If it weren't for bad luck, I'd have no luck (blood question)

Or: how I'm stressing out the IBD nurse again.

It was weird, though. I'd just finished filling out the IBD survey online (more about this later, can't post about two things at once though), when I got a phone call. Apparently my red blood cell count is knackered, with a haemoglobin of 7.4, so they want me to get another blood test done. They want to get a ferritin measurement this time, or something. The possibility of an iron or a blood transfusion was mentioned.

I said to the nurse it must be the methotrexate, but, somewhat surprisingly, she disagreed. What on earth else could it be, though? Nothing else has changed, except starting methotrexate a few weeks ago...

Anyways, I have been down this road once before, ending up with an extremely low haemoglobin of 7. This was a few years ago at the previous hospital. I had two iron transfusions, which sorted out the problem in double quick time. However, I cannot remember if the timing of the low hb coincided with starting 6MP or not. The hospital prevaricated endlessly about starting Remicade, so 6MP was literally the only med I was on while under their care.

My question is has anybody had their hb plummet after starting an immunesuppresant, such as MTX or 6MP? The nurse acted as though it was unheard of in her experience...

I suppose I now know why I have felt even more dreadful of late... :-/

PS: My haemoglobin has been hovering between 10-11 for a long time.

NCOT, maybe you should consider using a birth control pill that limits your menstruation - you can schedule your periods for once/quarter or twice/year if you want. This should lower your blood loss from one source.

I think there's a big issue with nutritional absorption when you have disease in the small bowel. It wouldn't show up as blood in your stool - you can leak blood from your small bowel, plus your small bowel isn't doing it's job of absorbing iron from your food.

I took iron for about 6 months a few years ago when my hemoglobin was down to 10 and my ferritin was zero. Since that time I've maintained good iron levels, I think primarily from being gluten-free and getting through the worst of perimenopause (when I menstruated every 3 weeks).

Hi NCOT...sorry for your continuing saga of medical complications!! For whatever it's worth, the times I have been anemic from internal bleeding (for me it was a bleeding ulcer in my small intestine) I wasn't able to visually detect it at all in my stool. They should test your stool for blood, and if it is positive, you probably need more scans to find the source. I agree though that I'd be suspicious of the MTX too, especially since it happened right after you started it. But then again,you have been really sick, so maybe you are bleeding somewhere. Unless you are having massive periods I double you can get to a hemoglobin of 7 just from that. I wish you'd catch a break!!!!!!!!

HOLY CANOLLI!!!! NCOT, I don't know if you happen to read my posts of late, but I AM ON 6MP and I have to have iron infusion bi-weekly and I usually need blood every 10-12 weeks. I know I have a bleeding ulceration in my duodenum, but what IF the 6MP is part of the culprit. This is very interesting, but then I am faced with the fact that if I stop the 6MP, what will happen? I hate this disease so much, seriously if I saw it on the street I would pump a few shells into it.
I just got back from 7 days at the lake with no internet, just catching up now, I read a lot but don't post too much. This site has really helped me. Had a real bad patch last fall.

I do not see blood in my stool because the bleeding it too high up. Surgery is scary in this area as they might have to remove the head of my pancreas as well, waiting for a gastroscope for the surgeon to see it first hand for confirmation of a few things before we decide upon surgery. I have really had a heck of time since 2007, been bleeding since, terrible iron levels, having to have numerous blood transfusion (ick). But what else I do?

I have the "Mirena" IUD in place so that I do not menstruate, have had it for 4 years now, next year it gets replaced. I don't need birth control, but had to stop the blood loss.

I think I was wrong, I am on Entocort, that is not 6MP is it?