Guest guest Posted September 2, 2002 Report Share Posted September 2, 2002 Dear or a, I have a question that I'm hoping you can help me with. My hemoglobin has been a little low for months now, and my red blood count as well. Not dangerously, but slightly. My rheumy did an iron level, and my iron is at the very top of the range. Value range Iron total 158 37-158 Iron binding 357 259-388 %Saturation 44.3 16-55 We were checking because he thought the slight anemia might be from low iron levels, but it certainly doesn't look like that's the case. I've read that there is a different type of anemia with chronic autoimmune disease, that's not from low iron. Is that what I must have? What can we do about it? What do these results infer to you? As always, thanks so much. I'm so grateful for your help in navigating the maze of this illness. Much love, Carol Carol Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 2002 Report Share Posted September 2, 2002 Carol, Anemia has many possible causes and comes in many forms. The most common in rheumatic diseases is Anemia of chronic disease (ACD), which is triggered by persistent inflammation. The immune system activates white blood cells and releases various compounds that cause inflammation. These blood cells may be triggered to fight the disease or they may even be part of the disease process itself. White blood cells called macrophages release small put powerful proteins known as cytokines, which are critical in the development of ACD. Cytokines are indispensable for healing. However, often in chronic and inflammatory diseases cytokines are overproduced and cause serious tissue injury and in some cases, even organ damage. Specific cytokines implicated in anemia are interleukin 1 (IL-1), tumor necrosis factor (TNF), and interferons. One theory on cytokines and other immune factors and their role in anemia suggests that they change the dynamics of iron circulation, causing iron to be held back from release into the developing red blood cells in the marrow. In this case, iron stores are high, but the usable iron in circulation is low. In some ACDs (such as chronic kidney failure), cytokines may blunt the effects of erythropoietin (EPO), the hormone that produces red blood cells. http://www.ucdmc.ucdavis.edu/health/a-z/57Anemia/doc57.html The causes of anemia in RA : http://www.arthritis.co.za/raanemia.html Anemia - chronic disease also called Anemia of inflammation http://www.nlm.nih.gov/medlineplus/ency/article/000565.htm Anemia - B12 deficiency http://www.nlm.nih.gov/medlineplus/ency/article/000574.htm Idiopathic autoimmune hemolytic anemia http://www.nlm.nih.gov/medlineplus/ency/article/000579.htm Hematologic, Electrolyte, and Metabolic Disorders: Anemia http://www.vh.org/Providers/ClinRef/FPHandbook/Chapter06/03-6.html My blood tests have always indicated anemia too but I never asked about my iron since I've always been told that anemia and RA are very common. Hope this helps. Hugs, a > Dear or a, > > I have a question that I'm hoping you can help me with. My hemoglobin has > been a little low for months now, and my red blood count as well. Not > dangerously, but slightly. My rheumy did an iron level, and my iron is at > the very top of the range. > > Value range > Iron total 158 37-158 > Iron binding 357 259-388 > %Saturation 44.3 16-55 > > We were checking because he thought the slight anemia might be from low iron > levels, but it certainly doesn't look like that's the case. I've read that > there is a different type of anemia with chronic autoimmune disease, that's > not from low iron. Is that what I must have? What can we do about it? > > What do these results infer to you? > > As always, thanks so much. I'm so grateful for your help in navigating the > maze of this illness. > > Much love, > Carol > > Carol > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 2002 Report Share Posted September 2, 2002 Thank you so much, a, for the really great info! Although I've heard about IL-1 and TNF and their role in RA, I didn't really know all that about cytokines. And I had no idea about the ACD. It's interesting to know it's simply another effect of inflammation. << However, often in chronic and inflammatory diseases cytokines are overproduced and cause serious tissue injury and in some cases, even organ damage.>> What I'm wondering: would ACD translate to a higher chance for joint destruction (because it's caused by overproduction of cytokines)? I hope not. I guess the upside is that the Remicade might improve the ACD, I would guess. One interesting side note is that my MD said he thought my spleen was inflamed, and I read on one of the links about that being a symptom of ACD. When I was first diagnosed, I thought that RA meant joint problems. I didn't realize the systemic effects it encompassed. a, I hope you're doing well! Much love, Carol Re: [ ] Anemia - Iron Level Carol, Anemia has many possible causes and comes in many forms. The most common in rheumatic diseases is Anemia of chronic disease (ACD), which is triggered by persistent inflammation. The immune system activates white blood cells and releases various compounds that cause inflammation. These blood cells may be triggered to fight the disease or they may even be part of the disease process itself. White blood cells called macrophages release small put powerful proteins known as cytokines, which are critical in the development of ACD. Cytokines are indispensable for healing. However, often in chronic and inflammatory diseases cytokines are overproduced and cause serious tissue injury and in some cases, even organ damage. Specific cytokines implicated in anemia are interleukin 1 (IL-1), tumor necrosis factor (TNF), and interferons. One theory on cytokines and other immune factors and their role in anemia suggests that they change the dynamics of iron circulation, causing iron to be held back from release into the developing red blood cells in the marrow. In this case, iron stores are high, but the usable iron in circulation is low. In some ACDs (such as chronic kidney failure), cytokines may blunt the effects of erythropoietin (EPO), the hormone that produces red blood cells. http://www.ucdmc.ucdavis.edu/health/a-z/57Anemia/doc57.html The causes of anemia in RA : http://www.arthritis.co.za/raanemia.html Anemia - chronic disease also called Anemia of inflammation http://www.nlm.nih.gov/medlineplus/ency/article/000565.htm Anemia - B12 deficiency http://www.nlm.nih.gov/medlineplus/ency/article/000574.htm Idiopathic autoimmune hemolytic anemia http://www.nlm.nih.gov/medlineplus/ency/article/000579.htm Hematologic, Electrolyte, and Metabolic Disorders: Anemia http://www.vh.org/Providers/ClinRef/FPHandbook/Chapter06/03-6.html My blood tests have always indicated anemia too but I never asked about my iron since I've always been told that anemia and RA are very common. Hope this helps. Hugs, a > Dear or a, > > I have a question that I'm hoping you can help me with. My hemoglobin has > been a little low for months now, and my red blood count as well. Not > dangerously, but slightly. My rheumy did an iron level, and my iron is at > the very top of the range. > > Value range > Iron total 158 37-158 > Iron binding 357 259-388 > %Saturation 44.3 16-55 > > We were checking because he thought the slight anemia might be from low iron > levels, but it certainly doesn't look like that's the case. I've read that > there is a different type of anemia with chronic autoimmune disease, that's > not from low iron. Is that what I must have? What can we do about it? > > What do these results infer to you? > > As always, thanks so much. I'm so grateful for your help in navigating the > maze of this illness. > > Much love, > Carol > > Carol > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 2002 Report Share Posted September 2, 2002 You¹re very welcome Carol. TNF and IL-1 ARE cytokines. Recent studies have shown that the IL-1¹s are more damaging to the tissues. RA is characterized by an overabundance of pro-inflammatory cytokines, and inadequate anti-inflammatory cytokines. They are looking at ways to correct this imbalance, but it is difficult since the levels of inflammation changes from day to day. I¹m not sure which came first, the chicken or the egg. My best guess is that although your body has sufficient iron, it cannot be used by the body. Every system in our body is like a clock. If one part malfunctions, it causes a chain reaction of other problems. Just wish someone would get to the bottom of the ladder and fix the root of the problem. I also didn¹t realize the systemic effects of RA until the internet. Hugs, a > Thank you so much, a, for the really great info! Although I've heard > about IL-1 and TNF and their role in RA, I didn't really know all that about > cytokines. And I had no idea about the ACD. It's interesting to know it's > simply another effect of inflammation. > > << However, often in chronic and inflammatory diseases cytokines are > overproduced and cause serious tissue injury and in some cases, even organ > damage.>> > > What I'm wondering: would ACD translate to a higher chance for joint > destruction (because it's caused by overproduction of cytokines)? I hope > not. I guess the upside is that the Remicade might improve the ACD, I would > guess. One interesting side note is that my MD said he thought my spleen > was inflamed, and I read on one of the links about that being a symptom of > ACD. When I was first diagnosed, I thought that RA meant joint problems. I > didn't realize the systemic effects it encompassed. > > a, I hope you're doing well! > > Much love, > > Carol > > > Re: [ ] Anemia - Iron Level > > Carol, > Anemia has many possible causes and comes in many forms. The most common in > rheumatic diseases is Anemia of chronic disease (ACD), which is triggered by > persistent inflammation. > The immune system activates white blood cells and releases various compounds > that cause inflammation. These blood cells may be triggered to fight the > disease or they may even be part of the disease process itself. > White blood cells called macrophages release small put powerful proteins > known as cytokines, which are critical in the development of ACD. > Cytokines are indispensable for healing. However, often in chronic and > inflammatory diseases cytokines are overproduced and cause serious tissue > injury and in some cases, even organ damage. Specific cytokines implicated > in anemia are interleukin 1 (IL-1), tumor necrosis factor (TNF), and > interferons. > One theory on cytokines and other immune factors and their role in anemia > suggests that they change the dynamics of iron circulation, causing iron to > be held back from release into the developing red blood cells in the marrow. > In this case, iron stores are high, but the usable iron in circulation is > low. In some ACDs (such as chronic kidney failure), cytokines may blunt the > effects of erythropoietin (EPO), the hormone that produces red blood cells. > http://www.ucdmc.ucdavis.edu/health/a-z/57Anemia/doc57.html > > The causes of anemia in RA : > http://www.arthritis.co.za/raanemia.html > > Anemia - chronic disease also called Anemia of inflammation > http://www.nlm.nih.gov/medlineplus/ency/article/000565.htm > > Anemia - B12 deficiency > http://www.nlm.nih.gov/medlineplus/ency/article/000574.htm > > Idiopathic autoimmune hemolytic anemia > http://www.nlm.nih.gov/medlineplus/ency/article/000579.htm > > Hematologic, Electrolyte, and Metabolic Disorders: Anemia > http://www.vh.org/Providers/ClinRef/FPHandbook/Chapter06/03-6.html > > My blood tests have always indicated anemia too but I never asked about my > iron since I've always been told that anemia and RA are very common. > Hope this helps. > Hugs, > a > > > > >> > Dear or a, >> > >> > I have a question that I'm hoping you can help me with. My hemoglobin has >> > been a little low for months now, and my red blood count as well. Not >> > dangerously, but slightly. My rheumy did an iron level, and my iron is at >> > the very top of the range. >> > >> > Value range >> > Iron total 158 37-158 >> > Iron binding 357 259-388 >> > %Saturation 44.3 16-55 >> > >> > We were checking because he thought the slight anemia might be from low > iron >> > levels, but it certainly doesn't look like that's the case. I've read > that >> > there is a different type of anemia with chronic autoimmune disease, > that's >> > not from low iron. Is that what I must have? What can we do about it? >> > >> > What do these results infer to you? >> > >> > As always, thanks so much. I'm so grateful for your help in navigating > the >> > maze of this illness. >> > >> > Much love, >> > Carol >> > >> > Carol >> > >> > >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 2002 Report Share Posted September 2, 2002 on 9/2/02 7:51 PM, a at paula54@... wrote: > Anemia has many possible causes and comes in many forms. The most common in > rheumatic diseases is Anemia of chronic disease (ACD), which is triggered by > persistent inflammation. Last year I had iron-deficiency anemia. I was taking methotrexate, prednisone, and a double dose of Aleve. The PCP said that since both my HCT and HGB were low, I was probably having blood loss. I had been having mild stomach discomfort, so he assumed that I had an ulcer. My iron level was 35 (normal 42-135) and saturation was 12 (normal 20-55). I stopped taking Aleve and took samples of Prevacid and Prevacid as well as prescription iron for a few months. My HCT, HGB, and iron levels returned to normal. But that prescription iron gave me such an appetite! That's how I managed to gain weight instead of lose while undergoing radiation treatments. I really think that the ulcer was a blessing in disguise. Sue Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.