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 !
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.
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.
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.
>>...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.
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:
>>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?
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.
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.
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.
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.
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.
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.
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/
Another anecdote: I am using ferrous bisglycinate instead of ferrous gluconate (Floradix) - it is even easier to take and absorbs well. I find it ridiculous that doctors still prescribe ferrous sulfate when these exist.
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.
Do you know the root cause? I have exactly the same problem for last two years, and I took Iron supplements for 6 months, still same situation.
I do have a autoimmune disease, just wondering if it can cause things like this.
You can have an iron deficiency, even if your hemoglobin levels are normal, because iron does more than just carry oxygen in red blood cells: It's a cofactor for many enzymes.
I'm curious if there's a third variable at play here; something preventing the iron from being accessible (since our bodies normally break down ferritin to access the iron), especially when hemoglobin levels are otherwise normal.
I didn't see Restless Leg Syndrome mentioned, but it's pretty heavily tied to iron deficiency. Both my kids were acting tired during the day and showing symptoms at night. Can't feel rested if you're moving all night long. Iron allowed them to actually sleep.
I eat ice, which people often say is due to iron deficiency, but so far no test has suggested iron deficiency. I did have folate anemia, but fixing that didn't cure my desire to eat ice.
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.
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.
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.
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.
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.
[+] [-] Coolerbythelake|3 years ago|reply
[+] [-] danachow|3 years ago|reply
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.
[+] [-] ravenstine|3 years ago|reply
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|3 years ago|reply
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.
[+] [-] samstave|3 years ago|reply
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:
>>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?
[+] [-] rvp-x|3 years ago|reply
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|3 years ago|reply
[+] [-] phkahler|3 years ago|reply
[+] [-] hprotagonist|3 years ago|reply
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|3 years ago|reply
Just regularly donate, no problem.
[+] [-] dhzhzjsbevs|3 years ago|reply
They're not giving out leeches.
[+] [-] xkbarkar|3 years ago|reply
[+] [-] yccs27|3 years ago|reply
[+] [-] danachow|3 years ago|reply
[+] [-] Blahah|3 years ago|reply
[+] [-] bmacho|3 years ago|reply
since I don't use twitter, I've set up a userscript to do it for me
[+] [-] abandonliberty|3 years ago|reply
[+] [-] dclowd9901|3 years ago|reply
[+] [-] amenghra|3 years ago|reply
[+] [-] dclowd9901|3 years ago|reply
[+] [-] Lammy|3 years ago|reply
[+] [-] hkt|3 years ago|reply
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/
[+] [-] tornato7|3 years ago|reply
[+] [-] bpye|3 years ago|reply
[+] [-] rahul1141|3 years ago|reply
[+] [-] lalwanivikas|3 years ago|reply
[+] [-] DantesKite|3 years ago|reply
You can have an iron deficiency, even if your hemoglobin levels are normal, because iron does more than just carry oxygen in red blood cells: It's a cofactor for many enzymes.
I'm curious if there's a third variable at play here; something preventing the iron from being accessible (since our bodies normally break down ferritin to access the iron), especially when hemoglobin levels are otherwise normal.
I suspect there might be.
[+] [-] schwartzworld|3 years ago|reply
https://www.hopkinsmedicine.org/neurology_neurosurgery/cente....
[+] [-] cameronh90|3 years ago|reply
[+] [-] Herodotus38|3 years ago|reply
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/
[+] [-] armchairhacker|3 years ago|reply
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.
[+] [-] danachow|3 years ago|reply
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.
[+] [-] unknown|3 years ago|reply
[deleted]
[+] [-] aaaaaaaaaaab|3 years ago|reply
[+] [-] yellowapple|3 years ago|reply
[+] [-] runjake|3 years ago|reply
[+] [-] bpye|3 years ago|reply
[+] [-] astura|3 years ago|reply
https://www.cvs.com/shop/vitamins/minerals/iron
[+] [-] jdadj|3 years ago|reply
[+] [-] DoreenMichele|3 years ago|reply
[+] [-] bilsbie|3 years ago|reply
[+] [-] fasteo|3 years ago|reply
[1] https://my.clevelandclinic.org/health/diseases/9385-low-bloo...
[+] [-] fiatjaf|3 years ago|reply
[+] [-] Hellbanevil|3 years ago|reply
[deleted]
[+] [-] PKop|3 years ago|reply
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|3 years ago|reply
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.
[+] [-] morninglight|3 years ago|reply
[deleted]
[+] [-] unknown|3 years ago|reply
[deleted]
[+] [-] Pakdef|3 years ago|reply
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[+] [-] ElSinchi|3 years ago|reply
Just. Write. An. Effin. Blog. Post.
Long form reading on Twitter is very cumbersome