Mild anemia, but not mild symptoms
May 28, 2017 6:21 PM Subscribe
It's a holiday weekend. I am weak, dizzy, exhausted, bleeding, and apparently mildly anemic. Trying to figure out what to do from here.
For the past few weeks, I've been getting dizzy spells that have been getting progressively worse. I feel it in my eyes--my eyes feel heavy and tired, and sometimes I get this rushing feeling in my head that makes the dizziness markedly worse. I've also been sick nonstop this year, so a doctor on Friday ordered extensive blood work (eight vials, to be exact!) and my PCP informed me today that I'm "a little" anemic (yes, on a sunday). My hemoglobin was 10.8 and my hematocrit was 35%. Normal for hemoglobin is apparently 11.2, and 34% for hematocrit, so I'm normal but low.
I've had the nexplanon since January. I've been bleeding since early February. It has been light overall but completely nonstop. At times it gets heavy (like right now; how convenient). I'm assuming this is the source of my woes but I'm not sure.
Here's my concern. My symptoms feel out of proportion to the numbers. It is disabling and it has gotten markedly worse the past few days. I'm terribly dizzy. It used to come in spells but the past few days it's been all the time. I've tried eating sugary snacks when it sets in. I've tried loading up on decongestants in case my ears are playing a role. Nothing works. And I'm exhausted, in spite of sleeping ten hours a night. My eyes are so heavy all the time. I'm in a daze. I'm sure I should be feeling a little crappy, but if I'm only a little anemic, should I feel THIS crappy?
She wants to repeat the CBC and run some other stuff, like folate, B12, ferritin, etc. I can't do that until Tuesday, and I likely wouldn't be able to start treatment until Wednesday. Given how bad I feel I don't know HOW I'm gonna last that long. I'd rather not go to emergency, and I'm not sure if urgent care can help? (Though please tell me if they can and I'll go!) I generally just don't know what to do and it's making me really anxious.
If you've been anemic, is this what it's like? A little peace of mind even would be helpful. I've never been anemic before (nor have I bled nonstop for almost four months before) so the extent of the dizziness/tiredness is bugging me out. I also, again, feel markedly worse than I did a few days ago (say, Thursday, though I've felt off for a while now) which is making it worse.
Thanks in advance.
For the past few weeks, I've been getting dizzy spells that have been getting progressively worse. I feel it in my eyes--my eyes feel heavy and tired, and sometimes I get this rushing feeling in my head that makes the dizziness markedly worse. I've also been sick nonstop this year, so a doctor on Friday ordered extensive blood work (eight vials, to be exact!) and my PCP informed me today that I'm "a little" anemic (yes, on a sunday). My hemoglobin was 10.8 and my hematocrit was 35%. Normal for hemoglobin is apparently 11.2, and 34% for hematocrit, so I'm normal but low.
I've had the nexplanon since January. I've been bleeding since early February. It has been light overall but completely nonstop. At times it gets heavy (like right now; how convenient). I'm assuming this is the source of my woes but I'm not sure.
Here's my concern. My symptoms feel out of proportion to the numbers. It is disabling and it has gotten markedly worse the past few days. I'm terribly dizzy. It used to come in spells but the past few days it's been all the time. I've tried eating sugary snacks when it sets in. I've tried loading up on decongestants in case my ears are playing a role. Nothing works. And I'm exhausted, in spite of sleeping ten hours a night. My eyes are so heavy all the time. I'm in a daze. I'm sure I should be feeling a little crappy, but if I'm only a little anemic, should I feel THIS crappy?
She wants to repeat the CBC and run some other stuff, like folate, B12, ferritin, etc. I can't do that until Tuesday, and I likely wouldn't be able to start treatment until Wednesday. Given how bad I feel I don't know HOW I'm gonna last that long. I'd rather not go to emergency, and I'm not sure if urgent care can help? (Though please tell me if they can and I'll go!) I generally just don't know what to do and it's making me really anxious.
If you've been anemic, is this what it's like? A little peace of mind even would be helpful. I've never been anemic before (nor have I bled nonstop for almost four months before) so the extent of the dizziness/tiredness is bugging me out. I also, again, feel markedly worse than I did a few days ago (say, Thursday, though I've felt off for a while now) which is making it worse.
Thanks in advance.
Feeling anxious is a symptom of anemia. Just FYI.
Uh, that said, I'm not sure what's going on but I suggest having your doctor paged for some advice, or maybe heading straight to the ER? Deep breaths while you sort this out.
posted by jbenben at 6:36 PM on May 28, 2017
Uh, that said, I'm not sure what's going on but I suggest having your doctor paged for some advice, or maybe heading straight to the ER? Deep breaths while you sort this out.
posted by jbenben at 6:36 PM on May 28, 2017
IANYD, but I doubt that it's the anemia alone that is causing you to feel this way, especially because you've been bleeding for a longer period of time as opposed to losing a large amount of blood suddenly, and because your numbers aren't really that horrible. A number of things could be causing your symptoms, and only a doctor who has examined you in person and reviewed your test results could help you, but it doesn't sound like anemia to me. I hope you feel better soon and get to the bottom of it!
posted by gemutlichkeit at 6:42 PM on May 28, 2017 [1 favorite]
posted by gemutlichkeit at 6:42 PM on May 28, 2017 [1 favorite]
Oh. I just googled nexplanon -- WHAT IS GOING ON WITH YOUR DOCTOR?? Bleeding for four months is not OK?!
Your insurance has a nurse helpline, right? Call them right now and ask about this. I am not a doctor, but you need treatment, like yesterday, and if your birthcontrol is causing this you want it removed asap. I know you're likely not thinking clearly right now, but I think 4 years of birth control is not worth what you are going through, and this reaction (if it is a reaction to the implant) sounds very serious. I really think you need to go to the ER, but see if you can get in touch with your nurse helpline first. Takecare of yourself, don't wait.
posted by jbenben at 6:45 PM on May 28, 2017 [4 favorites]
Your insurance has a nurse helpline, right? Call them right now and ask about this. I am not a doctor, but you need treatment, like yesterday, and if your birthcontrol is causing this you want it removed asap. I know you're likely not thinking clearly right now, but I think 4 years of birth control is not worth what you are going through, and this reaction (if it is a reaction to the implant) sounds very serious. I really think you need to go to the ER, but see if you can get in touch with your nurse helpline first. Takecare of yourself, don't wait.
posted by jbenben at 6:45 PM on May 28, 2017 [4 favorites]
I've had the nexplanon since January. I've been bleeding since early February.
I am not a doctor and this is not medical advice, but I wonder if perhaps you and the nexplanon are not a good match. I would set up an appointment with your OB-GYN, and look into getting this device possibly removed.
Four months of nonstop nausea and bleeding (especially going into the summer months) is just not worth it, especially in this day and age when women have so many birth control options available.
On preview: what jbenben said.
posted by invisible ink at 6:46 PM on May 28, 2017
I am not a doctor and this is not medical advice, but I wonder if perhaps you and the nexplanon are not a good match. I would set up an appointment with your OB-GYN, and look into getting this device possibly removed.
Four months of nonstop nausea and bleeding (especially going into the summer months) is just not worth it, especially in this day and age when women have so many birth control options available.
On preview: what jbenben said.
posted by invisible ink at 6:46 PM on May 28, 2017
I had anemia so badly that my hemoglobin was something absurd like 3 when I was a teenager, also the result of an unending light period. I literally fell asleep standing up in a work meeting once. I did not experience the dizziness or anxiety you are mentioning. I am not a doctor, only a fellow anemic period sufferer, but this sounds super disproportionate and like something else is going on.
The only other thing I can think of is that you perhaps used to have *much* higher iron and hemoglobin and their rapid decline is the cause: therefore while the number is not absolutely low it maybe be relatively very very low for you.
posted by hepta at 6:50 PM on May 28, 2017 [1 favorite]
The only other thing I can think of is that you perhaps used to have *much* higher iron and hemoglobin and their rapid decline is the cause: therefore while the number is not absolutely low it maybe be relatively very very low for you.
posted by hepta at 6:50 PM on May 28, 2017 [1 favorite]
I've been on and off low to medium anemic ever since puberty (and possibly before then but was never tested for it). It contributes a lot to my other since-puberty problem of depression and passive suicidal ideation, and of course one can be a symptom of the other!
What I've learned over the years is that anemia is a sneaky thing. It can be caused by many underlying things as well as cause many others, and it can become a cycle too. Combined with the lack of concrete data we have about something as common as irregular menstrual cycles that sets a lot of us up for misdiagnoses and doctors ignoring us when we tell them how we feel. There is also this thing where anemia symptoms can happen from a lack of micronutrients like magnesium and copper so you get tested and the numbers say you aren't anemic but absolutely everything else points to it. Simply put, manufacturing our own blood is a damn complicated process and there are lots of places for it to get out of whack and the tools doctors have to analyze it are pretty blunt still.
Although your description of symptoms don't seem entirely out of possibility for anemia there are two things that concern me. First is of course the bleeding for four months, that is not something that you should be ignoring. It may or may not be related to whatever else is going on but could certainly cause low level anemia I would think, but it also just means something is off with that system and you need to have a good obgyn take a look at you. But second and more concerning is the speed at which it seems your symptoms have changed and worsened. Only a couple days for things to get disabling? Not sure you can make it until Wednesday? That isn't okay and even if it is just anemia you need something to help you get through the next few days, and a medically trained person to ask the right questions to catch whatever else might be triggering this rapid change in symptoms.
You might be extremely dehydrated, which can contribute to everything you're dealing with. Decongestants can also dehydrate you. If you end up in the ER at least you are likely to get an iv bag of fluids! But seriously, if you have a nurse hotline to call or a good local practice or similar, you should call and ask what you can do right now about how you are feeling, and stress that things have changed rapidly and ask for your options. Anxiety is a symptom of anemia but it also is a healthy response to bad shit going down. Trust yourself and use what energy you have to get assistance.
posted by Mizu at 7:00 PM on May 28, 2017 [1 favorite]
What I've learned over the years is that anemia is a sneaky thing. It can be caused by many underlying things as well as cause many others, and it can become a cycle too. Combined with the lack of concrete data we have about something as common as irregular menstrual cycles that sets a lot of us up for misdiagnoses and doctors ignoring us when we tell them how we feel. There is also this thing where anemia symptoms can happen from a lack of micronutrients like magnesium and copper so you get tested and the numbers say you aren't anemic but absolutely everything else points to it. Simply put, manufacturing our own blood is a damn complicated process and there are lots of places for it to get out of whack and the tools doctors have to analyze it are pretty blunt still.
Although your description of symptoms don't seem entirely out of possibility for anemia there are two things that concern me. First is of course the bleeding for four months, that is not something that you should be ignoring. It may or may not be related to whatever else is going on but could certainly cause low level anemia I would think, but it also just means something is off with that system and you need to have a good obgyn take a look at you. But second and more concerning is the speed at which it seems your symptoms have changed and worsened. Only a couple days for things to get disabling? Not sure you can make it until Wednesday? That isn't okay and even if it is just anemia you need something to help you get through the next few days, and a medically trained person to ask the right questions to catch whatever else might be triggering this rapid change in symptoms.
You might be extremely dehydrated, which can contribute to everything you're dealing with. Decongestants can also dehydrate you. If you end up in the ER at least you are likely to get an iv bag of fluids! But seriously, if you have a nurse hotline to call or a good local practice or similar, you should call and ask what you can do right now about how you are feeling, and stress that things have changed rapidly and ask for your options. Anxiety is a symptom of anemia but it also is a healthy response to bad shit going down. Trust yourself and use what energy you have to get assistance.
posted by Mizu at 7:00 PM on May 28, 2017 [1 favorite]
Unscheduled and continuous bleeding is not an uncommon (and not an inherently dangerous) side effect of Nexplanon. Your hemoglobin is also not inherently dangerous, but your symptoms indicate that your body is not responding well to the blood loss or the low hemoglobin. I am not an alarmist (and am particularly liberal about birth control side effects) but I think this deserves a trip to the ER. They probably won't be able to remove your Nexplanon (although it's probably time to try a new method) but they may recommend a blood transfusion or a trial of some birth control pills, which may help get your bleeding in check in the meantime.
I am not a doctor, but I am a medical student with a special interest in contraception.
posted by i_am_a_fiesta at 7:08 PM on May 28, 2017
I am not a doctor, but I am a medical student with a special interest in contraception.
posted by i_am_a_fiesta at 7:08 PM on May 28, 2017
I've had much more severe anemia (hemoglobin 4.3, which is life-threatening) and was completely out of breath all the time, but not dizzy. Since your symptoms are steadily getting worse, I would suggest not waiting. Can you get ahold of your doctor? Also, even if urgent care can't help, they can at least determine if you need to go to the ER. IANAD.
posted by FencingGal at 7:14 PM on May 28, 2017
posted by FencingGal at 7:14 PM on May 28, 2017
I have a sister who had horrid bleeding, they wouldn't do a hot balloon cauterization, and good they didn't, they wouldn't do a hysterectomy, good they didn't. Then she had horrific bowel pain, and finally someone x rayed her and they found a copper piece had come off an IUD some time before, had time to perforate her uterus, and then her bowel. She is fine now. So.
But eat your iron rich meal at noon, with orange juice, avoid milk products, tea, or eggs for at least an hour before and an hour after that meal. It is one dietary means to get your iron back up, after you figure out what is making you lose blood.
That dietary recipe I taught to new moms for a dozen years at a hospital, and it sure worked for me.
posted by Oyéah at 8:17 PM on May 28, 2017
But eat your iron rich meal at noon, with orange juice, avoid milk products, tea, or eggs for at least an hour before and an hour after that meal. It is one dietary means to get your iron back up, after you figure out what is making you lose blood.
That dietary recipe I taught to new moms for a dozen years at a hospital, and it sure worked for me.
posted by Oyéah at 8:17 PM on May 28, 2017
I don't see any mention of your taking iron supplements. Are you?
posted by amtho at 9:22 PM on May 28, 2017
posted by amtho at 9:22 PM on May 28, 2017
My severe vertigo was caused by needing glasses. My ear actually stopped working right. The rest of all of it has been a combo of endometriosis and POTS. Definitely talk to a doctor ASAP. By the way none of those things can be found on blood work. I personally take flinstones vitamins with iron and that helped my iron stores (iron supplements made me sick.)
posted by Crystalinne at 10:18 PM on May 28, 2017
posted by Crystalinne at 10:18 PM on May 28, 2017
Best answer: On and off anaemia sufferer here. Iron shortage can cause tiredness. So even though your haemoglobin is slightly low, the iron stores in your blood and tissues will most probably be low. Your haemoglobin is the last thing to go and even mild anaemia can cause dizziness. I have to take an iron tablet daily to keep on top of it.
posted by charlen at 3:51 AM on May 29, 2017 [1 favorite]
posted by charlen at 3:51 AM on May 29, 2017 [1 favorite]
Best answer: Oh boy, I feel you. I had a Skyla IUD for just over a year that worked a treat for the first year and then my already borderline anemic self bled, at lighter/heavier intervals, for three months straight before my gyno looked at me grimly and said, "We're taking that thing out." My symptoms were.almlst exactly the same as yours even though I wasn't THAT anemic. It also contributed to my worsening anxiety at the time, I think.
Here's what my doc and I figured out:
a.) Iron supplements and a high-iron diet. Your supplements should be accompanied by a B-12 vitamin and some vitamin C (she told me either tablets or juice, I like the tablets.) Make sure to take them EVERY day and don't eat dairy before or after for at least an hour as interferes with iron absorption. Stat this right away-- today if you can. I'm shocked that if you're bleeding that much and already low iron your doctor hasn't already suggested it.
b.) I started limping along a bit better once my doctor told me how much fluid I was losing. It didn't seem like that much at any given time, but she said it was p much the same as being drenched in sweat 24/7 and sometimes even more if my flow was heavy. I started drinking Gatorade, alternating with water, and a LOT of it. I was worried about the sugar but my doc said it was probably an actual need for me since my body was working so hard all the time. Especially if you're also having unexplained weight loss like I was. Get fluids in you, as much as you can, ASAP.
c.) GET IT OUT! 3 months of bleeding is REALLY hard on your body and mind. This problem isn't minor or in your head or "normal". It took me a while to realize that's what needed to happen, but removal made me feel better very quickly and even though it took a little while to fully recover, I felt better just knowing it was gone right away.
Good luck. sorry Implanon didn't work for you. There are other options and I hope you find your perfect one!
posted by WidgetAlley at 4:17 AM on May 29, 2017 [1 favorite]
Here's what my doc and I figured out:
a.) Iron supplements and a high-iron diet. Your supplements should be accompanied by a B-12 vitamin and some vitamin C (she told me either tablets or juice, I like the tablets.) Make sure to take them EVERY day and don't eat dairy before or after for at least an hour as interferes with iron absorption. Stat this right away-- today if you can. I'm shocked that if you're bleeding that much and already low iron your doctor hasn't already suggested it.
b.) I started limping along a bit better once my doctor told me how much fluid I was losing. It didn't seem like that much at any given time, but she said it was p much the same as being drenched in sweat 24/7 and sometimes even more if my flow was heavy. I started drinking Gatorade, alternating with water, and a LOT of it. I was worried about the sugar but my doc said it was probably an actual need for me since my body was working so hard all the time. Especially if you're also having unexplained weight loss like I was. Get fluids in you, as much as you can, ASAP.
c.) GET IT OUT! 3 months of bleeding is REALLY hard on your body and mind. This problem isn't minor or in your head or "normal". It took me a while to realize that's what needed to happen, but removal made me feel better very quickly and even though it took a little while to fully recover, I felt better just knowing it was gone right away.
Good luck. sorry Implanon didn't work for you. There are other options and I hope you find your perfect one!
posted by WidgetAlley at 4:17 AM on May 29, 2017 [1 favorite]
I've recently been seeing a bunch of medical specialists to get to the bottom of dizzy/fainting issues (not BC related), and labs shows both my Vit D and Vit B12 were v. low. Was prescribed a 6 week course of substantial D supplement Rx and ongoing OTC B12 supplement. I also tend towards anemic. All that is to say, when they run labs might not be a bad idea to ask that both B and D levels are checked in addition to whatever else.
I hope you'll be feeling better soon.
posted by mcbeth at 11:17 AM on May 29, 2017
I hope you'll be feeling better soon.
posted by mcbeth at 11:17 AM on May 29, 2017
Response by poster: Thanks all. I've been trying to rest a lot and the dizziness has been better today. Hoping it's just the implant and some iron pills will fix it. It's been rough.
posted by Amy93 at 4:37 PM on May 29, 2017 [1 favorite]
posted by Amy93 at 4:37 PM on May 29, 2017 [1 favorite]
Best answer: Just to try to reassure you a little: I have been anemic with similar numbers, and I had the same symptoms with the same severity. I personally wouldn't go to the ER right now, but I would try to see a doctor soon (I have no medical training).
I agree with the advice to start taking an iron supplement and eating iron-rich foods (heme iron, from animal sources, is absorbed better than non-heme iron, from plant sources). Be aware that recovering from anemia can take longer than you might like -- a few months if you're like me, but maybe only a couple of weeks if you're not (I assume this is different if one gets a transfusion).
Another thought: some people are more prone to dizziness than others, which could explain the variety of perspectives here.
posted by Comet Bug at 4:38 PM on May 29, 2017
I agree with the advice to start taking an iron supplement and eating iron-rich foods (heme iron, from animal sources, is absorbed better than non-heme iron, from plant sources). Be aware that recovering from anemia can take longer than you might like -- a few months if you're like me, but maybe only a couple of weeks if you're not (I assume this is different if one gets a transfusion).
Another thought: some people are more prone to dizziness than others, which could explain the variety of perspectives here.
posted by Comet Bug at 4:38 PM on May 29, 2017
Response by poster: (all of the answers were great but I marked the ones that have had similar experiences as best answer because they were especially helpful at calming my nerves about this)
posted by Amy93 at 5:34 PM on May 29, 2017 [1 favorite]
posted by Amy93 at 5:34 PM on May 29, 2017 [1 favorite]
Response by poster: Exciting update: my ferritin is 3 so I guess that's why I feel so terrible.
posted by Amy93 at 7:37 PM on May 30, 2017 [1 favorite]
posted by Amy93 at 7:37 PM on May 30, 2017 [1 favorite]
This thread is closed to new comments.
posted by mermayd at 6:36 PM on May 28, 2017