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Author Topic: How much is too much? (a question for the women)
maui babe
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Full disclosure- I am going to be discussing menstration in this topic. Men, you've been warned.

For about 25 years, I've been a blood donor - as often as I've been able to between having babies and dental work. My mother was a regular donor, and set that example for me and my siblings.

About 3 years ago I was deferred for low iron. At that time, I made an appointment with my physician and had blood work done and all was well. My MD told me that the machines that they use at the Red Cross blood drives are not as accurate as the ones the lab uses, and that my blood was textbook perfect. I returned to the next blood drive 8 weeks later and didn't have any more trouble.

Until the blood drive last month, when I was deferred again. I made another appointment with my doc, and since it had been 3 years since I'd had blood work done, she ordered a full work up. I wasn't concerned, because I felt fine and I figured it would work out pretty much like it did last time.

This time, the commercial lab confirmed the Red Cross test. I have mild cytocytic anemia. The most likely cause is some sort of blood loss. My doctor ordered a few more tests (fecal occult blood, iron studies and hemoglobin electrophoresis) and nothing showed up.

The obvious suspect is of course my periods. My doc asked if they were heavy, and I don't really think they are. I mean, I'd notice right? I have a moderate to heavy flow for 2-3 days, then much decreased flow for another 3 days or so. But is it normal? Is it moderate? I never really paid that much attention, I guess. I decided to really notice for the next few months and see what happens.

In the meantime, my physician recommended that I have an endoscopy to look for a possible GI bleed. I'm not sure I want to go through with that right now - it seems awfully invasive.

She's asked me about symptoms, but I distrust subjective symptoms like nausea and abdominal pain. I didn't have any symptoms before the blood drive, and now I wonder how much of the symptoms I am having (fatigue, nausea, leg cramps) are psychosomatic and based on the fact that I KNOW I'm anemic.

Do any of you ladies know of any guidelines as to what a "normal" period consists of? You'd think that after over 30 years of periods I'd know for myself, but it's all so subjective. I've never measured or documented my bleeding, so it's hard to know. [Dont Know]

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rivka
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That sounds normal, but on the heavier side of normal, to me.

I frequently have iron that is just below the cutoff the blood donor testing uses. More than one doctor has assured me that does not constitute anemia in a woman of menstruating age. I guess your doctor is saying you are more anemic than that?

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maui babe
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My iron/RBC levels are not dangerously low, but they're all below the normal range. She recommended I take iron supplements, and plans to re-test in 3 months.

I guess the main reason I'm asking for advice here is because I need to decide whether to have the endoscopy, or to hold off for a bit. I'm leaning towards waiting, at least until after my follow up appointment in 3 months - to give the supplements a chance to work. I'd feel kind of silly to go through all of that only to discover that it was my periods all along.

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rivka
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You're getting close to the age they start recommending routine colonoscopies, neh? I guess one question for your doctor is whether they consider there to be a significant risk to waiting a few months.
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aspectre
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Would have thought that blood-marker workups and stool sample studies would be used before any colonoscopy was recommended.

Competitive inhibition of iron absorption by manganese and zinc supplementation. There is some evidence that multi-mineral supplements are self-defeating. ie One is better off taking the minerals separately and at different times.

Some foods and beverages can also inhibit the absorption of iron.

I also believe that aging itself can cause the small intestines to become less effective in absorbing iron...
...but I can only find embryonic and juvenile fruitfly/rat/etc studies.

[ May 23, 2008, 01:00 AM: Message edited by: aspectre ]

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rivka
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quote:
Originally posted by maui babe:
My doctor ordered a few more tests (fecal occult blood, iron studies and hemoglobin electrophoresis) and nothing showed up.


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imogen
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I have two days heavy then 3-4 days light. So on a one study comparison, I'd say your flow is heavier but probably still normal.

I guess the other question is how heavy is your heavy flow? Do you bleed through tampons/super pads? (When I had some fairly bad bleeding due to PCOS, I was bleeding through a super tampon within two hours: this is not normal bleeding!)

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ketchupqueen
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I have 3 days very heavy, 1 day moderate, and 2 days light, sometimes with another 1-2 days spotting. And I'm usually low on iron. And no, I don't take my calcium with my iron. [Wink] (Well, except in the prenatal vitamin I take.)

When I say "very heavy", I mean I go through 3 overnight pads a night and 3-4 overnight pads during a day (although it's gotten a bit better some months since having kids.) And sometimes lots of big clots, too.

My docs have always assured me that as long as I keep supplementing and my levels are only moderately low, it's not abnormal or spectacularly dangerous.

It's UNCOMFORTABLE enough that I wish there was something I could do about it (other than keep having kids for 14.5 month breaks from periods-- which I seem to keep doing. [Wink] )

I'd wait, personally. Probably. Unless you have another reason not to.

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Shanna
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The iron tests at blood drives really do suck. I was turned away for iron deficiencies several times but my doctor also found nothing wrong aside from a slight case of anemia. So I started taking iron supplements and would eat lots of red meat and dark greens for days in preparation for donating blood.

And I would still be turned away.

I started making them test me more than once during a visit because most of the time, the second test would be fine. Some of the volunteers started to recognize me and got used to my body being difficult.

If your periods haven't changed and you donated with no problem in the past, then I can't imagine that it would be the cause now. Course, you could always talk to your gyno about it. I know that once I got on the pill, my periods lessened by quite alot.

Certainly keep talking with your talk and have them continue to monitor you, but its seems that less drastic measures could be taken to rule out the cause. Why not start with a change of diet and the addition of supplements?

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The Rabbit
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Its probably worth consideringhow frequent your periods are in addition to how heavy they are. My cycle was 32 days from the time I was a teenager until I hit my forties and then it suddenly shortened to about 27 days, its no longer as consistent. After a couple of years with the shorter period, I ended up anemic.
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ludosti
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I don't have much to offer as far as "normal" periods go, because I've never had "normal" periods without medication, but I do know that endoscopy for GI bleeding is not nearly as uncomfortable as it seems. My mother had the same thing done last year (also looking for GI bleeding and just general strangeness) and she said it wasn't bad at all. She said she'd worked herself up way more than necessary over it. Good luck with figuring out the anemia!!
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katharina
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What you described is normal for me, and I have mine every 22 days when not on birth control.
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The Rabbit
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An endoscopy is much less traumatic than a colonoscopy.
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kmbboots
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Maui babe, I could have written that myself. My doctor did both an endoscopy and a colonoscopy and found nothing unusual. My periods have gotten a bit closer together (27 days down from 28 when I was on the pill) and I have about two and a half heavyish days and 3 - 4 tapering off days. By "heavy" I mean that I go through 3 regular tampons a day and fill an overnight pad overnight. Also, my flow seems to be more "clotty" than it used to be.

I am fine on iron pills when I remember to take them. Also, I donate platelets at the local hospital instead of whole blood. Your iron count can be lower to donate platelets. (Also, they know me really well there as I have been a donor for a long time. They know my history and that I never have any problems donating so they will take me when I am borderline, though if I am on the low side of the border they will only take one unit rather than a double.)

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The Rabbit
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quote:
I have mild cytocytic anemia.
I'm very curious about this one. I know a fair bit about anemia (I was anemic almost constantly for the first 35 years of my life) and I've never heard of cytocytic anemia. I googled it and this thread is the only thing that came up. Maui Babe, Are you misremembering the diagnosis, is it mistyped or is the doctor off the deep end on this one.

I'm also curious. Do you remember the numbers hemoglobin, serum iron or hematocrit?

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Belle
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I would recommend going ahead with the tests, simply because anemia should be checked out. Granted, yours is mild, but still I'd want to verify that everything is okay. Most people I know that have had endoscopies said the test is not that bad of an experience.

In fact, I can say that colonoscopies aren't even that bad - I personally would rather have a colonoscopy than a CT scan. You're asleep through the procedure, there was no pain or discomfort except the IV insertion, which is nothing.

At the risk of being alarmist, anemia was the first major sign of my cancer - but I didn't know. In fact, the words the doctor used in the hospital after I was admitted was "You're shockingly anemic." Of course, anemia can be caused by a myriad of factors, most of then much more benign than cancer, no doubt. Still, the possibility, however remote, exists that it IS something serious, and I firmly believe people should not take unnecessary risks with their health.

If there is bleeding somewhere, you need to find the cause and fix it. If your doctor thinks an endoscopy is necessary, I would certainly consider it.

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maui babe
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quote:
Originally posted by The Rabbit:
quote:
I have mild cytocytic anemia.
I'm very curious about this one. I know a fair bit about anemia (I was anemic almost constantly for the first 35 years of my life) and I've never heard of cytocytic anemia. I googled it and this thread is the only thing that came up. Maui Babe, Are you misremembering the diagnosis, is it mistyped or is the doctor off the deep end on this one.

I'm also curious. Do you remember the numbers hemoglobin, serum iron or hematocrit?

Sorry, I was typing from memory. It's microcytic anemia, not cytocytic. [Embarrassed]
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maui babe
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Thanks for all of your input. I have a consultation appointment with the specialist for the endoscopy next week, then I leave the following week for a 3 week vacation on the mainland. So I likely won't do anything until at least July and possibly later, depending on the specialist's schedule.

I'm going to continue with the iron supplements, although I stress out a bit about when to take them. I'm not supposed to take them with soy products, so I can't take them in the morning when I drink my soy milk. Caffiene is an inhibitor, too, so I gotta watch my Dr. Pepper habit. <sigh> I'm being more aware of my dietary iron intake as well.

I love having a place where I can ask personal questions like this and get such a variety of open answers.

[Group Hug]

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katharina
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I'm so glad you're here, maui babe. [Smile]
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romanylass
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That sounds a lot like my periods- and I have been borderline anemic all my adult life.
Have you talked to your dr about Floradix? that's the ONLY thing that gives me a normal hemo count.

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The Rabbit
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Hey, I've ssen that stuff and the reformhaus in Germany but I had no idea if it was any good. I'll have to pick some up this summer.

I pretty much have to take iron supplements all the time and I get sick of the side effects.

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ketchupqueen
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I've never been told about that! After looking it up, I may try switching since even with supplementation my iron is low, and I HATE the constipation!
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maui babe
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I just checked their website and there's a store down the street from my home that sells it. I'll check it out this weekend. Thanks for the recommendation!
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