernicious anemia is a megaloblastic anemia caused by B12 malabsorption. In this condition, atrophy of the gastric glands is severe, with loss of parietal cells and an inability to secrete intrinsic factor, a necessary cofactor in B12 absorption"

To diagnose PA in someone with low B12, a doctor orders 2 tests:
1. Anti-Intrinsic Factor Antibodies
2. Anti-Parietal Cell Antibodies

Look up Harrisons.
Do a Google Search.

Think of it this way:

1. The auto immune disease occurs, the anti intrinsic factor antibodies attack.

2. No absorption of B12 occurs.

3. PA results, the loss of rbc's.

The loss of rbc's is the result of all this, not the cause.

Originally posted by kokopuffs
2. No absorption of B12 occurs.
3. PA results, the loss of rbc's.
The loss of rbc's is the result of all this, not the cause.

PA was the cause at the start.
For Point 3: Megaloblastic anaemia results, not PA.

PA leads to MA.
Not all MA is due to PA.

PA identifies a condition where the rbc's are defective. The defective rbc's do not cause the destruction of the parietal cells. It's the antibodies that perform the destruction.

Please can we let this go?

In PA: damage to parietal cells => loss of IF => low B12 => impaired DNA formation in the RBC precursors in the bone marrow => megaloblastic anaemia.

PA is a cause of anaemia.
Patients with PA are not necessarily anaemic.
Following treatment with B12 injections, their haemoglobin will improve - ie they are no longer anaemic - but they are still labelled as having "PA" as still have those auto-antibodies and still have low IF.

A vegan who gets low B12 due to poor intake and gets anaemic does not have PA.

Not when you're so wrong.

As I said, the anemia doesn't cause loss of IF. It's the antibodies.

As Dr Evil said, "You just don't get it, do ya?"

Just say today, you were to develop what will become PA. For whatever reason, you start producing auto-antibodies today.
Soon you will stop having enough IF. In a year or two your B12 store run out. After that you get anaemic.
BUT, if someone were to test you next week and find you had positive anti-IF-Abs, you could be diagnosed with "Pernicious Anaemia" even though you are not anaemic and wouldn't be for probably a couple of years.

Pernicious anaemia is a name of a disease that doesn't necessarily mean you are anaemic at the time.

Again - please let it go. Just accept that you were wrong and move on!