[HN Gopher] Why does iron deficiency cause fatigue, even in the ...
___________________________________________________________________
Why does iron deficiency cause fatigue, even in the absence of
anemia?
Author : panabee
Score : 167 points
Date : 2022-07-03 14:50 UTC (8 hours ago)
(HTM) web link (twitter.com)
(TXT) w3m dump (twitter.com)
| Coolerbythelake wrote:
| So things that can look like anemia can be other things! Case in
| point, my wife was misdiagnosed for months with Anemia. What she
| really has is several tick Bourne diseases. For 5 months her
| doctors kept giving her blood transfusions as he hemoglobin
| reading was around 4-5 and it should be 12-13 for a normal
| person. Can't tell u how many specialists and emg room visits.
| Finally found a female md that listened to her and gave the
| approval to do a comprehensive tick panel. Sure enough rocky
| mountain spotted fever, erlicheaosis, recurring Lyme fever and
| regular old Lyme. The blood they were giving her was basically
| like throwing gas on a fire. Almost was ready to make funeral
| arrangements. Let me say tick diseases are going bonkers and a
| lot of people don't know they have it. Plus a lot of doctors
| won't believe or authorize tests. Advocate for yourself or you
| might die! Not kidding !
| danachow wrote:
| A hemoglobin for 4-5 is _anemia_ - the definition of anemia is
| low hemoglobin concentration. If your wife had hemoglobin that
| low, then she was correctly diagnosed with anemia.
|
| It is a bit odd though the apparent coinfection with multiple
| tick borne illnesses from different species of ticks - A lyme
| and ehrlichiosis coinfection is not surprising, but rocky
| mountain spotted fever is a very different illness, often more
| acute in presentation with distinctive signs and symptoms - but
| coinfection with the other two would be quite rare.
|
| Also, those specific tick illnesses listed are unlikely to
| cause that profound of an anemia by themselves, so there's
| probably some other pathology going on - the tick borne
| infection may only be a trigger.
|
| Any relatively young person that is otherwise healthy (no near
| end state kidney disease) should definitely get referral to a
| hematologist for hemoglobin of 4-5 if it isn't something
| blindingly obvious like blood loss.
| lkrubner wrote:
| I had some illness for much of 20 years. Doctors were uncertain
| about what it was. They eventually called it Lyme disease
| because they weren't sure what else to call it. But I was stuck
| taking antibiotics for 20 years. I tried several times to quit
| the antibiotics, but I always got badly sick when I did. I
| eventually managed to achieve a complete cure, by fasting with
| only water for 2 weeks. I describe this whole saga in detail
| here:
|
| http://www.smashcompany.com/philosophy/how-i-recovered-from-...
| Gatsky wrote:
| Small adjustment here... anemia is not a disease, it merely
| describes the state of having reduced hemoglobin concentration
| in the blood. It doesn't make sense to say things can 'look'
| like anemia. It has myriad causes. It is never benign, and
| should always be investigated thoroughly.
| afterburner wrote:
| Lyme disease is spreading northward, areas that would have
| never thought about it 20 years ago need to exercise caution
| when hiking on uncleared paths (or when diagnosing patients),
| but the awareness isn't that huge right now.
| xenocratus wrote:
| It took years for me to be diagnosed with thalassemia when my
| GP found some of my blood results suspicious. Got treated for
| anaemia a few times before, and was refused for blood donations
| as well without being able to explain what was wrong. My blood
| tests said "anaemia", but my life experience said "all seems ok
| to me...?" - luckily I have a mild form, I just need to watch
| my diet a bit.
|
| My dad also found out through my diagnosis why he kept getting
| those same signs in his tests... :) Eastern European medical
| system at its finest.
| ClumsyPilot wrote:
| > Plus a lot of doctors won't believe or authorize tests.
| Advocate for yourself or you might die! Not kidding !
|
| Experienced this myself. So mant doctors behave like JavaScript
| developer and I am another webpage
| pojzon wrote:
| At least in Eastern Europe thats because they dont really
| have the time needed to help the patient.
|
| Its a business and you have 10m to do all paper work, check
| patient and prescript something.
|
| Its horrible. Doesnt help that private doctors are super
| expensive, dont care about you and dont believe you.
|
| Health became just another accommodity only super rich can
| pay for.
| InCityDreams wrote:
| >Advocate for yourself or you might die! Not kidding !
|
| Paid healthcare? As a europopulator i can choose to pay for my
| healthcare. Rest assured, that when i do pay, i insist on
| certain things. Like doing the tests i insist on...
|
| "Plus a lot of doctors won't believe or authorize tests."
|
| Surely, the money talks in a situation like this? I can pay for
| any test i like and no (socialist, here) doc would ever say no,
| nor would they actually give a crap.
| pojzon wrote:
| Not everyone can pay. Health should not be gated behind a
| paywall. Life is not a microtransaction game.
| brewdad wrote:
| If insurance doesn't approve the test, it won't be paid for.
| Insurance also means US prices for tests are elevated to 10x
| what they "should" cost because providers expect insurance to
| knock the price back down to a reasonable cost. As a result,
| ordering a bunch of unapproved tests leads to huge out of
| pocket costs for patients so only the wealthiest will ever be
| willing to push for them.
|
| Ironically, that same population also is the most likely to
| have insurance that will cover the tests in the first place.
| So it goes.
| robonerd wrote:
| > _Let me say tick diseases are going bonkers and a lot of
| people don 't know they have it. Plus a lot of doctors won't
| believe or authorize tests._
|
| The existence of Chronic Lyme disease is very controversial and
| diagnosing it can get doctors in trouble (depending on the
| jurisdiction.) Whether or not Chronic Lyme disease is real (I
| don't know), I think the general consensus of CLD diagnoses
| being quackery might bias doctors against diagnosing _any_ sort
| of tick related disorders, particularly chronic ones.
| joshgel wrote:
| Err it's more that tick-borne diseases cause anemia.
|
| There are lots of things that cause anemia! And someone with
| unexplained anemia deserves a complete work up (especially with
| hemoglobin levels in the 4-5 range), including for tick-borne
| illnesses, especially if they have been in an endemic area. But
| lots of other things worth checking too, many more dangerous
| than tick-borne illnesses.
| Herodotus38 wrote:
| Iron deficiency can also cause restless leg syndrome even without
| anemia, it's sometimes overlooked. Better to take iron than
| something that messes with your dopamine receptors.
|
| Also recent research has shown evidence that taking iron every
| other day is better than taking it daily.
| https://pubmed.ncbi.nlm.nih.gov/31413088/
| bpye wrote:
| This was a surprise to me when I had a panel of blood tests and
| my ferritin was very low, but haemoglobin was normal A few weeks
| on iron supplements did lead to a notable improvement day-to-day
| and reduced fatigue. I always find it surprising how much
| difference this sort of thing can make.
| lalwanivikas wrote:
| Do you buy it over the counter?
| bpye wrote:
| At least here (BC, Canada) you have to talk to a pharmacist
| to get it, but there is no prescription required. You should
| also have your levels checked semi-regularly if you're taking
| supplements to ensure that your levels aren't getting too
| high.
| PKop wrote:
| Arguably we have a problem of too much iron, especially
| supplemented in cereals and such, producing free-radicals that
| damage cells:
|
| https://raypeat.com/articles/articles/iron-dangers.shtml
|
| Ray Peat advice for men is to donate blood periodically to remove
| excess iron from our body.
| Brybry wrote:
| I'm unfamiliar with Ray Peat.
|
| Is there a reason Ray Peat advice should be treated differently
| than say, Mehmet Oz advice? Or Linus Pauling advice?
|
| I couldn't seem to find much of anything published by him that
| was peer-reviewed.
| rvp-x wrote:
| I've noticed the same. I'm a woman so bleed often, I'd feel the
| fatigue but my blood work didn't show anemia, so my primary care
| physician didn't feel the need to prescribe it yet. I decided to
| take supplements on my own and monitor the ferritin levels to
| make sure I don't over-do it.
|
| Note, if you aren't bleeding regularly, it's very unlikely you
| need it, and iron might be harmful. Make sure to test your
| ferritin levels before and regularly as you do it.
| Faaak wrote:
| How do you monitor ferritin levels ? Blood test ? I couldn't
| find any auto-test where I live
| rvp-x wrote:
| From blood tests, yes
| danachow wrote:
| Frequent monitoring of iron/ferritin levels while on oral
| iron supplementation is likely not necessary -- barring a
| genetic disease, you're extremely unlikely to get iron
| toxicity or overload at instructed oral doses. Periodic
| monitoring is more to assess a positive response - since if
| your levels are not going up on supplementation it warrants
| further investigation.
|
| Oral iron is now recommended given only every other day to
| avoid GI side effects and there is evidence that the response
| is just as good to more frequent.
| coredog64 wrote:
| That's good news. Oral iron gives me an upset stomach
| unless I have lots of recent carbs.
| redtexture wrote:
| Disolving tablets and consuming in liquid form is an
| alternative.
| r1ch wrote:
| My partner takes Megafood's "Blood Builder" iron
| supplement which seems to work well and avoids the GI
| symptoms.
| mirthflat83 wrote:
| Listen to this person who is likely an actual MD
| johnfn wrote:
| This frustrates me. Right in this very thread are many
| accounts of people saying that doctors won't listen to
| you and will do only the minimal amount of work possible
| to get you out of their office, and that you should do
| your own research. Then like 3 comments down are posts
| like yours, sarcastically putting down people sharing
| results of that same research.
|
| So which one is it?
| phkahler wrote:
| And...? Did it help?
| runjake wrote:
| Is there any decent way to supplement iron? I've never seen any
| pills in regular stores.
| bpye wrote:
| As I mentioned elsewhere, you can get supplements but at least
| in BC you need to speak to a pharmacist to get them, though no
| prescription is required.
| Lammy wrote:
| Supplement anecdote: I really like Floradix because it doesn't
| make me puke like the over-the-counter Ferrous Sulfate tablets
| always do: https://www.floradixusa.com/products/floradix-iron-
| herbs-liq...
| hkt wrote:
| Supplemental supplement anecdote: I also really like Floradix
| for its gentler GI effects. I was anaemic (from a long term
| health condition) and well, now I'm not. Daily seems fine, too.
|
| I also use an app to check my haemoglobin levels. It is weird
| that an app can do this, but I've calibrated it against less
| frequent in-hospital blood tests and it checks out. See:
| https://sanguina.com/anemocheck-mobile/
| ElSinchi wrote:
| Annoying huge Twitter threads.
|
| Just. Write. An. Effin. Blog. Post.
|
| Long form reading on Twitter is very cumbersome
| aaaaaaaaata wrote:
| How do I one-click retweet my favorite two lines of a blog post
| and get all my friends to do the same?! /s
| Nowado wrote:
| You're laughing, but there are popular plugins for doing
| exactly that.
| yellowapple wrote:
| This is the first I'm hearing of polycythemia vera having
| anything to do with iron deficiency, but considering the overlap
| of symptoms (and the fact that the former involves making _way_
| too many blood cells) it makes a lot of sense.
| hprotagonist wrote:
| Too high isn't good either; the solution is downright medieval.
|
| https://www.mayoclinic.org/diseases-conditions/hemochromatos...
|
| https://www.webmd.com/men/features/too-much-iron-in-your-blo...
|
| So don't go gulping down the supplements all willy-nilly, either.
| DelightOne wrote:
| > Treatment includes regularly removing blood from your body.
|
| Just regularly donate, no problem.
| seper8 wrote:
| Donating apparently also removes microplastics from your
| body...
| SoftTalker wrote:
| Any references for that? What about just drinking a lot of
| water so you have to pee more often?
| robonerd wrote:
| If there are any synthetic textiles in your home, it's
| probably a lost cause; plastic dust everywhere. Every
| time you eat, drink or breath, you'll be taking more in.
| cma wrote:
| Are they just freefloating in blood? Capillaries are tiny
| and I thought micro plastics were closer to 1mm than
| 1micron, despite the name. Capillaries are 8-10microns.
| CoastalCoder wrote:
| I'm curious if the donated blood is processed in a way that
| removes those microplastics.
| plorkyeran wrote:
| Probably not, but if you're in need of a blood
| transfusion you have more immediate concerns.
| hprotagonist wrote:
| yup!
| toast0 wrote:
| If you're diagnosed with hemochromatosis, you may not be
| permitted to donate; it seems to depend on your local blood
| banks. There's some amount of concern that because the
| donation is theraputic for the donor, they may not be
| forthcoming about other factors that should disqualify them,
| if present.
|
| Of course, if it hasn't been diagnosed and you're a regular
| donor, that's a happy accident.
| im3w1l wrote:
| That kinda makes sense. If you allowed them to donate even
| with disqualifying factors (but flushed it down the drain),
| it would fix the incentives. May not give enough additional
| blood to be worth the bother?
| dhzhzjsbevs wrote:
| I'd hardly call a regular trip to give blood "medieval".
|
| They're not giving out leeches.
| hprotagonist wrote:
| right; those are for cleanly healing scars.
|
| "your humours are imbalanced and you should be bled, you'll
| feel better" is not far off from "your iron level is too
| high", though...
| robonerd wrote:
| Medical leeches are used to encourage blood flow,
| particularly after reconstructive surgeries; the benefit is
| not from the leech sucking your blood, but from the
| bleeding that continues after the leach is removed. (Their
| saliva has anticoagulant and anti-inflammatory properties.)
| [deleted]
| yjftsjthsd-h wrote:
| > "your humours are imbalanced and you should be bled,
| you'll feel better" is not far off from "your iron level is
| too high", though...
|
| The difference is that now we have both empirical evidence
| that it works, when it works, what the side effects are,
| and generally why it works. As opposed to cargo culting,
| poor cost/benefit analysis, and inaccurate understanding of
| what's actually happening.
| hprotagonist wrote:
| we have a much better model now, i agree.
| phkahler wrote:
| >> those are for cleanly healing scars.
|
| My go-to for that is Iodine.
| metadat wrote:
| I use those silicone scar strips. Wound healing
| technology is nearly magical these days.
| hprotagonist wrote:
| the normal use is reduction of venous congestion at an
| incision site after a major surgery, which i hope you're
| not doing regularly enough to have a go-to!
| treeman79 wrote:
| Medical leeches are a thing.
|
| https://www.uhhospitals.org/Healthy-at-
| UH/articles/2020/03/h...
| armchairhacker wrote:
| for a long time, until I started eating meat I had low ferratin.
| Iron supplements didn't help and even some weird ferratin
| supplements didn't seem to work.
|
| But iron is not ferratin (it's some kind of stored iron) and I'm
| not sure if it really had any affect. I was low ferratin but
| could I have been not low on iron?
|
| Either way iron deficiency is common in vegetarians and vegans,
| but there are plenty who are just fine. They get iron from tofu
| and spinach which is different from the iron from meat and maybe
| affects their levels differently, but it seems to work out.
| aaaaaaaaaaab wrote:
| *ferritin
| [deleted]
| danachow wrote:
| Ferritin is the protein that stores iron in cells in almost
| every organism from bacteria to humans - but its exact
| structure and mechanism do differ. As a blood test, endogenous
| ferritin level gives an indirect measure of iron stores.
| Ferritin <25-30 ng/mL is consistent with iron deficiency anemia
| - levels higher than this are more difficult to interpret -
| they don't rule it out.
|
| Whether or not consuming plant ferritin (when you buy
| "ferritin" supplements that is what you're getting - usually a
| pea plant) is an effective iron supplementation is another
| question entirely. And as far as I know there is no great
| evidence that it is non-inferior to typical oral iron products
| (salts and saccharide compounds). The ideal treatment for iron
| deficiency anemia is typically IV iron (or blood transfusion if
| the anemia is profound enough to warrant it - but IV iron
| replacement is one of those things coming back into fashion
| finally after many years of being feared for reasons with poor
| evidence.
| morninglight wrote:
| [deleted]
| Pakdef wrote:
| bilsbie wrote:
| Could this cause dizziness standing up?
| fiatjaf wrote:
| That's B12 deficiency.
| bilsbie wrote:
| I take b12 but maybe I'm still not getting enough?
| fiatjaf wrote:
| How much are you taking? 5000~10000mcg per day may not be
| too much, also there are no side effects or overdose risks.
|
| I think you should do a blood test and ensure you're at
| least over 500 pg/ml.
| petercooper wrote:
| It's certainly worth checking B12 levels properly. It's
| quite hard to be B12 deficient and a common reason to be
| so is due to being unable to absorb it properly in the
| digestive system (I think this is quite common with
| celiac disease, for example). That's why injections are a
| common approach. I went with sublingual administration
| instead and it worked very well.
| fasteo wrote:
| Check this out [1]
|
| [1] https://my.clevelandclinic.org/health/diseases/9385-low-
| bloo...
| ravenstine wrote:
| Iron is also needed in the electron transport chain as a
| component of cytochrome C oxidase. If fewer iron molecules are
| being prioritized for creating this enzyme, then less oxygen will
| be reduced at a time. The rest of the Krebs cycle can be in an
| optimal state but the cycle can only go as fast as the electron
| transport chain will allow it. I imagine that given a deficiency,
| the human body will prioritize iron formation in the blood over
| creating new cytochrome C oxidase since transporting oxygen to
| cells is more important than running the Krebs cycle at full
| speed.
|
| I have no idea if this is really what's going on, and it's
| interesting that this is not mentioned in the linked articles.
| The reduction of oxygen is really the final step for oxygen
| before it becomes a part of metabolic water, and throwing off the
| timing of binding oxygen atoms with protons will slow everything
| down.
| adrian_b wrote:
| Your hypothesis is plausible, but as you have said, whether it
| is true or not depends on the order in which the availability
| of iron for each of its many functions in the body becomes
| affected when iron is scarce.
|
| Cytochrome C oxidase needs not only iron, but also copper. So
| any symptoms caused by an iron deficiency to it, presumably a
| decrease in the capacity for aerobic effort, should also appear
| in the case of a copper deficiency.
| phkahler wrote:
| >> Your hypothesis is plausible, but as you have said,
| whether it is true or not depends on the order in which the
| availability of iron for each of its many functions in the
| body becomes affected when iron is scarce.
|
| I just assume that every logical/plausible concept is at play
| and evolution does its best to balance everything. Rarely is
| anything absolute.
| samstave wrote:
| >> _...prioritize iron formation in the blood over creating new
| _-_-cytochrome-_-_ C oxidase since transporting oxygen to cells
| is more important than running the Krebs cycle at full speed._
|
| https://en.wikipedia.org/wiki/Cytochrome
|
| Whats really interesting to me is the above statement related
| to a longtime conspiracy-curriosity about the 'Russian kid from
| Mars' ala an 'Indigo Child' and when back in the ~1990s or some
| time when he was interviewed, he was ~10 years old and he said
| that "Humans came from Mars, and after we got to earth, is when
| we started to age - because Earth is oxigen based, and
| breathing oxygen is what makes you age."
|
| And this crazy piece talks about the iron found in the martian
| atmosphere:
|
| http://www.nuclearplanet.com/Martian%20Iron.html
|
| >> _The atmosphere of Mars is 95.7% carbon dioxide (CO2), which
| is available everywhere at the surface and which can readily be
| compressed. The Martian carbon dioxide can be, simultaneously,
| a source of carbon monoxide (CO) and a source of oxygen (O2)
| through the thermal decomposition reaction:_
| >>*2 CO2 - 2 CO + O2
| (20.2)*
|
| >> _Reaction Eq. (20.2) requires a temperature of about 1100C.
| Note that the iron reduction reaction Eq. (20.1) can take place
| at about 700C, but a higher temperature, such as 900C, would be
| desirable._
|
| ---
|
| What happens if a Nuke goes off in the Martian atmosphere?
| xkbarkar wrote:
| Was twitter really the right place for this? Very informational
| piece, I liked it. But having to read it in 12 sections was
| awkward. Disclaimer, I already dislike twitter.
| yccs27 wrote:
| It forces the writers to make every sentence count. No space
| for fluff, people would just stop reading the chain. It results
| in a much more condensed style than e.g. blog content.
| greggsy wrote:
| I like that each tweet/paragraph can have its own commentary.
| Provided it isn't anything political or bait-ey, the
| discussion following each tweet can be insightful, and are
| more contained and targeted than those usually found at the
| end of a blog post.
|
| It's important to remember that it's just a different medium
| - you'll find blogs, Reddit and Facebook posts, memes and
| infographics on this topic.
| caymanjim wrote:
| Except I stopped at the first sentence when I realized there
| wasn't a link to any actual readable content.
| amenghra wrote:
| There's bots to unroll threads. Eg tag @threadreaderapp and
| type unroll. Or just tag @UnrollThread.
| bmacho wrote:
| replace twitter with nitter:
| https://nitter.it/tony_breu/status/1543311124560592898
|
| since I don't use twitter, I've set up a userscript to do it
| for me
| Blahah wrote:
| For a lot of people it's both the most effective way to
| communicate atomic components of a stream of thought, and to
| reach an audience. Very few other platforms offer the same
| opportunity.
| wrs wrote:
| What I don't get is why it's good to communicate "components
| of a stream of thought" as opposed to, you know, a complete
| thought.
| heavenlyblue wrote:
| Probably for the same reason bible is separated into
| verses. Easier to find more profound meaning in a small
| atomic bit of a though taken out of context.
| yellowapple wrote:
| I'm suddenly tempted to tweet the entire Bible.
| irrational wrote:
| Somebody already did.
| InCityDreams wrote:
| Which version?
| sieabahlpark wrote:
| abandonliberty wrote:
| fixed:
| https://threadreaderapp.com/thread/1543311124560592898.html
| danachow wrote:
| I'm not the biggest fan of twitter but this is a practicing
| internal medicine doc that is conveying information primarily
| aimed at other doctors in training or practice - this is
| information that is for the most part readily available,
| nothing groundbreaking here, there are podcasts on the topic,
| videos and other paid for sources of information. The novelty
| is the medium - and if there are some that benefit from it and
| the like the format I don't see the harm.
| dclowd9901 wrote:
| Not sure why people are defending this. It's not like
| separating a page into paragraphs. This is so jarring it's
| distracting.
| hombre_fatal wrote:
| On the other hand, I'm not sure I would have sat through an
| entire blog post on the same issue. The tweet format is a
| highlight reel, especially for subjects I don't even know I'm
| interested in yet (this wouldn't go looking for long form
| content).
| dclowd9901 wrote:
| Not sure why people are defending this. It's not like
| separating a page into paragraphs. This is so jarring it's
| distracting. I don't know what it is about the format, but
| separating the piece like this makes it so I've completely
| forgotten what the previous tweet was when I've gotten to the
| next one.
| greggsy wrote:
| I don't have the same problem with long threat tweets, and in
| many cases prefer them over blogs as they're forced to
| include only the most salient points.
___________________________________________________________________
(page generated 2022-07-03 23:00 UTC)