3 months after adding carbs but im still Anemic!!

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3 months after adding carbs but im still Anemic!!

Postby dc10 » Thu Mar 21, 2013 1:18 pm

April 2012 i started the Wahls diet, which in October my blood tests showed low red and white cell counts, and lymphocytes, which i believe is a clear sign of Anemia

So since m y legs/bladder kept getting worse on the diet or at least remained poor, i sincluded gluten free grains in December and removed red meat/high fats from my diet,

Last week i had fresh blood tests which still showed low blood counts = anemia:


White cell count = 3.8 10*9L - Range = 4 - 11
Red cell count = 4.18 10*12L Range = 4.5 - 6.5
Mean compusc. haemoglobin (MCH) = 32.5 pg range = 27 - 32
Lympocyte count = 1.1 - 10*9/L , Range = 1.3 - 4
Haemoglobin estimation - 136 - g/L - Range = 130 - 180
B12 and Folate were both high again.
Serum ferritin - 66 ng/mL - range = 30 - 400


But my red cell size were in range, so not sure what that means regarding anemia:
Red blood cell size = 12.1 - fL - Range = 9 - 15

So as for the last 3 months ive been eating carbs in gluten-free grains, and have gained 30 lbs but im still anemic with low red/white cell counts, etc, it obviously wasnt my lack of nutrients/calories causing the anemia,
also foR 2 months before these bloods were taking i increased my copper intake from 2mg daily to 4-6mg daily as a test from October showed borderline low copper serum levels,



So yet again i am lost! i am due to see my doctor next week and i will ask him how i can stop being anemic with low blood counts, but i, not too hopeful

i should get my new zinc and copper results next week but am not expecting any change


i had my eyes tested recently (i havent had them tested for 10+ years) as i noticed my vision reading was poorer and ive never needed glasses before,
the optician saw mild nystagmus and that i was slightly short sighted, so have been prescribed glasses.,

but i read online that being anemic can cause vision problems, so hopefully, if im able to raise my white/red cells, my vision will improve too

but is it possible to improve levels like mine?
or does it just take longer than the 3 months ive been eating more?

- i will ask my dr next week, i just want some opinions to put forward

thank you
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Re: 3 months after adding carbs but im still Anemic!!

Postby jimmylegs » Thu Mar 21, 2013 1:52 pm

hi :)

can you clarify what meats you do eat now?

and could you pls refresh my memory re the decision to quit red meat when anemic?

can i get an updated snapshot of your current diet, ie typical breakfast lunch and dinner? i know you said you still have high intakes of veggies, and that you're eating gluten free grains.
how about the rest?
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Re: 3 months after adding carbs but im still Anemic!!

Postby jimmylegs » Thu Mar 21, 2013 1:57 pm

based on your efforts to control zinc and copper and your history of extreme dietary limitations, you may need to consider adding an iron supplement. higher zinc intakes in the absence of dietary heme iron could be causing an imbalance.

for serum ferritin you would be better off up at 90 mg/mL but don't go much over 100.
ignore that bit about the top end of the range for ferritin being 400. that's like hemochromatosis bad. over 300 is bad enough, and over 200 can be risky. in some cases risk of disease is elevated with serum ferritin levels down lower than 200.

all that said, 66 is certainly not ideal.
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Re: 3 months after adding carbs but im still Anemic!!

Postby dc10 » Thu Mar 21, 2013 2:29 pm

Hi Jl,

meats i eat npw are chicken 3 times a week, salmon twice, king prawns on ce, scallops once.

I removed red meats and significantly reduced fats because my Dr kept stressing the bad affects it has on MS, even though i assured him it was grass-fed organic red meat, he still wasnt happy about red meat, and since stopping the red meat and subcsequently reducing fats my MS symptoms have improived somewhat.

current diet =
Breakfast = 3 mugs of veg, = 1 carrot, 1 cabbage, 1 kale, for example
Lunch = Either chicken or beef bone broth with all the fat removed in a blended veg soup containing 4-5 cups of veggies
After lunch so e fruit
Dinner = plate of greens so kale or spinach, meat = chicken/salmon/prawns/scallops, mug of colored veg like carrots, mug of sulfur veg like brocolli
Pudding = small bowl of home made rice pudding using rice milk or porridge or millet flakes/puffed rice cereal

do you of any methods to increase my white and red blood cell counts?
i was shocked to see my blood results after gaining all my weight back from eating g3 grains

thanks
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Re: 3 months after adding carbs but im still Anemic!!

Postby jimmylegs » Thu Mar 21, 2013 2:50 pm

i'd say *excess* fats are one thing, healthy fats are another (esp in an anemic underweight individual..), and red meat nutrients are another. esp. grass fed organic!! and most esp in someone who's anemic. fyi venison is your best bet for good dietary heme iron.

other than that the protein looks okay. but... chicken and salmon aren't appreciable sources of zinc OR iron. your shrimp and prawns are providing you with about 5mg of zinc per week.

i know you have been supplementing zinc plenty, but you should try to get a good chunk of your zinc from whole food every day... and unless you want to get very bored (not to mention bioaccumulating heavy metals from the seafood), red meat is where it's at. plus the zinc and iron content are balanced naturally.

where are your nuts and seeds? did they get cut when you started cutting fat? pumpkin seeds could help with zinc although i am not certain about bioavailability. and you need fat, obviously, to absorb fat soluble nutrients.

gtg, lots of issues figuratively on my plate right now :(
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Re: 3 months after adding carbs but im still Anemic!!

Postby dc10 » Fri Mar 22, 2013 1:32 pm

Are you aware of any daily limits a MS patient should consume fats and sat fats,
As in Dr Swanks MS diet book he advises no more than 15 grams of saturaed fat per day, and to consume 20 - 50 grams unsaturated fats per day

i do supplement with 50mg zinc picolinate daily and today have started taking 14mg Iron tablets (

Ingredients
Cellulose,Dicalcium Phosphate ,Ferrous Fumarate ,Maltodextrin ,Hydroxypropylmethylcellulose ,Magnesium Stearate ,Silicon Dioxide ,Glycerol ,Colour (Iron Oxide)
Typical Values Per tablet -
Iron 14.0mg (100% of RDA) -


http://www.tesco.com/groceries/Product/ ... =273234944


on the label it says just one 14mg tablet per day, is this sufficient to rase my ferritin from 68 to 100 ng/ml?


it is strange that my ferritin levels in December 12' when on the wahls diet 100% and being 110lbs were : Serum Ferritin = 137 ng/ml ----- RANGE = 30 - 400

So now by just removing red/organ meat and introducing g3 grains my ferritin levels have gone down to 68 ng/ml

hopefully the 1x 14mg iron daily tablet (=Ferrous Fumarate) will be sufficient to raise my iron levels,

i appreciate organic grass fed red meat is nowhere near as bad as farmed red meat, but as i feel better off red meat, im scared to go back to eating it, as much as i like the taste!



re: nuts/seeds - as i only started the minimal fat idea yea=sterday, i have since read too many articles promoting fat and its benefits, so after my one day stint of extremely low fat, i went back on nuts/seeds today, albeit a small amount, a small handful after lunch and dinner.
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Re: 3 months after adding carbs but im still Anemic!!

Postby jimmylegs » Fri Mar 22, 2013 3:30 pm

i don't bother calculating fat normally. i did once just to see how far off swank's guidelines i was, and it wasn't far enough for me to make any changes to my status quo. good idea to keep up the nuts and seeds!

good re the zinc, i'm looking forward to seeing the latest serum results.

14mg iron may not do the trick. here's what i used to take: Ferrous gluconate - Tablets, oral 325 mg (elemental iron 37.5 mg). the upper limit for daily intake is 45mg.
when shopping you should have to ask for it over the counter. it's been years since i needed it but if i recall correctly it shouldn't be available in that amount off the shelf.

that said, EAT YOUR RED MEAT sheesh. is it possible that you have changed too many things at once to decide conclusively that stopping red meat was responsible for your feeling better? could it be that you feel better the increased energy intake evidenced by your successful weight gain?

you'd be better off getting your iron from meat than from supplements. furthermore, i don't know of any standard recommendations for ms that say cut red meat entirely. it really makes me mad when people take 'avoid/limit' recommendations and turn them into 'eliminate' orders.

the best bet program says 'no more than one serving of red meat per week'. perhaps if you were to reintroduce a serving of red meat per week. something to think about.
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Re: 3 months after adding carbs but im still Anemic!!

Postby dc10 » Sat Mar 23, 2013 4:31 pm

the 14mg iron tablet i take says in the top womens health, so i came across this article about problems with men taking iron supplements,
but as my ferritin levels are already low, hopefully the 14mg ttablet wont overload my ferritin levels:
http://www.livestrong.com/article/24173 ... pplements/

i do appreciate red meat does carry benefits, this is what i read online of the benefits/risks of red meat:


Benefits
High in zinc, which is important for a healthy immune system.
Contains more iron than most foods, and it is more easily used by the body than iron from other sources
Also a good source of other vitamins and minerals, including phosphorus, potassium, magnesium, selenium and b vitamins.
Excellent source of complete proteins
A high-protein diet based on lean red meat has been shown to help weight loss

Risks
An increased risk of bowel cancer was found for people who ate more than two servings of red meat per week.
The Mediterranean diet, which is low in red meat, has been shown to decrease the risk of Alzheimer's disease
Excessive amounts of red meat can lead to a higher risk of osteoporosis due to an acid byproduct from digesting very large amounts of protein.
Eating red meat every day can double the risk of Arthritis
Red meat is high in saturated fat and cholesterol
A recent study found that rating more than one serving of red meat per day can double the risk of breast cancer, especially in young women.



So it looks like id benefit from the zinc and iron content of red meat,
but looking at the amounts you get in two 150g beef patties (i ate 2 pattys once per week of beef+ 2 of lamb once per week... two 150mg beef:
Iron = 3.57mg
Zinc = 18.96mg

In two 150mg Lamb:
Iron = 2.33mg
Zinc = 5.12mg

So per week, by eating beef once and lamb once i would get:
Iron = 5.90mg
Zinc = 24.08mg

When i gain my iron/zinc from supplements i get per day:
Iron = 14mg
Zinc = 50mg

as im getting over double per day what id get if i ate red meat twice a week, by supplementing, i cant help but assume even if the supplements are not as well absorbed as food, that i would still gain more iron/zinc by supplementing

So the amount of zinc and iron would be superior compared to eating red meat twice a week, plus i avoid the above listed risks with red meat consumption plus these values are for one DAY of iron/zinc supplement, and one WEEK of red meat
I understand getting these nutrients from food is superior to vitamins, but i would be getting more zinc/iron than i would eating 2 beef burgers and 2 lamb burgers per week, without any of the claimed risks.


Also, if you remember when i had my last zinc/cu tests i was eating the red meat twice a week 6 months prior, and i was low in the range of zinc, and just outside the range of copper



All that said, you're right i shouldn't have removed red meat and added gluten-free grains at the same time, but i was in a state of desperation so wasn't thinking straight

One thing i noticed from my latest bloods was my vit d3 levels were very similar to my previous 25OHD3 results (October 12' = 122nmol/L and i had a 5 day washout before bloods taken) and that was when i was taking just 5000IU per day,
for this recent test i was taking 2x5000IU D3 so 10,000 daily for 2.5 weeks, then one day washout before bloods and my results were: [b]131nmol/L range = 50 - 200[.b]

thanks JL
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Re: 3 months after adding carbs but im still Anemic!!

Postby jimmylegs » Sat Mar 23, 2013 4:43 pm

i think it would be good to eat some red meat once a week anyway, since we don't know everything about how nutrients work in the whole food context. think back to the fish example, where dietary fish can outperform supplemental fish oil in terms of increasing omega 3 levels.

interesting about your d3. do you have recent mineral tests too?
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Re: 3 months after adding carbs but im still Anemic!!

Postby dc10 » Sun Mar 24, 2013 4:22 am

At the same time as these FBC and ferritin tests I also had:

Thyroid stimulating hormone TSH = 3.99 mu/L 0.27 - 4.2 (i am concerned as my TSH is always high in the range indicating hypothyroidism)
Urea and electrolytes = includes creatinine, sodium, potassium, GFR - all in range
Liver function test
B12 = 583 ng/L 191 - 663
Folate = >20 ug/L 4.6 - 18.7
Bone profile = Albumin was slightly high like in October = 54 g/L 35 - 50 ... everything else in range
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Re: 3 months after adding carbs but im still Anemic!!

Postby jimmylegs » Sun Mar 24, 2013 6:49 am

i'm curious about zinc copper and mag if those are in the mix. i have the usual skepticism about things being 'in range'. good number for b12.
re folate high - mine was also quite high at one time (if i remember correctly and do a really quick and dirty units conversion it would have been around 21.7)
but it turned out to be poor utilization. resolved once i sorted out low numbers in other stuff (notably zinc), then i could take the same amount of folic acid (1mg) without side effects. interestingly, folic acid supplementation has been demonstrated to impair zinc utilization in individuals with marginal zinc status.

Folic acid
http://lpi.oregonstate.edu/infocenter/minerals/zinc/
The bioavailability of dietary folate is increased by the action of a zinc-dependent enzyme, suggesting a possible interaction between zinc and folic acid. In the past, some studies found low zinc intake decreased folate absorption, while other studies found folic acid supplementation impaired zinc utilization in individuals with marginal zinc status(4, 5).

Comparison of folate conjugase activities in human, pig, rat and monkey intestine.
http://www.ncbi.nlm.nih.gov/pubmed/3839013
Folate conjugase, an intestinal enzyme that hydrolyzes dietary polyglutamyl folate to the absorbable monoglutamyl derivative, is present in two locations in human jejunal mucosa: one on the brush border membrane, the other soluble and intracellar. Although the brush border enzyme has not been found in the rodent, a recent study demonstrated both brush border and intracellular folate conjugases in the pig with properties similar to the human enzymes. To confirm and expand these data, we compared folate conjugase activities in intestinal brush border and 30,000 X g supernatant fractions in human, pig, rat and monkey mucosa. In both the human and pig, brush border folate conjugase was active from pH 4.5 to 8.5, and activity was significantly increased by zinc acetate.
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Re: 3 months after adding carbs but im still Anemic!!

Postby dc10 » Fri Apr 12, 2013 2:02 pm

yes so as my folic/b12 levels levels are high i wont need to supplement with folic acid,

i got my latest (from 13 mar) zinc and copper results, which like usual are:

Zinc= 15.2 umol/L, 11-24
Copper = 9.0 umol/L no range given but i take it this is low, i will find out the range on monday

So yet again my cu is low, yet i was taking 2x 2mg cu for weeks leading up to the test with one day wash out

and as per the FBC results to still shows lo red/white cell counts, so i must still be anemic

im so lost now what i can do to increase my blood counts,
is there a specialist i could see regarding my bloods?
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Re: 3 months after adding carbs but im still Anemic!!

Postby jimmylegs » Fri Apr 12, 2013 2:49 pm

all right yes zinc is still suboptimal by a good chunk, and you're outright deficient in copper (the last range you gave from dec tests was 11-20)

time for another look at daily dietary influences - how's your dietary fruit vs starchy veg balance lately? could be inhibiting copper retention and contributing to copper deficiency anemia..

Role of dietary fructose in the enhancement of mortality and biochemical changes associated with copper deficiency in rats
http://ajcn.nutrition.org/content/38/2/214.full.pdf
Hepatic copper level was significantly lower in copper-deficient rats fed sucrose or fructose than in those fed starch. Fasting blood glucose, cholesterol, and triglyceride levels
were significantly higher in copper deficient rats fed fructose than in those fed starch.

High Fructose Feeding Induces Copper Deficiency in Sprague-Dawley rats: A Novel Mechanism for Obesity Related Fatty Liver (2012)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261305/
interesting - figure 2B shows plasma copper in four study groups - copper adequate diet, marginal copper diet, adequate with fructose, marginal with fructose. shows the negative impact of fructose on copper retention: http://www.ncbi.nlm.nih.gov/pmc/article ... figure/F2/
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Re: 3 months after adding carbs but im still Anemic!!

Postby lyndacarol » Fri Apr 12, 2013 6:29 pm

dc10 wrote:i do appreciate red meat does carry benefits, this is what i read online of the benefits/risks of red meat:


Risks
An increased risk of bowel cancer was found for people who ate more than two servings of red meat per week.
The Mediterranean diet, which is low in red meat, has been shown to decrease the risk of Alzheimer's disease
Excessive amounts of red meat can lead to a higher risk of osteoporosis due to an acid byproduct from digesting very large amounts of protein.
Eating red meat every day can double the risk of Arthritis
Red meat is high in saturated fat and cholesterol
A recent study found that rating more than one serving of red meat per day can double the risk of breast cancer, especially in young women.[/b]


All that said, you're right i shouldn't have removed red meat and added gluten-free grains at the same time, but i was in a state of desperation so wasn't thinking straight.


Protein is important; can you eat more eggs, fish, or nuts? It may be a good idea to limit red meat consumption – NOT because of saturated fat or cholesterol – but because it contains carnitine:

New health worry in red meat

Published April 08, 2013
| The Wall Street Journal

Doctors have long assumed that saturated fat and cholesterol in red meat are what raise the risk of heart disease. But a study in the journal Nature Medicine fingers another culprit: carnitine, a compound abundant in red meat that also is sold as a dietary supplement and found in some energy drinks.

Carnitine typically helps the body transport fatty acids into cells to be used as energy. But researchers at the Cleveland Clinic found that in both humans and mice, certain bacteria in the digestive tract convert carnitine to another metabolite, called TMAO, that promotes atherosclerosis, or a thickening of the arteries.

The researchers, led by Stanley Hazen, chief of cellular and molecular medicine at the Cleveland Clinic’s Lerner Research Institute, tested the carnitine and TMAO levels of omnivores, vegans and vegetarians, and examined records of 2,595 patients undergoing cardiac evaluations. In patients with high TMAO levels, the more carnitine in their blood, the more likely they were to develop cardiovascular disease, heart attacks, stroke and death.

Many studies have linked consumption of red and processed meat to cardiovascular disease and some cancers. The Harvard School of Public Health reported last year that among 83,000 nurses and 37,000 male health professionals followed since the 1980s, those who consumed the highest levels of red meat had the highest risk of death during the study, and that one additional serving a day of red meat raised the risk of death by 13 percent.

The new findings don’t mean that red meat is more hazardous than previously thought. But they may help explain the underlying risk of eating red meat, which some researchers have long thought was higher than the saturated fat and cholesterol content alone could explain.

Dr. Hazen speculated that carnitine could be compounding the danger. “Cholesterol is still needed to clog the arteries, but TMAO changes how cholesterol is metabolized—like the dimmer on a light switch,” he said. “It may explain why two people can have the same LDL level [a measure of one type of cholesterol], but one develops cardiovascular disease and the other doesn’t.”

One surprising finding, Dr. Hazen said, was how a long-term diet that includes meat affected the amount of TMAO-producing bacteria in the gut and thus magnified the risk. In the study, when longtime meat-eaters consumed an eight-ounce steak and a carnitine supplement, their bacteria and TMAO levels rose considerably. But when a vegan ate the same combination, he showed no increase in TMAO or bacterial change.

“Vegans basically lose their ability to digest carnitine,” said Dr. Hazen.

The study, sponsored by the National Institutes of Health, didn’t assess how little red meat people could consume and still have elevated TMAO. Nor did it look at how long someone had to abstain from red meat to end the process. “We know it will be longer than one week, but shorter than one year,” Dr. Hazen said.

He and his colleagues have been exploring how altering gut bacteria might influence the risk of heart disease. “In the future, maybe there will be a heart-healthy yogurt, or a drug to block the formation of TMAO,” he said.

http://www.foxnews.com/health/2013/04/0 ... meat/print
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UPPER LIMIT FOR COPPER 10MG/DAY

Postby jimmylegs » Sat Apr 13, 2013 9:43 am

actually I think the article suggests we need to ensure healthy gut microbiota so that carnitine handling is done in such a way as to protect against cardiovascular disease risk.. "Chronic dietary l-carnitine supplementation in mice altered cecal microbial composition, markedly enhanced synthesis of TMA and TMAO, and increased atherosclerosis, but this did not occur if intestinal microbiota was concurrently suppressed." need to tease out exactly what is meant by that..

also, I was posting back in December about fruit intakes and possible links to copper depletion and copper deficiency anemia. let's keep the focus on that for the time being.

from dec 2012
diet-f9/topic21310.html#p201565
as i said above "your zinc levels still need to go up, but it looks like the copper is more important in the short term. ... consider a short term therapeutic megadose at the upper limit (10 mg/d) for two weeks, then wash out and retest." and you could do an experiment after that - reduce dietary fructose, see if it helps you retain copper. i personally eat lots of veg and pretty negligible fruit, and i stay on target taking 50mg zinc balanced with 2mg copper. even if you only manage to find 2mg elemental copper in whichever form and take 4 a day as we recently discussed, it should help put things back on track.


so 10mg copper per day for a short term therapeutic correction. that should help kick things into back into the right range. then you can go back to lower daily doses, and work on dietary adustments for fine tuning.
READ ME key info on nutrient targets - www.thisisms.com/ftopict-2489.html
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com
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