Pallor. Fatigue. Decreased exercise tolerance. light-headedness. Orthostatic symptoms. Young female.
What does that spell?
I mean, it seems awfully obvious in retrospect (and doesn’t everything?). But this has probably been going on for ages. Was always a pale kid, didn’t spend much time outside, and was constantly praised for my paper-white skin (“You’ll never get wrinkles!” “You’ll never get skin cancer!”). I was never totally athletic, though I’ve picked up running (very, very light running, mind you) over the last few years and when I started to get light-headed or began puffing like crazy over the last few months, I was told I should probably work out more. Probably deconditioned.
Not so much, apparently.
I started to put the pieces together seriously after a recent lecture on the differential for anemia. When I went back to study, I listed off the symptoms in my head and thought, “Gee whiz and golly, that sounds awful familiar, don’t it?”
So I went to get it checked out. (Which is more difficult than you might think – taking an hour off to go to walk-in in the middle of internal medicine is challenging, to say the least. Never mind taking time to get bloodwork, go to the follow-up appointment, go get the prescription…) And the pieces just kept falling into place. The history fit. The physical fit (conjunctival pallor, anyone?). And finally the labwork fit.
And I couldn’t have been more thrilled.
I had a reason to be tired. A reason to feel like my brain’s foggy and sluggish. To feel terrible after climbing a single flight of stairs. I know there are lots of people out there who suffer from fatigue who don’t have the luxury of an obvious iron deficiency, so I was a bit excited that I had a potentially reversible cause for all these things. (In case you’re curious: hemoglobin 109, ferritin 2.)
Problem is, the solution is more iron. And, as anyone who’s ever been on oral iron knows, taking iron pills kinda sucks. They have a notorious side effect profile in causing abdominal pain, constipation, and pretty much every other GI complaint. These are especially prominent in the iron salts like ferrous sulfate and ferrous fumarate. However, I’ve been lucky enough to be able to afford one of the newer versions where the iron is actually complexed to a sugar so I should hopefully have fewer issues. (This means it’s preferentially absorbed in the small intestine, rather than the stomach, so you run into fewer problems with side effects and poor absorption due to pH fluctuations. Sorry. It’s just pretty cool science.) So far just a bit of nagging belly pain, but maybe that’ll fade with time?
And I’ve already noticed the difference! Just being able to go for a full 30-minute workout again has been amazing, never mind jogging up stairs without feeling woozy. I’m not quite there yet – my heart still pounds when walking fast for more than a block and I still can’t tolerate very much running – but it’ll take weeks and months to correct, so I have to be happy with my progress so far.
This has been another trip to the strange, alternate universe of patient care. Brought to you by Hemoglobe Inc – Moving You and Your Body! (Unless you don’t feed us iron. Then you better move your own butt, Whiny.)
Photo courtesy of: David Castillo Dominici | FreeDigitalPhotos.net