Hematologist (Blood Specialist) Questions Anemia

“What else can I do to see a specialist ASAP?”

I’m a 50 year old white female, 125 lbs, and have a 10 year history of a never- ending chronic migraines plus extreme fatigue, purple hands and feet, restless leg syndrome, tinnitus, and within the last few years, a couple of seizures, agoraphobia, panic attacks, depression and in Dec 2018 started having uncontrollable episodes of rage. Awesome childhood, parents & siblings I am very close to, a terrific husband of 22 years & two daughters - one is a senior, the other in her 3rd year of college. Most of the above symptoms sounds like I’m anemic but hemoglobin has always been within range. I just returned from the Mayo Clinic where I had my ferritin and folate levels also checked. Ferritin was 5.7 & folate was 3.2. Iron level was 10. I was perfectly fine until I had chicken pox at age 40. Not sure if that triggered the low ferritin, folate and iron or not. My dr at Mayo said I should skip the iron pills and do an infusion ASAP. My husband & I have tried our hardest to get into a hematologist and have a referral from my GP however the soonest appt is a month out. Are the low levels dangerous enough that we need to maybe be louder? I’ve had the same GP for over 12 years and have “complained” many many times that I feel like I have mono again (had it in HS). But ferritin was never checked, just regular CBC where hemoglobin was within range. Then it was dropped basically.

What else can I do to see a specialist ASAP? I feel I have not been a good mother or wife for the last decade and want to feel like myself again! Plus we had a tornado completely destroy our home 12/26/2015 - yes the day after Christmas - welcome to Texas - and although we were not at home, the psychiatrist at Mayo diagnosed me with PTSD. Never even crossed our minds since we didn’t live through the actual tornado. But made perfect sense once she explained why.

Thank you for any feedback.

Female | 50 years old
Complaint duration: 10 years
Medications: 1 mg Klonopin pm - REM sleep disorder, adderall (for hypersomnolence), Zoloft, Emgality - migraine, relpax as needed, omeprazole 40mg for GERD, pravastin 20mg
Conditions: Migraine, extreme fatigue (daytime hypersomnolence) , restless legs, tinnitus, depression, anxiety, panic attacks, REM sleep disorder, chronic GERD, high cholesterol (hereditary)

1 Answer

I think that there is a good chance that repletion of your iron stores with iron infusion will resolve or at least improve your fatigue and restless legs. This is a chronic problem and if your hemoglobin is normal, it is not likely that waiting until next month will cause physical harm, though I do suggest calling your PCP to see if the appointment can be bumped up. I think it is also important to consider why you might have problems with low iron stores. Have you been checked for celiac disease (gluten intolerance)? Another potential cause of poor iron absorption is chronic use of proton pump inhibitors (your acid medication). It might be reasonable to try to treat GERD with strict diet and a wedge pillow instead of chronic use of high doses of omeprazole. Also, make sure to disclose all supplements used. Some can be toxic, especially in higher doses. It is completely possible that your sleep study showing REM sleep disorder could be related to restless legs and caused by iron deficiency. In this case, klonopin might be tapered off. Benzodiazepines can worsen GERD and can have a lethal
withdrawal syndrome, including seizures if you take them long term or at high doses or both. Celiac disease can also cause GERD and seizures. Interestingly, common viral infections such as chicken pox can actually trigger immune responses that cause celiac (gluten intolerance). So, you might be right about that detail. So the common denominator here is potentially celiac disease and/or omeprazole. I do strongly suggest finding a good gastroenterologist. These are simply my random thoughts and are not meant to constitute medical advice.
Expert Answers

Why do I feel so weak even though my blood counts are...

Have a question aboutAnemia?Ask a doctor now

More from FindATopDoc on Anemia

Expert Answers

How to help anemic son?

Expert Answers

What should you eat if you are anemic?

5 Warning Signs that Indicate Anemia
Article

5 Warning Signs that Indicate Anemia