lead - < 0.1. negative.
h. pylori - negative. this is a bacteria that can interfere with iron absorption.
haptoglobin - 1.48. this is in the exact middle of the range. combined with lowish reticulocytes, this points strongly to a production issue rather than a loss issue.
hepcidin - not available. this is the hormone test to determine a genetic condition that blocks absorption.
he is suggesting that i need to go off the iron pills for two weeks to do a poop test, and i'm not there yet - i want to get my ferritin up to normal levels, first. another month, probably. while it seems to be highly unlikely, i can't rule out bleeding entirely until we do the poop test, and i may need to do two of them to check for stomach issues and for colon issues. i'd rather do that than do a scope - or, at least, i'd rather do that first than do a scope.
the doctor is pushing a scope, to rule it out, and i understand where he's coming from, but i'd rather try and rule out bleeding using less invasive procedures, first. i really think that the chances that i'm bleeding are very unlikely. but, i'll work that out with the gastric specialist, who i am now going to send a fax to. i mean, he's a doctor, so he knows things about disease that i don't, but i'm a logician and i have more trust in my ability to produce a syllogism out of the data. cancer does not add up, here. i mean, i'm even gaining weight, recently.
rather, i'm entirely certain that all of these tests strongly point to a reduced ability to absorb iron in the diet, but not in pill form. and the serious question left to figure out is if it's being blocked by something in my diet or if it's a genetic deficiency being overpowered by the sheer amount in the pills. while the data with my father suggests a genetic deficiency, the fact that the pills are working rather spectacularly suggests that the interactions might not be helping.
so, if something is blocking absorption, what could it be?
i think these are the two potential genetic possibilities:
- it could be heightened hepcidin levels, and i'll need to find a lab that will test me for it to find out.
- yes - it could be celiac. but, celiac would tend to block not just iron but also B12, calcium, vitamin D, zinc, folate, magnesium and copper, amongst other things. i am absorbing b12, calcium, d, folate, magnesium and zinc - and we're going to check for copper, as well as for b12 a second time. i'm also absorbing the iron in pill form just fine. so, this seems unlikely given that it's just iron. the doctor is pushing a scope, but i need at least two deficiencies before it makes sense to me to do a scope. so, i'm also checking for selenium, iodine, manganese & vitamins a, e and k. if anything else seems amiss, i'll have to relent and either do a scope or a blood test. but, if the only problem is iron, it strikes me as too unlikely to bother with. that said, after we've done all of this, i may put aside some gst money to take the celiac blood test, just to be sure. but, i'm taking the pasta out of the diet anyways (while keeping the cereal, wheat and flax bread), and we'll see if that helps. actually, here's a way for me to do this - next appointment, i'll make a bet with the doctor - i'll put the money down for the celiac test just to be sure, but if i don't have it, he has to pay me back for it. just a little wager...
i'd rather pay the $70 than get scoped.
but i don't have celiac.
what have we got so far, in terms of absorption?
a - pending
b1 - next time
b2 - next time
b3 - next time
b5 - next time
b6 - next time
b7 - next time
b9 - absorbing
b12 - absorbing, but rechecking.
c - next time
d - absorbing
e - pending
cholesterol - perfect
k1 - pending
sodium - absorbing & regulating
potassium - absorbing & regulating
magnesium - absorbing & regulating
phosphorus - absorbing & regulating
chlorine - absorbing & regulating
calcium - absorbing & regulating
chromium - next time
manganese - pending
iron - not absorbing in food, but absorbing in pills
nickel - next time
copper - pending
zinc - absorbing & regulating
selenium - pending
molybdenum - not available
iodine - pending
does that look like celiac to you? it doesn't look like celiac, to me.
- it could be colitis or crohn's disease, which would suggest difficulty with fat soluble vitamins, as well as iron. my d was normal, but lowish. checking for a, e and k will help rule that out - or present it as more plausible. colitis would also be the disease that is most consistent with red stool, which i think was caused by the beets - but i really don't seem to be bleeding. this will be what the poop test is for, ultimately.
- it could be phytates, but if it was phytates then i'd likely have problems with zinc, magnesium and calcium as well, and i don't. so, the idea that phytates are blocking the iron - on their own - seems to be unlikely. but, the interaction might be exacerbating some underlying genetic condition that is iron-specific.
- it could be too much calcium. it really could be. but, trying to eat cereal without soy milk or eggs without cheese is going to suck. if it's really too much calcium, i'd rather take iron pills - it seems to work.
- it could just be too many minerals, in general. this is counter-intuitive, but because humans tend to have difficulty with iron absorption, in general, you could actually end up anemic if your diet has too many nutrients in it because they crowd the iron out. the answer would be to take pills like i'm doing - albeit perhaps less frequently, once levels are normalized. maybe an iron pill every other day...
- it could be eggs, but eggs also inhibit calcium and magnesium, and that's not happening. on top of that, i should be getting most of my iron from the fruit bowl, not the eggs.
- likewise, it might be oxalates, but my calcium levels are not being impacted.
- i used to drink coffee with meals but stopped several months ago. while i suppose that it might have exacerbated an existing problem, it doesn't seem to be the primary problem.
- or, it could be something in a long list of obscure diseases, like cystic fibrosis. and, i'll need to let the doctors direct me regarding anything like that.
so, none of these are really good answers, but this is the mess i need to sort through and try to figure out.
the immediate things for me to do are to:
1) take another blood test to fill out the absorption chart
2) wait to get a poop test
3) communicate with the gastric specialist about less invasive ways to check for bleeding (which obviously isn't happening) or malabsorption (which in some sense obviously is)
4) how do i check my hepcidin levels?