Tl;dr: I have severe iron-deficiency anemia that went undiagnosed for the last couple of years. I not only don’t have enough iron in my blood, I lack ferritin, the protein that allows your body to store iron. Because my body won’t reserve enough iron from meals, I have to take in new iron every single day, and will for as long as I live, if I want to keep, you know, living.
After losing my health insurance along with being laid off last year, I got new health insurance in 2016 (thanks, Obamacare!) and last week, got into a new doctor’s office. I knew, before I went, that I was going to want to talk about my health and the way I’d felt it was going downhill the last couple of years. I’d done a lot of hard work to get in shape, to eat healthier, and I was getting there. Two years ago I was only 40 pounds away from my goal, and expected to be there by the end of 2014. I was walking an average of 5 miles a day, doing cardio and yoga and lifting a little free weight at home, starting to buy clothes I really liked to wear. Then, it all sort of fell apart. I was exhausted, constantly, sometimes sleeping 10 hours and then still having to take a nap in the afternoon. I started to be short of breath. I stopped walking so much. My skin got dry; my nails became ridged and brittle, and my hair started to tangle easily, even when it was short, to the point that I kept it tied up or under a hat most of the time. The dark circles under my eyes got worse. I was struggling to do everyday things. I got dizzy when I stood up too fast, and sometimes my fingers tingled like they were asleep. My hands and feet were very cold, and I noticed I was turning the heat on more than before.
I’d also talked to my old doctor about the same symptoms and his response was literally, “You’re getting older, so you’re just going to have to get used to that.” That didn’t seem right to me so I insisted, in a followup appointment, that no, really, there’s something wrong. Old doctor then said I was probably pre-menopausal, at 41, with no family history of that. I said it didn’t seem likely, so he ran tests, and found that no, that wasn’t my problem. He told me then to sleep more (I was already sleeping too much). He said I was probably depressed. (No. I’ve seen a therapist when I’ve felt I needed it before, and I wasn’t afraid to do so again. That wasn’t the problem.) He said I needed to eat better and exercise more and, again, to just accept that I was slowing down because I was a woman, and I was getting older.
The last appointment with him was a year ago. Knowing I had a chance to get the new doctor to maybe pay attention to my concerns, the night before my appointment I sat down and wrote out my medical history, and every symptom I had now. I printed out my calorie intake, sleep, and exercise logs from my fitness tracker.
When I went in to the office, two things happened:
- New doctor saw right away that I hadn’t been sent in for a followup thyroid ultrasound, even though it was in my file that I needed to get them every year or two after the (benign) nodule we found in 2013.
- He looked over my info, heard my frustrations, and promised to run every test we needed until we figured out the problem.
He took my vitals, and told me what he wanted to look for. My resting heart rate was 93 beats per minute, unusually fast, especially for someone who always felt sluggish. My lungs sounded clear, so it was unlikely an obstruction was the cause of me feeling short of breath. He asked if I’d always been so pale. He ordered labs. I fasted overnight and went back in the next morning, where they took 6 vials of my blood, to test for iron, and thyroid function, but also cholesterol, and various vitamin deficiencies. He added the test for ferritin, which I hadn’t heard of before.
And he let me know that my thyroid felt swollen and lumpy, a sure sign that I’d developed another thyroid nodule. We scheduled a sonogram for this week. (I’m hopeful it’s benign, like the last one; some people just develop these non-cancerous thyroid tumors without it affecting much else. My thyroid hormone levels came back okay, which is another good sign that the nodule is just annoying, and not dangerous.) But…
It turns out that I’m anemic in a big way. Like, wow, it’s impressive that I’m as healthy as I am, considering. I have very low hemoglobin, Mean Corpuscular Hemoglobin, Mean Corpuscular HGB Conc and very low serum ferritin scores. In addition to taking iron supplements, I’m also taking daily B12 to help with the absorption of iron. Unrelated, but my vitamin D levels were also so low that I was prescribed a mega dose to be taken once a week for 12 weeks, with a smaller daily dose thereafter. I live in the frozen north, so lots of folks around here have lower D levels than usual, but my doctor said, “If I tested everyone in town, 98% of them would have low D, and you’re at the bottom of that group.”
It’s going to take a while for everything to kick in, and we’re going to monitor it closely over the next few months to make certain my health improves. I’d always thought of anemia as you’re a little pale, go eat a steak and you’ll feel better. (This diagnosis might explain why eating a good cheeseburger really did make me feel great, for a few hours.) In my grandma’s time, people with serious chronic anemia used to develop pernicious anemia and then die, and I’m hoping to avoid that. These days, with medical care, it should be that I simply take a pill for what my body doesn’t have, and then I’ll be fine. I can do that.
But I’ll be damned if I let a doctor tell me I’m just a woman getting old, ever again.