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Suggest Treatment For Blood In Stool, Internal Hemorrhoids, Severe Weakness And Fatigue
Question: Hi I'm in this forum for a while!!!
To brief about my health issues - my Haeomoglobin level was too low -around 11 in the month of March
and m a male -28yrs of Age
I checked my Ferrtitin levels in the Month of March which was just 7.5 ng/ml (lab reference- 23.9-336ng/ml)
Also had Vitamin B12 checked which was jus 220 and
Ive been taking supplements for sometime and now.
One thing i could correlate is, i use to have bloody stools and i had it for around 5yrs which i ignored and thought it was due to heat.
But when went to the Doc, he found out i had painless internal Haemmoroiid which is the cause of the bloody stools
Now the bloody stools is almost stopped and now i don bleed.
Also my vitamin D was low for which i was taking Supplements for Soometime and then stopped it but now since i felt weak thought VITD must have gone down and
01) I took Calcirol XXXXXXX last monday (which has 60000 iu of Vit D) - after which i had severe weakness and fatigue and had several episodes of anxiety and Panic attacks
and when i checked My vit D levels on friday it was - 343 nmol/L which is high against the lab reference range (75-250 nmol/L)
02)Could this Vit D toxicity be the cause for my muscle weakness and panic attacks and fatigue?? (if so HOW to bring down the VITD levels)
03)Also i checked my iron studies on friday,which is as below
Test Name-FERRITIN (Serum)
Result=37.9 ng/ml
Reference Interval-23.9 - 336 ng/mL
Test Name-TOTAL IRON BINDING CAPACITY
Result=415 ug/dl
Reference Interval-261 - 478 ug/dl
Test Name-IRON (Serum)
Result=45 ug/dl
Reference Interval-45 - 182 ug/dl
Test Name-TRANSFERRIN SATURATION
Result=10.8 %
Reference Interval-15 - 50%
04)what could be the reason that my IRON SERUM and TRANSFERRIN SATURATION is become low which was in the normal range last month?
is it something to worry?
05)Are my ferrtinin levels are okay??to be healthy? or it should come up still
To brief about my health issues - my Haeomoglobin level was too low -around 11 in the month of March
and m a male -28yrs of Age
I checked my Ferrtitin levels in the Month of March which was just 7.5 ng/ml (lab reference- 23.9-336ng/ml)
Also had Vitamin B12 checked which was jus 220 and
Ive been taking supplements for sometime and now.
One thing i could correlate is, i use to have bloody stools and i had it for around 5yrs which i ignored and thought it was due to heat.
But when went to the Doc, he found out i had painless internal Haemmoroiid which is the cause of the bloody stools
Now the bloody stools is almost stopped and now i don bleed.
Also my vitamin D was low for which i was taking Supplements for Soometime and then stopped it but now since i felt weak thought VITD must have gone down and
01) I took Calcirol XXXXXXX last monday (which has 60000 iu of Vit D) - after which i had severe weakness and fatigue and had several episodes of anxiety and Panic attacks
and when i checked My vit D levels on friday it was - 343 nmol/L which is high against the lab reference range (75-250 nmol/L)
02)Could this Vit D toxicity be the cause for my muscle weakness and panic attacks and fatigue?? (if so HOW to bring down the VITD levels)
03)Also i checked my iron studies on friday,which is as below
Test Name-FERRITIN (Serum)
Result=37.9 ng/ml
Reference Interval-23.9 - 336 ng/mL
Test Name-TOTAL IRON BINDING CAPACITY
Result=415 ug/dl
Reference Interval-261 - 478 ug/dl
Test Name-IRON (Serum)
Result=45 ug/dl
Reference Interval-45 - 182 ug/dl
Test Name-TRANSFERRIN SATURATION
Result=10.8 %
Reference Interval-15 - 50%
04)what could be the reason that my IRON SERUM and TRANSFERRIN SATURATION is become low which was in the normal range last month?
is it something to worry?
05)Are my ferrtinin levels are okay??to be healthy? or it should come up still
Brief Answer:
Hi Continue iron tablets, repeat stool for occult blood test
Detailed Answer:
Hello mam,
I did review your concern.
Your iron profile is definately diagnostic of iron deficiency anemia and mostly it is due to GI source loss. Although You cannot see any bleeding right now, I would recommend a test to detect occult blood in stool. Many times blood can not be grossly seen but it can leak away in minute amounts everyday to cause the problem you are having. So the best is to get this stool test done and if positive get your hemorrhoids treated surgically.
Your ferritin levels are within low normal range, but TIBC is high and iron is low. SO you need to continue your iron pills and B12 pills also with them.It takes about 2-4 months for iron levels to return to normal and all stores to replenish and in your case it can be longer due to regular menstrual bleeding as well as potential GI bleeding.
About the vitamin D, I would recommend do not take any more vitamin D. Vitamin D toxicity can infact cause headaches, muscle aches due to raised pressure inside brain. There is no specific treatment to relieve it but it will slowly go down on its own. Vitamin D is a fat soluble vitamin and it should be taken in adequate amounts only, never excess, for future references.
SO all in all, nothing to worry about
Just keep eating your iron B12 folic acid pills and meanwhile get a stool occult blood test done to confirm active small amounts of bleeding from GI source eventhough it is stopped on looking in naked eye.
I hope this helps
Wish you all the best
Let me know if you have any more questions or concerns
Sincerely
Dr Parth Desai
Hi Continue iron tablets, repeat stool for occult blood test
Detailed Answer:
Hello mam,
I did review your concern.
Your iron profile is definately diagnostic of iron deficiency anemia and mostly it is due to GI source loss. Although You cannot see any bleeding right now, I would recommend a test to detect occult blood in stool. Many times blood can not be grossly seen but it can leak away in minute amounts everyday to cause the problem you are having. So the best is to get this stool test done and if positive get your hemorrhoids treated surgically.
Your ferritin levels are within low normal range, but TIBC is high and iron is low. SO you need to continue your iron pills and B12 pills also with them.It takes about 2-4 months for iron levels to return to normal and all stores to replenish and in your case it can be longer due to regular menstrual bleeding as well as potential GI bleeding.
About the vitamin D, I would recommend do not take any more vitamin D. Vitamin D toxicity can infact cause headaches, muscle aches due to raised pressure inside brain. There is no specific treatment to relieve it but it will slowly go down on its own. Vitamin D is a fat soluble vitamin and it should be taken in adequate amounts only, never excess, for future references.
SO all in all, nothing to worry about
Just keep eating your iron B12 folic acid pills and meanwhile get a stool occult blood test done to confirm active small amounts of bleeding from GI source eventhough it is stopped on looking in naked eye.
I hope this helps
Wish you all the best
Let me know if you have any more questions or concerns
Sincerely
Dr Parth Desai
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Well, m wondering if your read the 5th line of my query!!!!
M A MALE OF 28yrs of Age(haha)
Okay no probs!!
Well I've started Iron tablets(OROFER XT)
In the month of March and for a month I took the tablet regularly after which when I take tabs continuously for 6 days I experience side effects like fatigue,muscle weakness and if I stop the tablet the symptoms disappear!!!
So m trying to raise my iron levels with food!! Which looks like working fine!
Still some of my questions are not answered
What is that iron serum?? In the month of March when I had low ferritin levels the iron serum was high
Now after taking iron supplements ferritin levels are gone high but iron serum is down
Is this expected?
An the same with transferrin saturation.
And my b12 also is gone high 1500+
And now any B vitamin if I take I land up into side effects like fatigue, muscle weakness pls advise
M A MALE OF 28yrs of Age(haha)
Okay no probs!!
Well I've started Iron tablets(OROFER XT)
In the month of March and for a month I took the tablet regularly after which when I take tabs continuously for 6 days I experience side effects like fatigue,muscle weakness and if I stop the tablet the symptoms disappear!!!
So m trying to raise my iron levels with food!! Which looks like working fine!
Still some of my questions are not answered
What is that iron serum?? In the month of March when I had low ferritin levels the iron serum was high
Now after taking iron supplements ferritin levels are gone high but iron serum is down
Is this expected?
An the same with transferrin saturation.
And my b12 also is gone high 1500+
And now any B vitamin if I take I land up into side effects like fatigue, muscle weakness pls advise
Brief Answer:
Hi, I would advice the following.
Detailed Answer:
Hello sir,
I am extremely sorry for the previous mistake.
But coming back to your questions.
Sometimes serum iron can be high. The reason is that it is an acute inflammatory marker and when you take iron pills it spuriously becomes high. But the best is to follow serum ferritin in your case. Your ferritin should rise and reach to the mid level of its range(it is in low normal zone right now, which means it is improving). We see this in many patients.
Transferrin saturation will eventually come down but it will take time. Most important is to raise that serum ferritin level. Vitamin B12 if its reached its peak then no need to continue that. High Vitamin B12 generally does not cause any problem as it is a water soluble vitamin.
But high vitamin D can cause such problems.
Along with iron tablets It is imperative that you get a stool blood test to rule out chronically active bleeding from the hemorrhoids you had or from any other GI source.
I hope this helps.
Once again I am sorry for the mistake.
Let me know if you have anymore questions or concerns sir.
Wish you all the best
Hi, I would advice the following.
Detailed Answer:
Hello sir,
I am extremely sorry for the previous mistake.
But coming back to your questions.
Sometimes serum iron can be high. The reason is that it is an acute inflammatory marker and when you take iron pills it spuriously becomes high. But the best is to follow serum ferritin in your case. Your ferritin should rise and reach to the mid level of its range(it is in low normal zone right now, which means it is improving). We see this in many patients.
Transferrin saturation will eventually come down but it will take time. Most important is to raise that serum ferritin level. Vitamin B12 if its reached its peak then no need to continue that. High Vitamin B12 generally does not cause any problem as it is a water soluble vitamin.
But high vitamin D can cause such problems.
Along with iron tablets It is imperative that you get a stool blood test to rule out chronically active bleeding from the hemorrhoids you had or from any other GI source.
I hope this helps.
Once again I am sorry for the mistake.
Let me know if you have anymore questions or concerns sir.
Wish you all the best
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks for your reply!!!
Jus a question can blood loss due to haemmoroid cause b12 deficiency?
How come my b12 went down? Can iron and b12 coexist? And since my iron is now 38 can I raise the ferritin level with iron rich food? Because if I take supplements OROFER XT for more than 5 days it gives me side effects so m scared to take iron supplements as the side effects are worse like fatigue,muscle weakness,and panic attack
Will I be cured from all my symptoms once my ferritin level is above 70?
And I met gastroentrologist who done colonoscopy and said the haemmoroid is very small and surgery is not needed. Since the blood looks bright red he said its from the rectum(haemmoroid ) do I still need to check my stool test?
Jus a question can blood loss due to haemmoroid cause b12 deficiency?
How come my b12 went down? Can iron and b12 coexist? And since my iron is now 38 can I raise the ferritin level with iron rich food? Because if I take supplements OROFER XT for more than 5 days it gives me side effects so m scared to take iron supplements as the side effects are worse like fatigue,muscle weakness,and panic attack
Will I be cured from all my symptoms once my ferritin level is above 70?
And I met gastroentrologist who done colonoscopy and said the haemmoroid is very small and surgery is not needed. Since the blood looks bright red he said its from the rectum(haemmoroid ) do I still need to check my stool test?
Brief Answer:
hi please see below for my recommendations.
Detailed Answer:
Hello sir thank you for your reply query.
if its bright red blood , then no need to do stool test. You can wait for few more months and even after 3 months of iron therapy the ferritin does not go up then it msy be time to treat those hemorrhoids.
yes, many patients have vitamin b12 deficiency with iron deficiency. The major cause of b12 def. Are lack of vit b12 in diet as in pure vegetarian diet or it could be due to inability to absorb.since your b12 is now high, that problem is solved.
if you are having iron pill effects which many of my paitients have, we give parentral iron prep injections. But in your case it is not needed as ferritin is not very low. Yes with food rich in iron especially meat, cod liver, rich in organic iron, it helps to increase iron.even spinach and jaggery, sugarcane are rich veg sources of iron.you can also use iron fortified flour to increase iron intake.
I amsure with this corrective measure your ferritin stores will rise and many of your symptoms will go away.
I hope this helps.
let me know if you have any more questions or concerns.
wish you all the best.
sincerely,
dr parth desai.
hi please see below for my recommendations.
Detailed Answer:
Hello sir thank you for your reply query.
if its bright red blood , then no need to do stool test. You can wait for few more months and even after 3 months of iron therapy the ferritin does not go up then it msy be time to treat those hemorrhoids.
yes, many patients have vitamin b12 deficiency with iron deficiency. The major cause of b12 def. Are lack of vit b12 in diet as in pure vegetarian diet or it could be due to inability to absorb.since your b12 is now high, that problem is solved.
if you are having iron pill effects which many of my paitients have, we give parentral iron prep injections. But in your case it is not needed as ferritin is not very low. Yes with food rich in iron especially meat, cod liver, rich in organic iron, it helps to increase iron.even spinach and jaggery, sugarcane are rich veg sources of iron.you can also use iron fortified flour to increase iron intake.
I amsure with this corrective measure your ferritin stores will rise and many of your symptoms will go away.
I hope this helps.
let me know if you have any more questions or concerns.
wish you all the best.
sincerely,
dr parth desai.
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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