How to deliberately induce low hemoglobin

June 6, 2018 10:46 AM

Is there any way that I can deliberately induce low hemoglobin? I have chronic extremely low ferritin and iron saturation, for which I have previously received IV infusions that helped tremendously, but my current insurance company won't cover them because my hemoglobin is stubbornly hovering one point above the level at which they will approve them. Is there anything I can do to temporarily push this fucker down just a titch so I can get my infusion?
posted by HotToddy to Health & Fitness (14 answers total)

You might be able to temporarily lower your hemoglobin levels by making sure you are extremely well hydrated in the days leading up to your test date. Your test result might also be slightly lower if the test is taken later in the day. Avoiding all red meat for several weeks before your test or donating blood a few days before the test might also lower your hemoglobin count, but I don't know if this any of this is advisable or safe for someone with chronically low ferritin and iron saturation.

I strongly encourage you to explain your dilemma to your doctor and ask if they have any advice. A sympathetic doctor might have some suggestions, particularly if you presented your questions as hypotheticals.
posted by RichardP at 11:12 AM on June 6, 2018 [2 favorites]

Drink a bunch of coffee. Caffeine binds to iron. I used to be 1 point +/- consistently, and drinking coffee within 5 hours of the test kept me below the threshold to donate blood. Obviously YMMV.

Other than that, try the opposite of all the iron-building advice. Stop eating iron-rich foods for a week!
posted by blnkfrnk at 12:33 PM on June 6, 2018 [1 favorite]

Just want to chime in with sympathy. I have in-the-toilet ferritin and iron saturation, but only slightly below normal Hg, and I just get shoulder shrugs when I describe the crushing fatigue and inability to climb stairs.
posted by raspberrE at 3:26 PM on June 6, 2018

Are you a person who menstruates? You might try timing your next test for right after a period.
posted by Serene Empress Dork at 4:08 PM on June 6, 2018

Response by poster: I am a person who menstruates, and menstruation is thought to be the cause of the low ferritin, but apparently I'm menstruating the Goldilocks amount.

Will they take my blood at a blood donation center with this low ferritin? Maybe if I go give blood right at the end of a period?
posted by HotToddy at 4:17 PM on June 6, 2018

Take up running! Female runners are prone to anemia because of the mechanical crushing of red blood cells during foot strike that aren’t replaced fast enough by the body. This is more of a problem for women than men because we already need to replace blood from menstruation.
posted by cakebatter at 5:03 PM on June 6, 2018 [1 favorite]

I ended up with low hemoglobin after several months of drinking a lot of iced tea. I was stumped, because I had been taking iron to raise it, but the phlebotomist told me that the tannins in the tea were causing it to go down despite the supplements. I then stopped drinking tea and my hemoglobin levels went up.
posted by all the light we cannot see at 5:32 PM on June 6, 2018

To add to cakebatter's idea, inflammation can also decrease hemoglobin. Maybe you're interested in running way too hard for a week or two before a CBC?
posted by WasabiFlux at 6:49 PM on June 6, 2018

Calcium prevents iron absorption. Maybe take a calcium supplement for a few days before the test?

Is it possible to get your doctor to cooperate with an appeal to your insurance company that yes, the infusions are necessary?
posted by Autumnheart at 7:24 PM on June 6, 2018

Dr. Google also recommends skipping vitamin C, which assists in iron absorption.
posted by Autumnheart at 7:28 PM on June 6, 2018

I came here to also mention running! It happened to me...
posted by itsflyable at 9:30 PM on June 6, 2018

If blood donation is the route you choose, you can do a double red (red cross now calls this "power red") where they use a machine that takes out the red cells while returning the plasma & platelets back to you- this takes away twice the amount of red cells than a regular blood donation. You might not pass the prescreening but it's worth asking about.
posted by Hiding From Goro at 10:26 PM on June 6, 2018 [1 favorite]

I donate platelets and in my experience you need a hemoglobin count of 12.5 before they will let you donate. YMMV. I also think that this is the measure they use for other donations. You should be able to check with your chosen donation site before traveling there or making an appointment. But it does tamper with my hemoglobin levels to give platelets.
posted by janey47 at 4:54 PM on June 7, 2018

Response by poster: Followup: In addition to the advice here, I also consulted with a nurse friend who said she had gotten a patient's hemoglobin to drop two points by having them drink a liter of water a few hours before the blood draw, so I tried drinking 2 liters of water. I also went on 8-mile hike the day before (I can't run, sadly.)

No result. Hemoglobin is exactly where it was the last time. Now I have an appointment with a different hematologist.
posted by HotToddy at 6:00 AM on June 30, 2018