LOW HEMOGLOBIN AND LOW HEMOCRIT

[AZRider 1]

My husband had RNY bypass surgery in 2000. Last two blood tests (2x per year) he has low Hemoglobin and Low Hemocrit. Web says that is low anemia. Doctor put him on Ferrous Sulfate 65Mg 1x per day and B12 injections 2x per month. Blood test now she his high on B12 and 1 point over high end of scale on Iron. But, still has no energy. He is even taking Vitamin D3 supplementation. His thyroid is low.. close to hyper they say. I wonder if this may have anything to do with it and should he see an endocrinologist? Or Is it possible he could have a gastric bleed? He takes allot of pain reliever for back pain as he has had 3 back surgeries. Just trying to figure this out.

[RickM 1,747]

An endocrinologist, particularly one familiar with bypass patients, would not be a bad idea to get a handle on things; this far out, he has gotten used to things and there may have been a slow decline in levels, or some other physiological activity may be going on.

A minor bleed is possible (presumably no obvious signs like bloody or dark, tar like stool) as that is something of a characteristic of the bypass - the anastomosis between the pouch and intestines is somewhat delicate and can be irritated by its acidic environment. Pain relievers can be a red flag as NSAIDs are a big no-no with the bypass, but sometimes they can sneak into some pain relief products without being aware of it, and that can cause a bleed.

[AZhiker 2,252]

Is he at his goal weight? Just wondering, because the back pain is often relieved by weight loss. He may need to see a pain specialist - injections can be incredible when they work. But the NSAIDs are big no-no. There are other ways to work with pain and the pain specialist can offer other choices,

Thyroid issues can definitely contribute to fatigue.

Sounds like he needs a complete workup with all the Vitamin levels, an endoscope, and general over all screening for other stuff unrelated to the surgery, How old is he? Does he get his annual physicals with *all* the exams? Has he had a screening colonoscopy? Is he eating a really healthy diet? Getting some red meat, fish, maybe some liver? Eating his veggies, legumes, nuts/seeds? Any processed food? Has he been taking all his Vitamins since surgery?

After surgery, every bite one takes needs to have maximum nutritional value. No room for junk food and processed stuff. The endocrinologist would be a good step, maybe also a nutritionist, but don't let the speciaists miss the general health issues. It is easy for them to focus on just their specialty. A friend of mine had chest pain, and his kidney doctor thought it was the kidney tumor coming back - missed the fatal heart attack!

[AZRider 1]

Thanks for the feedback and tips. He is 63. Has put on 20 lbs since original lowest point back in 2000. He takes all his Vitamins regularly. Has lost taste for red meat.. since he gets tired of chewing. So, been doing mainly chicken and tuna as Protein. Not a big fish person.. so tuna is about it. I make chili and Soups with Beans and legumes and he likes nuts and Peanut Butter for other sources of protein. He gets work up with VA twice a year as well as his reg doc. They are the ones who boosted the Iron and the B12 since he is anemic. VA treats him real good with regular screenings, so he is covered there. Just had nerve conduction tests and MRI's for back issues. And total body ultra sound. As far a pain mgt he gets injections as needed and gets acupuncture. He basically has clean bill of health other than I suspect the thyroid?

[AZhiker 2,252]

sounds great! So glad he is getting such good care. When was his last colonoscopy? Do you know what his actual thyroid numbers were? T3, T4, TSH?