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Determining Sports Anemia (pseudo-anemia) vs iron deficiency?

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Determining Sports Anemia (pseudo-anemia) vs iron deficiency?

Old 05-26-14, 09:38 AM
  #1  
Drew Eckhardt 
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Determining Sports Anemia (pseudo-anemia) vs iron deficiency?

My doctor noted low hematocrit, hemoglobin, and red blood cell counts at my last appointment and wants me to see a gastroenterologist which I understand because men usually don't suffer from iron deficiency. Internal bleeding is a common cause when meat-eaters do.

However my pattern of low and regular numbers correlates perfectly with when I've had a training plan and pseudo-anemia from increased plasma volume is a common side effect of training for endurance sports - athletes have enough iron, it's just diluted. Six days worth of poop also passed the occult blood screen making that less likely.


What do I point my doctor or the GI at to make a reasonable determination between sports (pseudo) anemia and actual low iron levels? Perhaps a ferritin test would be enough because the huge "normal" range outweighs 10% dilution?

4/21/09 and 9/2/09 I'd decayed into middle age and yet to try to be less slow.

12/18/12 I was also lapsed.

2/1/11 I was at my middle aged peak, and when they bled me this month I was about six months into getting back into decent shape

[TABLE]
[TR]
[TD][/TD]
[TD]4/21/09[/TD]
[TD]9/2/09[/TD]
[TD]2/1/11[/TD]
[TD]12/18/12[/TD]
[TD]5/19/14[/TD]
[/TR]
[TR]
[TD]Hematocrit[/TD]
[TD]42.6[/TD]
[TD]42.8[/TD]
[TD]40.1[/TD]
[TD]43.3[/TD]
[TD]39.5[/TD]
[/TR]
[TR]
[TD]Hemoglobin[/TD]
[TD]14.7[/TD]
[TD]14.4[/TD]
[TD]13.4[/TD]
[TD]14.6[/TD]
[TD]13.5[/TD]
[/TR]
[TR]
[TD]RBC[/TD]
[TD]4.74[/TD]
[TD]4.73[/TD]
[TD]4.30[/TD]
[TD]4.71[/TD]
[TD]4.30[/TD]
[/TR]
[/TABLE]

Last edited by Drew Eckhardt; 05-26-14 at 10:17 AM.
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Old 05-26-14, 09:49 AM
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It could be this.

It could be that.

It could be lots of stuff.

Your doctor isn't willing to make a wrong assessment.

Given that the differential diagnosis involves colon cancer, how risk-tolerant are you when it comes to your health and well-being?
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Old 05-26-14, 09:58 AM
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Your doctor knows what to do.
If you need a good source of iron, I've found out that in some of the 100% cocoa dark chocolate bars for cooking, there is as much as 80% of the daily iron intake in just 2 small chocolate squares

Last edited by erig007; 05-26-14 at 10:04 AM.
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Old 05-27-14, 12:51 PM
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Originally Posted by Dudelsack View Post
It could be this.

It could be that.

It could be lots of stuff.

Your doctor isn't willing to make a wrong assessment.

Given that the differential diagnosis involves colon cancer, how risk-tolerant are you when it comes to your health and well-being?
I'm OK with a 1 in 100 annual fatality rate in sporting contexts. Colon cancer killed 12 out of 2602 colonscopy patients who had polyps removed in the New England Journal of Medicine over 23 years versus 25.4 in the general population which is orders of magnitude lower risk.

If I'm going to quickly get to an actual iron deficiency (or not) call I'll do that because I'd welcome a fix leading to increased capacity to exercise or energy when I've fallen off the training wagon. Guidance in getting doctors there (blood tests to order, suggestions of seeing a sports medicine person, etc. ) would be appreciated.

Otherwise I've exceeded my annual appointment every 18 months limit.

Last edited by Drew Eckhardt; 05-27-14 at 05:51 PM.
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Old 05-28-14, 07:31 AM
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What's the normal range for those numbers? Your hematocrit looks fine to me, but then again I had a hematocrit level of 17 a bit a year ago. Made racing bicycles a bit difficult... (I tracked my diet and found I was seriously iron-deficient...)
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Old 05-28-14, 01:08 PM
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You could try eating more liver, I suppose? Lay off the coffee or tea a while to increase absorption. I'm taking your idea to mean that you could benefit from larger stores.

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