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Iron, ferritin, vit d dropping but hemoglobin levels are increasing

Hello everyone, I'm a 25 year old female, pretty healthy for the most part except for the past two years. A couple of years ago I posted here about pain in my RUQ but after multiple tests all they found was gastritis and MALS that they said they couldn't operate on since the celiac was only 40% compressed. Fast forward, I weened myself off of the pantoprazole after 1 year on it and went back to being able to eat, for the most part, normal food. However, my Vit D and ferritin levels have significantly dropped despite taking 50000 IU of vit D for 4 months and Iron supplements with vit C. My Dr. doesn't know what is causing all of this. This past summer I started to get dizzy so I had my levels checked. The ferritin was 20 and the vitamin D was 15. I was placed on supplements for 4 months. The vitamin D went up to 30 and the ferritin dropped to 13. The Dr told me to keep taking the supplements, eat more leafy greens and meat, and cut out tea. I did all of that but the dizziness got even worse. She rechecked them last week and found that my ferritin is now 9, the actual iron dropped from 148 to 42, but the hemoglobin went up from 12.0 to 14.1. I have no signs of internal bleeding. I take birth control for pcos and haven't had a period in 2 months. She is sending me to a hematologist for iron infusions, but there is a risk that I could have an allergic reaction to it. My Dr told me she has never seen anything like this, and has no idea what could be causing the levels to drop like this. Anyone go through similar and have any other answers from their doctors?
6 Responses
1530171 tn?1448129593
Hi Sandy.

Vitamin D activates numerous enzymes and genes that work on the digestive & G/I systems, where there are the most vitamin D receptors, where the assimilation & absorption of B12 and iron-among most of other nutrients and vitamins- takes place AND about 80% of your entire immune system is there too !!!
The problem gets amplified, when most iron supplements are of
the non-heme form ( poor absorption).
Hemoglobin increasing while iron and ferritin drops, is indeed confusing, however, this is usually followed by a drop in hemoglobin at a later time.

I hope you'll be able to tolerate the infusions.

Meanwhile, you should know that healthy thyroid function is dependent on adequate iron levels.
It can become a vicious cycle because, being hypothyroid can result in a lowered production of stomach acid which in turn leads to the malabsorption of iron.

There are many unanswered questions in your case.
-Do you know your stomach acid levels?
-PCOS and possible hypothyroid connection?
"The relationship between thyroiditis and polycystic ovary syndrome: a meta-analysis."  Search under  PMC3832324  for the free full article.
-Vitamin D resistance? Has it been ruled out? What form of D are you taking?
- Methylocobalamin B12 levels?
-Gastritis. Present status, treatment Helicobacter pylori infection has ever been ruled out?
I'm sure there are more possible outstanding issues which could be explored if all the pertinent medical information was available.
Please answer as many as possible.

Take care.
Niko



Avatar universal
Thank you so much for your quick response. I'll try to clarify as much as I can.
-I don't have a numeric value or anything on stomach acid levels, but they were high last year causing the inflammation in my stomach lining and thus the pain. The ppi meds I was on lowered the stomach acid giving the lining time to heal. I haven't had symptoms of it since, but I stopped those meds last year.  
-I was diagnosed with PCOS last year but numerous tests for thyroid function have all come back normal.
-I have been vit D deficient for as long as I can remember. My numbers were always in the low 20s in the middle of summer. They had me taking 50000 iu of d for 4 months on 3 different occasions then supplementing with 5000 units once daily d3. the levels always rose slightly and then fell back down.
-My b12 levels have always been borderline low, i take an over the counter supplement for that as well
-They ruled out h. pylori, celiac disease, gluten intolerance, peptic ulcer.
-I had an endoscopy that only showed gastritis and an ultrasound that showed no visible abnormalities.

My Dr is worried because she said that as soon as the iron in the blood starts dropping the hemoglobin will too. Im just so confused as to how this could happen, Ive been taking the supplements and eating an iron rich diet. If anything the levels should stay the same not drop. She also said if they do the iron infusion and I have an allergic reaction to it, then I have no choice but to go back to supplements which aren't working in the first place. So basically they don't have a plan b if the infusions don't work. I just want to feel like a normal 25 year old, instead of feeling winded just doing simple tasks.
1530171 tn?1448129593
Some things do not add up Sandy.
Persistently low iron, low D, low B12 with normal stomach acid levels   and thyroid levels?
Can you do for current stomach acid levels the "baking soda burp test" and/or the Betaine HCL challege?
Just do a search.
Also for thyroid FUNCTION search under "Dr Barnes Basal Temperature Test" but please follow the online instructions precisely.
When you get results-if you decide to do them-please post them or message me, so I can offer you some suggestions.
You may have vitamin D resistance, but first things first.
In the mean time, taking sublingual emulsified D3 drops with K2 if possible
might be a better way to supplement.
B12 again in B12 methylocobalamin drops is recommended.
Iron supplementation is the toughest one. Most people have issues with iron supplements.

Cheers,
Niko
1530171 tn?1448129593
Here's some additional information

--- Problems with Vitamin D absorption, assimilation & Vit.D Resistance--

--General Inflammation and G/I inflammation(very common with low thyroid or low adrenal sufferers) Leaky Gut Syndrome, Crohn's, Colitis. etc.
-- Low fat diet or issues with fat digestion also relating to not enough cholesterol for hormonal AND vitamin D synthesis ( Vit. D is fat soluble)
-- Obesity
-- Certain drugs
-- High Cortisol
-- Vitamin D Receptor (VDR) gene mutation  ( genetic /autoimmune) or decreased VDR expression, common with Hypothyroid & Hashimoto's sufferers also.
In this case need increased levels of D, well above and beyond normal serum levels, for optimum function.  Supplementation at higher amounts than current may be beneficial.
--Your D3 levels (vit­a­min D 25OH test) should ideally be about 50- 60ng/ml


             ---Vitamin B12 & Folate---
Inorganic mercury may also cause a B12 deficiency in the nervous system as it accumulates in the Blood-Brain-Barrier and restricts Methylocobalamin (the ONLY form of B12, used in the nervous system) flow through the BBB.

It is possible to have  B12 and folate levels within normal range, through a standard MMA test, yet still have a B12 ( methylocobalamin ) nervous system deficiency  and folate (tetrahydrofolate) nervous system deficiency, so a  test for Homocysteine levels in the CSF may help determine this.
---B12 levels should be 500pg/ml minimum to avoid neurological issues.
500pg/ml is the minimum low range in EU, much higher than the N.American min. low range.

Any questions, I'm just a click away.
Niko
Avatar universal
So I went to a hematologist/oncologist. He thought it was pernicious anemia. They checked the b12 and folic acid levels. Normal. Yet he still wants me to get b12 shots for a couple of weeks. I don't understand this at all. If my b12 is normal why should I get b12 shots? And the iron in the meantime is continually dropping and yet he doesn't want to give me iron injections. I'm so incredibly frustrated. I've been taking the supplements, avoiding taking them with starches like the dr said, but no improvement. I keep getting random bruises all over my arms and legs for no reason. I still feel exhausted all the time and get dizzy spells. I'm not sure what to do now.
1530171 tn?1448129593
Because a really good doctor KNOWS that the reference values in North America regarding B12, are far too low in comparison to European and Japanese values.
There are  too many people with problems on this side of the world because of this!
Also make sure you get METHYLOCOBALAMIN shots and NOT cyanocobalamin -the much cheaper version of B12 which is of little neurological value!
I already explained some of this.

Did you follow up on any of the suggestions I posted ?
To make any breakthrough, I think it would be wise to get all that cleared.
Don't expect the doctors to do it all for you, because, you will likely stay in limbo, unless your doctors are exceptionally good, holistic-minded and thorough!

Best,
Niko
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