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Saturday, June 16, 2012

Iron Woman I am Not

As part of the follow-up care my local living donor program offers, I can opt in to yearly tests to make sure everything is a-ok with Righty. It is a win-win situation-my test results help living donor programs on a national level track the health of donors over time and I get to have my results looked at by a local nephrologist who would likely spot small changes my family doctor might not notice. I can opt out of the program any time but to me it is a no-brainer. Get the tests and know I am healthy every June, and continue to see my family doctor for annual check ups in October.

The tests include a half dozen things tested via blood samples, a urine test (to look for protein or infection) and a 24 hour blood pressure test. I completed the tests the last week in May. I knew I had passed the blood pressure test with flying colours and it was my biggest concern. So I was pretty surprised when I got a call from the program. They are only supposed to call if there is an issue so the message to call them back they left had me a bit nervous. Eventually I got a hold of them and they booked me an appointment to see the nephrologist (Dr. Kidney) as my iron (or hemoglobin) was "a bit low".

It turns out a bit low meant a lot low, especially for me. Normal for a woman is 120 g/L to 160 g/L. Before I donated, I was always in the high 130's to min 140's. Right after I donated, that fell to the high 120's (which is normal). That drop was okay because kidneys are responsible for the maturation of red blood cells. Without the kidneys, red blood cells would be without hemoglobin, the iron-rich protein that carries oxygen to various locations throughout the body. So when Leftie departed, it was another job Righty had to start doing on her own and would need time to adjust to.

My iron levels held there own at least until October, which was when my last blood test was prior to these most recent ones at the end of  May. Something since the fall has made my iron drop to 106, which mean I am anemic. As there was no change in my diet, "monthly gifts" and I didn't have any other major bleeding issues, my doctor was a bit perplexed.  Other than fatigue, I wasnt showing any symptoms such as:

  • Pale skin
  • Heart palpitations 
  • Shortness of breath
  • Cramping
  • Hair loss
  • Malaise (general sense of feeling unwell)


I was a little concerned about my results, more because I pride myself in being very healthy and having "good numbers". I was also curious if this was typical of donors or if I was abnormal. I bounced that thought off some friends in an online donor group. It turns out it isn't super common but a couple of other donors did have a similar issue and are otherwise very healthy. Phew. Also, my other test results showed Righty is functioning very well and doing all the things she should be doing (as per Dr. Kidney).

My nephrologist ordered a few more follow up tests and put me on a gentle iron supplement which should do the trick. I'll need follow up blood tests once a month for the next few months to make sure things improve. While my diet has always been good, I am also going to look for ways to ensure I am getting enough iron there as well. This means I will try to focus on eating more of things like:
  • Red meat (woot steak!)
  • Egg yolks
  • Dark, leafy greens (spinach, collards)
  • Dried fruit (prunes, raisins)
  • Iron-enriched cereals and grains 
  • Mollusks (oysters, clams, scallops)
  • Turkey or chicken giblets (um no)
  • Beans, lentils, chick peas and soybeans
  • Liver (um no)
  • Artichokes
I know a fair number of women who haven't donated a kidney and have had problems with anemia over time so this doesn't concern me too much right now. It's also nice to know why I've had bouts of being really tired over the last couple of months too. I am being monitored by the Living Donor program AND my family doctor so I am in good hands.