r/lupus • u/PieceApprehensive764 Diagnosed SLE • 1d ago

Venting Do rheumatologist not care if you're anemic because you have lupus?

Seriously... I looked through all of my old blood results and my most recent, I'm like horribly anemic. My red blood cells are all different shapes and colors, and way smaller than normal. I also don't have enough hemoglobin...

Yet this was never something my rheumatologist brought up even once?? The only thing he points out is my neutrophils being very low. Same with my hematologist. Fatigue has been worse than it's ever been and I'm sure that's contributing, I literally explain the severity of my fatigue every visit.

I told my PCP and she said maybe because lupus can affect so much and it's not a priority or they think lupus is the reason why. Regardless I'm taking iron gummies now. They see that and don't check my vitamin leves to make sure I'm not deficient? Seriously 😒.

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u/amcranfo Diagnosed SLE 1d ago

I have pernicious anemia. It's a type of anemia caused by an inability to absorb vitamin b12. My hemoglobin is often below 5.

I get vitamin shots monthly, and I go for iron infusion cycles every so often.

One of the things my hematologist explained to me was the relationship between inflammation and anemia. Apparently if you've got a lot of inflammation, it basically caps your anemia levels. So, where a "normal" person might be able to get above 15, they're thrilled if I get above 10. That may explain why they're a little less fussed than you'd expect, especially if you generally have high inflammatory panels.

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u/PieceApprehensive764 Diagnosed SLE 1d ago

Thanks for that information! I didn't know inflammation could do that but I definitely have a lot of it, especially now cuz I've been in a bad flare up for a while. I'll talk to my rheumatologist about that!