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Old 02-02-2014, 02:17 PM   #1
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Diabetes and anemia NOT from monthly cycle

My brother just told me that his latest blood test showed Hgb of 11.1. This really upset me because he's been diabetic for the past 20 years (Type2) and I'm very worried about kidney disease. He told me that he's always been slightly anemic because he has ulcerative colitis and bleeding hemorrhoids, but he hasn't noticed any bleeding for quite a while (its always been very apparent, as opposed to occult blood in the stool). He gets a colonoscopy every year and he's now due. I didn't want to upset him by telling him my concerns, but I did ask him about his kidney function results and he said they were normal. If the anemia was due to his kidneys, would those numbers be elevated? His doctor recently doubled his metformin dose and as a result, he immediately suffered from nausea, vomiting and diarrhea for over a week. He cut back on the Metformin and feels a little better, but I'm now wondering if he actually had some kind of stomach bug that coincidentally coincided with his increased Metformin because he said his white cell count was slightly elevated. If that's the case, maybe there was some bleeding along with his diarrhea that he didn't see. I'm mainly concerned about his kidneys at this point. If his kidney function tests are normal, would this rule them out as a cause for his anemia? Any insight you could give me would be greatly appreciated. FYI, he has an appointment with his endocrinologist tomorrow. Thank you.
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Old 02-03-2014, 06:52 AM   #2
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I don't anything about kidney problems and won't even attempt to remark about it but I do know that an A1c of 11.1 is very high. It is equivalent to an average blood glucose reading of 272. That alone would scare me.

If he is having a problem with metformin maybe his Dr. could prescribe the extended release form. Some people do much better with it. And make sure he takes it with his meal, even midway through the meal to help keep the side effects to a minimum.

And as I suggest to everyone who is concerned about diabetes get a copy of Dr. Bernstein's Diabetes Solution. It has been my map to success in controlling diabetes.
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Old 02-03-2014, 08:16 AM   #3
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Quote:
Originally Posted by Jrw85705 View Post
I don't anything about kidney problems and won't even attempt to remark about it but I do know that an A1c of 11.1 is very high. It is equivalent to an average blood glucose reading of 272. That alone would scare me.

If he is having a problem with metformin maybe his Dr. could prescribe the extended release form. Some people do much better with it. And make sure he takes it with his meal, even midway through the meal to help keep the side effects to a minimum.

And as I suggest to everyone who is concerned about diabetes get a copy of Dr. Bernstein's Diabetes Solution. It has been my map to success in controlling diabetes.
His A1c isn't 11.1, his Hemoglobin is (Hgb). Normal Hgb for a man is around 13. I believe his A1c was 8, which is the highest it's been for him for a while. My concern is his anemia. I know Metformin can also cause B12 deficiency which can lead to anemia, but he really hasn't been on it that long.
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Old 02-04-2014, 01:47 AM   #4
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There's definitely more than one type of anemia. Do you know the bottom and top range numbers for the Hgb test?

I found out about 7 years ago that I have mild hemolytic anemia. It's either heredity or an autoimmune condition. I'm not sure which mine is but I have another autoimmine thing going on also which is Hashimoto's Thyroiditis and I'm hypothyroid. Although, it could be heredity too but I don't know. Both my dad and uncle were slightly anemic but I don't know what kind. I've found that the older generation (now deceased) don't tend to question things as much and have blind faith in their doctors. Hemolytic anemia is where the reticulocytes (immature [young] blood cells) die off early. My blood cells also don't look like normal ones. Luckily I have a mild case. I take folic acid 2x/day for it per my doctor.

They did extensive testing every couple of weeks for about 6 weeks to come to that diagnosis. Before all the blood tests they tried iron pills, then B12. When those didn't have the results they thought they should have, I was referred to a specialist.

I checked my results for the last 6 years and the bottom of their lab's Hgb range is 11.5. I was always under the range. In the beginning I was in the low 10's. The last one was 11.0 (still a little under). I think I had every blood test they do, at least it seemed like it at the time. Each time it was 5-7 vials. He even went so far as to test for leukemia which was a surprise to me. I think the only way I found that out was because that vial looked different than all the rest. It was long and very skinny and had a lavender top and I asked what that one was.

He could definitely get more blood tests to pinpoint his anemia. It's always good to know so we can do something about it.
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Old 02-04-2014, 07:35 AM   #5
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Thank you for your comprehensive reply, Watcher. I don't know what the ranges are on my brother's blood test regarding the Hgb, but I do know 11.1 is low, especially for a man. Yesterday the doctor took more blood to test my brother's iron and B12 levels plus more which he didn't specify. I did some research and read that many diabetics are low in B12 especially if they take Metformin, which can deplete B12 stores. I'm hoping that's the cause of his anemia as it's my understanding that treatment is simply B12 injections. He also has ulcerative colitis which can further deplete B12. We'll see what the blood test shows. You have a good doctor who is thorough; I thank you again for your input.
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Old 02-05-2014, 01:46 AM   #6
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That good doctor I have works in the oncology/hemotology department. I remember when I was referred to him, I was told not to freak out when the oncology department called to set up the appointment. I'm glad they warned me. It just happens to be where they work.

I used to have B12 shots every 4 weeks like clockwork for about 2-3 years. About the 3rd week after the shot I could Feel tiredness coming on. Then they decided to have me try OTC sublingual B12 tablets (2500 mcg.) for 3 months to see how it worked. My thought about it was that they were trying to free up the nurses time who gave the shots, but I'm not sure if that was the case or not. It did work for me and keeps my levels up. I take them about 3-4 days a week and that seems to be enough. Under the tongue it dissolves in about a minute.

It's a thought instead of shots. I get them at Costco but every pharmacy has them.

Last edited by watcher513; 02-05-2014 at 01:47 AM..
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Old 02-05-2014, 06:59 AM   #7
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If his anemia is due to low B12 I'll definitely share that with him, thank you again!
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Old 02-15-2014, 07:34 PM   #8
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Does anyone know how long it takes to not feel tired after you start taking B12? My numbers plummeted this past year when I had to stop eating dairy due to an allergy. The Dr. started me on 1,000 mcg's of Vit. B12 a few weeks ago. I'm still exhausted, fuzzy thinking, depression. I've got too much to do so this needs to be over. :-)
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Old 02-17-2014, 04:10 AM   #9
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Grammy G, I'm also Hashi's/hypothyroid so I'd have to think about if it was from my thyroid hormone replacement needing adjustment or is it my B12 level being off. A tricky one for sure for me.
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