i mean, if i can absorb iron and can absorb b12, but can't store iron and can't store b12, that ultimately points towards some kind of liver disease. right?

is there a hormone to test for?

did we already do that?

i mean, i didn't even know you could store b12 until a few months ago.

but, you can.

and, i get tons of it - i should be higher. i'll grant that.

that said - and i've pointed this out a few times - my mcv is not that high.

from what i can see, a lot of labs wouldn't say it's high at all.

but, it's certainly on the higher end - and my b12 is certainly on the lower end.

what i will say is this - i may also be having difficulty storing b12, rather than digesting it. i mean, that's what the data seems to ultimately suggest, i think - i'm getting just enough in my diet, but i'm not storing it anywhere, so it comes up and down with my diet.

let me look into that because it might help me understand what's causing the low iron stores, as well.

and, the coffee worked, but it's a gloss - i'm still not feeling so well.

see, this is the weird thing...

if i was suffering from sort of normal iron deficiency - which is what it looks like, granted - then i should also be generating small blood cells. but, i'm not - my blood cells are unusually large and it seems like they get bigger and bigger as i eat less and less.

this combination - low ferritin and large rbcs - is weird.

now, i only have three data points and they're bunched up in time. but, it seems like the size of my red blood cells increases as i eat less, and decreases as i eat more. so, is it possible that my iron is low because i'm producing extra large rbcs, which kicks in when i don't eat enough?

whatever it is is weird, but that's just pointing more and more towards the marrow.

so, for example, this is certainly possible and not entirely ruled out from what i can see:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565132/

but, shouldn't this bacteria mess with my other vitamins and minerals, as well?

H. pylori infection can cause a deficiency of vitamins (such as vitamin C, vitamin A, α-tocopherol, vitamin B12 and folic acid) and essential minerals. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177464/

if i'm ruling out celiac and b12/b9 deficiency, i'm going to need to get all these other things tested, too.

how many can i test with urine instead of blood?

if i really want to test for parasites or bacteria - including h. pylori - it seems like i'm going to need to provide a stool sample, and i'll either need to do it at the er or wait for direction from the stomach specialist.

again - i think i'd be dealing with general malabsorption, though, and not merely an iron deficiency.

and i seem to be absorbing the caffeine in the coffee just fine, which is welcome.

when they did the last test, it tested for igG and it came up in the normal range. 

while i'm ruling out intestinal bleeding, i have noticed some white specs in my stool. i can't tell if it's parasites, their eggs or sunflower seeds.

if i understand correctly, the igG test does not rule out parasites as a cause, entirely, although it minimizes the likelihood of it. but, as with celiac and ibd, you'd think that i'd be experiencing general malabsorption, and not an iron-specific problem, and that's not the case.

my post for april 8th is my second record, inri021. 

there will be some compilation records to follow, but this is the last entry in period 1.2. 

as with the first record, the reconstruction of the second record is fully instrumental.

=====

the second record was always a...second record. see, the phenomenon of the underperforming second record is actually well-established. i just think it's worth thinking about what a second record actually is, in order to understand this. 

a second record is necessarily the tracks that did not make it on to the first record. 

i actually tried to resist this, but i was swayed by the argument (with myself) that the tracks would otherwise be lost because i was shifting in a direction away from the electro-grunge sound, and i would eventually go back and compile them anyways. i had enough raw sound for a full record, so i released a full record. 

something that is common of second records is that they are uneven because the tracks are recorded at differing levels of attention. demos that were forgotten tend to get promoted without cause, while the tracks that show evidence of attention tend to seem overproduced, in comparison. in recompleting this record, i've paid attention to the uneven nature that the tracks initially existed in and taken an effort to close the gap where it was needed. 

i've also removed two tracks from the initial recording due to a combination of technical and artistic incompatibilities. 

while most of these songs have defined concepts underlying them, i have ejected these concepts from the final recording and left them in a series of singles, or behind altogether. i would prefer that this album be understood solely as the instrumental recording of electronic music that i am presenting it as. 

written and demoed in multiple stages from 1993-1999. initially constructed in this form in feb, 1999. a failed rescue was attempted in 2013. reconstructed and resequenced over november and december, 2016 from parts that were rebuilt over 2013-2016. re-released & finalized on dec 15, 2016. first liner note release added on feb 9, 2020 to also include the deleted masters from 1999 and 2013 in 192 kbps mp3 only. this is my second official record; as always, please use headphones. 

this release also includes a printable jewel case insert and will also eventually include a comprehensive package of journal entries from all phases of production (1996-1999, 2013-2020). as of feb 9, 2020, the release includes a 126 page booklet in doc, pdf & html, with an html5 audio frontend, that includes journal entries from the remastering process over sept-dec, 2013, as well as the deleted masters from 1999 and 2013 in 192 kbps mp3 only. 

released january 25, 1999 

j - guitar, effects, bass, bass synth, synthesizers, piano, octavers, drum programming, sequencing, found sound (paper crumpling), noise generators, sound design, cool edit synthesis, light-wave synthesis, windows 95 sound recorder, sampling, mic noises, digital wave editing, loops, a broken tape deck, chance, production.

my iron's so low that i can't stay awake long enough to determine if my iron's so low that i need to go to the hospital.

i was actually feeling relatively good before i left, leading me to believe that the six vials they took was far too much for me to deal with.

if i go to the hospital, what are they going to do? they're going to take another blood test, first. of course. maybe give me pills...

i get paid on saturday morning, i think. i'm going to want to do some groceries on saturday morning, if so. so, if i'm going to go, i should go early on saturday morning to try to catch them when they've got a few minutes.

so, what have i learned?

the basic problem is that i'm using more iron than i'm able to process. as a basic accounting process, as a conservation problem, i'm either losing too much too fast or not taking in enough, fast enough. and, i don't know which, yet.

have i always had iron this low or is this a new thing? see, i don't know. i'm sort of "cherry-picking" data. i wish i had information going back many years, so i could see if this is unusual or not.

the fact that i'm tired and have a headache is suggesting i've lost some blood, but i don't normally get my blood taken on regular intervals, either. i could very well be sick from the blood test, itself.

but, what can i conclude from what i've done so far?

- i do not appear to be eliminating blood in my stool. i may still be bleeding (perhaps in my brain), but i don't appear to be bleeding from my gut.

- if i'm not bleeding, either i can't absorb iron or i can't process it.

so, the first thing to test for is absorption. assuming absorption...

- i learned that eating meals with large amounts of elemental iron that are also high in calcium & phytates is not allowing me to increase my iron stores.

- i also learned that supplementing with small amounts of heme iron, regularly, and with vitamin c, on an empty stomach, is not enough to increase my iron stores.

- therefore, altering my diet on it's own cannot solve this problem - i need deeper medical intervention.

i'm absorbing everything else, including b9, calcium and d. i haven't been tested for a or e or k. that makes something like celiac unlikely, as the only thing i can't absorb is iron - i don't have a general absorption problem, i have a specific iron absorption problem.

and, if it was due to blocking from calcium or the phytates or the oxalates then the meat should have helped. it has not - the decrease is continuing.

so, if it's not my diet, i'm left with:

a) i have a genetic condition that is doing something like overproducing hepcidin.

b) i have something more serious like leukemia, and i'm not able to produce enough red blood cells due to that

i don't actually menstruate, though.

at least as far as i know.

so, yes - high estrogen may be correlated with low ferritin, but that's because women menstruate, not because estrogen reduces iron storage.

rather, it seems to increase absorption, leading to what i have - relatively normal circulating iron, with critically low iron stores.

and, if i was a menstruating woman, these numbers wouldn't be a cause for concern.

just to close the thought on that, if you google the terms you'll see people try to build a correlation between estrogen decreases in menopause and ferritin increases about the same time.

while it is obvious that iron stores should increase once the post-menopausal woman stops bleeding, there's no causal relationship or known mechanism tying these things together (besides the obvious trigger mechanism). that is, ignoring the triggering process, the increase in iron doesn't seem to have anything to do with the decrease in estrogen (nor do low iron stores seem to have much to do with high estrogen levels). that's an example of an easily intuited and absolutely valid correlation, without any concept of causality underlying it.

rather, the link i posted discussed the actual chemistry, the actual mechanism, how it actually works, and what their conclusion is is actually the opposite of that - because women that produce estrogen also menstruate, high estrogen levels are both associated with increases in bleeding and with increases in iron absorption. so, if you take away the bleeding, what's left is the absorption.

of course, i might be bleeding somewhere else, after all....in which case, the fact that my blood work actually looks a whole lot like i'me menstruating would be borne out in parallel.

on top of that, if it's genetic, as i suspect it is at this point, then it probably has to do with the same hormone.  estrogen suppresses this hormone, which causes increases in absorption; if i'm overproducing it due to genetics, it could be the cause of the problem.

....in which case, i need to find a way to suppress it more, and that could very well be by taking more estrogen.

i already posted about how low testosterone should increase ferritin, and this study suggests that high estrogen should also do the same thing.

and, if you think about that, it makes sense - women need more iron then men because they bleed more often. on a regular schedule, in fact. so, when i point to studies suggesting that hormone therapy should increase rather than decrease iron stores, there's some good, clear thinking, there.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380311/

listen - if i came in with a specific problem, and somebody could tie it to the hormones, i'd think it through and react and adjust.

but, the science around iron and female hormones suggests the opposite concern - that estrogen supplementation & testosterone suppression should make my body more efficient with iron, and not less so.

in fact, women will often be asked to go off the pill when testing for iron, because it may interfere with the results by boosting it.

so, let's rule this out, immediately. it doesn't seem to have anything to do with it. in fact, it's the opposite of what you'd expect - both via the existing science and via common sense.

i'm going to send my doctor a fax and ask him to mail it to me or print it for me for pick up...

if i end up going to the er, they should have access to the system, right?

maybe i can get them to print the results.

celiac is a bullshit, hipster non-disease that bourgeois liberals invented to sell gluten-free bread.

i don't have it because it doesn't exist.

and, the bottom line is this: i didn't consent to having my results withheld.

that's the sole, important concern here: my consent. my choice. what i want. 

and, nobody even asked.

it's pathetic.

i'm not going to consent to any sort of treatment unless i research it first. i've seen how these doctors work - they just google everything. i can do that myself, and i trust my own judgement better than theirs.

what i''m going to do if i show up at the doctor's office without getting the chance to review the results myself is ask the doctor to print the results off, rebook and come back once i have.

i'm more frustrated by the stupidity of the system than angry at the lack of access, but i can get very annoying if they're going to force me to be.

let's try to understand what i have directly in front of me, first. my next follow-up isn't until the 21st so i have time to figure it out. or, at least i think i do...so long as i don't run out of iron...

so, i just slept for 15 hours and i'm still feeling exhausted. i guess i know why, now.

if i thought that checking my iron with blood tests every few weeks was a good idea, maybe it isn't.

i need to eat and figure out what these results mean, but i'm finding the fact that they're incomplete to be rather enraging. it's my blood, my results. what kind of an idiot would decide that i don't have the right to see my own blood results? what kind of backwards society would argue for such stupidity?

so, i'd like to call the lab and yell at them, but google canceled the outbound calling feature, and i'll have to either figure that out or use a pay phone to call them. ugh.

so, this week is not going to be what i wanted it to be.

first, i need to eat.