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Dr. Andrew Rynne

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Suggest alternative treatment for low ferritin levels while having thalassemia

Answered by
Dr.
Dr. Monish De

Oncologist

Practicing since :2004

Answered : 1908 Questions

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Posted on Thu, 4 Oct 2018 in Blood Disorders
Question: have thallesemia since i was 18 now 35 and on thyroid medication since 2012. i cant get my iron levels up heavy ectopics from thyroid ive figured . indont eat much meat and worried iron tablets give me ectopics as i had them last time and scared to take them again. as im constipated as it is. my ferritin in now 12. Is this too low and danverious and how do i get it up ? Ive tried it all i feel.
doctor
Answered by Dr. Monish De 41 minutes later
Brief Answer:
Increase your ferritin levels by having plant-based foods.

Detailed Answer:

Hi,

After hearing your history I would say your ferritin level is on the lower side.

Normal ferritin levels range from 12 to 300 nanograms per milliliter of blood (ng/mL) in males.

Ferritin is a protein that stores iron releasing it when your body needs it.

It usually lives in your body's cells with very little actually circulating in your blood.

Ferritin contains 20 per cent iron.

The greatest amount of ferritin is in the liver and immune system.

Ferritin is stored in the body’s cells until its time to make more red blood cells.

The body signals the cells to release ferritin.

This ferritin then binds to another substance called transferrin.

Transferrin is a protein that combines with ferritin to transport it to where new red blood cells are made.

While it is important for a person to have normal iron levels having enough stored iron is important too.

If a person does not have enough ferritin iron stores can deplete quickly.

If your results are lower than normal you have iron deficiency and possibly anemia.

As your iron tablets are giving you ectopics and constipation I would advise you to increase your ferritin levels by having plant-based foods.

You can have broccoli, asparagus and dark leafy greens such as spinach, collards and XXXXXXX which are the richest iron sources among vegetables while lima beans and kidney beans are iron-rich legumes.

If you have any more queries I will be glad to help.

Regards.
Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Monish De 10 minutes later
i have been plant based for 6 months once and no real improvement. i also ate liver for 3 months no rral improvment either. i am aneamic and aware if my body but as a professional is my results low? how to fix it? i will attach my results as of today please review and let me know
doctor
Answered by Dr. Monish De 16 minutes later
Brief Answer:
Eat fruits rich in vitamin C and cook your food in cast iron utensils.

Detailed Answer:

Hi,

I have seen your attached reports.

Your ferritin level is low.

Since you have taken plant-based foods and iron tablets my advise you to increase ferritin level would be to eat the animal source from lean meat, chicken, eggs, oysters, crabs, fish, pork, liver etc.

You can also take dried fruits such as figs and dates also contain iron in sufficient amount.

Wheat germ whole grains such as brown rice has plenty of iron in them.

You can take vitamin C.

Vitamin C is important as it facilitates easy absorption of iron from the intestine.

You can eat fruits which are naturally packed with abundant vitamin C.

Fruits such as oranges, kiwi, grapefruits, strawberry, blueberry have a rich amount of vitamin C.

You need to cook your food in iron Pots.

Cooking your food in cast iron utensils adds the iron value of food.

Foods that have high moisture content can easily absorb iron from the utensil when it is being cooked.

Avoid foods that hamper iron absorption like alcohol and caffeine which can interfere with the absorption of iron, so avoid them when you are on iron therapy.

Calcium is known to affect the rate of iron absorption. Therefore if you are taking calcium supplements keep an interval of at least six hours after eating iron-rich food or after taking an iron supplement.

If you have any more queries I will be glad to help.

Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Monish De 6 minutes later
my question is simple. am i in dangerous results? are my results ok? remmeber im 10 yrs if anemia and have tried it all amd how often should i eat meat? would ypu like to see my thyroid result will they matter ? i really want to get on tip of this amd feel better as i have heavy periods what will be the best route to take to improve this ?
doctor
Answered by Dr. Monish De 1 hour later
Brief Answer:
Your ferritin level is not at a dangerous level.

Detailed Answer:

Hi,

Your ferritin level is not in dangerous level.

I would like to see your thyroid results.

As you are having a heavy period you can take Tranexamic Acid tablet with your doctor's advise.

If you have any more queries I will be glad to help.

Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Monish De 14 minutes later
this is my last question please answer thoroughly and all questions as i wont get you again after this. whats a dangerous level? can my level give me ectopics? . am i anemic would you say? anything else to get it up fast or is it just diet or iron tablets from yoir opinion as a hemotologist? tsh 5.7 t4 12.9 t3 3.2 endocrinologist said to stay on same dose and see him in 2 mths again.
doctor
Answered by Dr. Monish De 19 minutes later
Brief Answer:
Ferritin levels 15 or less is considered dangerous level.

Detailed Answer:

Hi,

Ferritin levels 15 or less is considered dangerous level.

You are anemic.

Ectopics are not related to ferritin.

It is related to a thyroid problem and low salt in the body.

I will advise you to do an echocardiography test.

For reducing ectopics you can reduce alcohol and caffeine, avoid fizzy drinks with caffeine, stop smoking, avoid or reduce stress, do not take beta blockers group of drugs like Bisoprolol, Propranolol, Metoprolol and calcium channel blockers like Verapamil or Diltiazem.

Your TSH is 5.7 which is high could be a cause of ectopic heartbeat.

You need to take the correct dose of Levothyroxine Sodium with your doctor's advise.

You also need to check your blood salts which are blood for sodium and potassium.

Proper diet as advised above will bring back your ferritin level and anemia to normal.

If you have any more queries I will be glad to help.

Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Monish De 15 minutes later
i saw my endocrinologist today and said my tsh was just over amd could have been because i took my medication then had my blood test as i should withhold meds before blood test hence why it could have been 5.7. as 5 is within range. i have seen a cardiologist amd electrophysiologist 2 holters and ecg and two echocardiograms. heart is structurally normal and healthy. i eat very healthy no smoke drink. what is good toneat for low blood salts? also you said 15 or less is dangerous my ferritn is sitting at 12l as of today as the results i sent. how do i get better ? optimal health?
doctor
Answered by Dr. Monish De 10 minutes later
Brief Answer:
Sprinkle salt on salads, sandwiches, vegetables or fruit to increase sodium.

Detailed Answer:

Hi,

If you are having low blood salts then you can reduce your intake of water to raise your sodium levels in your blood.

Water that you drink is absorbed in your blood and reduces the overall concentration of sodium and other electrolytes in your bloodstream.

Therefore drinking less water will prevent dilution and raise the concentration of sodium in your blood stream.

You should also take a sports drink that contains sodium.

Sports beverages contain sodium in addition to other electrolytes and may be necessary if your sodium levels are low.

You also need to add additional salt to the foods you eat to increase the sodium levels in your blood stream.

Additional sodium that you add to your foods will be absorbed in your digestive tract and absorbed by your blood stream.

Eat low-calorie foods to prevent weight gain.

Sprinkle salt on salads, sandwiches, vegetables or fruit to increase sodium intake.

As your ferritin is low taking the above-mentioned diet will bring back it to its normal level by 3 months.

If you have any more queries I will be glad to help.

Regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Monish De 42 minutes later
ypu said anything lower than 15 of ferritin is dangerous. mine is 12. again ive tried it doesnt go up!
doctor
Answered by Dr. Monish De 1 hour later
Brief Answer:
Intravenous vitamin B12 injections.

Detailed Answer:

Hi,

As your ferritin is in less than 15 and you have taken iron-rich diet along with iron supplements to increase it but still it persists I will advise you to go for intravenous vitamin B12 injections.

You may receive this injection directly in your vein so that goes in your bloodstream.

You may consult your local doctor regarding it.

If you have any more queries I will be glad to help.

Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monish De 37 minutes later
ypu said my ferritin isnt at a dangerois level at first then said below 15 is. i hope you rlare listening to ly concerms as i cant afford a hemotologist. i habe had b12 shots also. how does b12 give me better iron when my iron is low not my b12? what you you suggest for me to do going forward having my results?
doctor
Answered by Dr. Monish De 21 minutes later
Brief Answer:
Consume food which contains rich sources of ferritin.

Detailed Answer:

Hi,

Your ferritin is on the lower side as I mentioned before.

Anything less than 15 is considered dangerous because it can lead to symptoms like loss of appetite, pale skin, rapid heart rate, headache, fatigue and weight loss.

The only way to increase it other than iron injections and supplements is by consuming food such as beef, liver, poultry and seafood.

Plant sources include pulses and beans, such as chickpeas, lentils, red kidney beans, navy beans, soybeans and lima beans.

You can have vegetables like spinach, potatoes, tomatoes, turnip greens, peas, beet greens and mushrooms.

You could snack on nuts and dried fruits to increase your ferritin levels.

Also, you need to cook your food in iron pots.

Cooking your food in cast iron utensils adds the iron value of food.

Foods that have high moisture content can easily absorb iron from the utensil when it is being cooked.

On average if you take your diet as mentioned by me then ferritin level will come back to normal range within 4 weeks.

If you have any more queries I will be glad to help.

Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monish De 7 hours later
i have thallesemia also.
doctor
Answered by Dr. Monish De 6 hours later
Brief Answer:
Proper diet can only bring your ferritin level back to normal.

Detailed Answer:

Hi,

I know you have thalassemia.

I hope you are undergoing regular blood transfusions with the advice of your doctor.

As you are having thallesemia you must be careful taking vitamins that contain iron.

If you are receiving blood transfusions then your body receives extra iron that the body cannot easily get rid of.

Iron can build up in tissues which can be potentially fatal.

So if you are receiving a blood transfusion as part of your treatment you may also need chelation therapy.

This generally involves receiving an injection of a chemical that binds with iron and other heavy metals.

This helps remove extra iron from your body.

That is why proper diet containing sufficient ferritin as mentioned by me above is needed in your case to normalize your low ferritin level.

Hope I have answered queries.

Regards,
Dr. Monish De, Oncologist
Above answer was peer-reviewed by : Dr. Kampana
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