Tired? Anemia might be the blame.

Anemia

Anemia

Unfortunately, if you have an autoimmune disease, it’s likely that you also have Anemia which can make you feel extremely tired, one of many symptoms.  In case you’re not familiar, Anemia is a blood disorder where oxygen is inefficiently carried to lungs, tissues and other organs.  The process starts with our bone marrow.

“Conditions such as infections, inflammation, and cancer particularly suppress production of red blood cells in the bone marrow.”-Merck Manuals

“Anemia is the most common extra-articular manifestation of rheumatoid arthritis (RA), estimated to occur in 30-60% of patents.  Two primary types of anemia, iron deficiency anemia and anemia of chronic diseases (ACD) are seen in RA patients.  The retrospective study of 225 patients with RA showed that 64% of patients were anemic, and 77% were found to have ACD and 23% to have iron deficiency anemia.

ACD is an inflammatory anemia and inflammatory cytokines such as IL-6 and TNFa are thought to play important roles in anemia in RA.  However, it is still unclear how anemia is induced and which cytokine is most important.”-Springer-Verlag 2008

If your anemia is from inflammatory cytokines, your best bet is to get your disease under control and talk with your doctor about other options including B-12 injections.

“Erythropoiesis is often suppressed in chronic inflammatory diseases due to expression of hepcidin, a regulatory hormone that limits the availability of iron for erythropoiesis even when dietary iron intake is sufficient.” –FibroGen

Taking B-12 and iron supplements can be helpful for some people.

“Low hemoglobin may be a temporary problem remedied by eating more iron-rich foods or taking a multivitamin containing iron.”-MayoClinic

And I know personally, that taking B-complex vitamins along with iron does help with my energy level.

In addition to iron, your body needs folate and vitamin B-12 to produce sufficient numbers of healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Additionally, some people are unable to effectively absorb B-12.”-MayoClinic

Another worry is pregnancy.

“If you’re pregnant, you’re at an increased risk of iron deficiency anemia because your iron stores have to serve your increased blood volume as well as be a source of hemoglobin for your growing fetus.”-MayoClinic

Even more worrisome than your anemia during pregnancy is how it will affect the unborn child.  According to Health&Wealth, “Anemia during pregnancy can cause growth retardation of fetus.”

So what are your options?

1.  Get your disease under control (easier said than done of course)

2.  Avoid alcohol

3.  Avoid antibiotics if your anemia is severe, “Certain medications, such as some antibiotics used to treat infections, also can break down red blood cells.”-MayoClinic

4.  Get blood-work done before conceiving so you can take necessary precautions.

5.  If you do have anemia, find out what kind you have.

Sometimes there’s not much you can do.  Even chemotherapy drugs can contribute to anemia.

Sick Days, No thanks!!

Vomiting is one of the many side effects of Methotrexate

Vomiting is one of the many side effects of Methotrexate

Being part of a support group, I check daily posts written by fellow RA sufferers. In a recent post called “MTX questions” a person asked what others do in regards to taking their MTX, (Methotrexate). Do they take it Friday and feel sick on Saturday or do they take it Sunday and feel horrible for Monday? This is a common question and it gets addressed often. For those of you that don’t know, Methotrexate is a chemotherapy drug, also known as a DMARD and it works by suppressing the immune system. For those of us with an autoimmune disease, the common thought is that an autoimmune disease means an overactive immune system. I have found information that states autoimmune diseases are simply the body confusing healthy tissue for non-healthy tissue, meaning it’s not a system that’s overactive as so much it is an immune system that isn’t working correctly. Suppressing the immune system does not make it work correctly. Instead, it keeps the body from destroying itself, kind of. Methotrexate may cause damage to the liver, intestines and sometimes the lungs, just to name a few. Although it doesn’t seem like methotrexate is a good option, doctors don’t present many other options when you get diagnosed with RA. And you can’t go on living with uncontrollable inflammation. Inflammation in itself, if left uncontrolled can cause cancer, intestinal damage, organ damage, other diseases and with RA will most likely cause joint erosion and deformation. So although taking a toxic drug like methotrexate seems out of the question, not taking it is just as scary.

It’s no wonder I kept searching for alternative options. I was tired of dreading my weekends. On Monday and Tuesday I still felt like I was a little bit “sick” from the methotrexate. If you haven’t taken this drug and it hits you hard like it did with me, this is what I experienced: The next morning after taking methotrexate I would feel more swollen, more painful and more stiff. My kidney area always felt like it had been kicked in the night and this would last until later in the evening. I would feel extremely fatigued and as if I had slept on rocks. Imagine you haven’t slept in 2 days. That’s how fatigued I felt. Or imagine what the flue feels like. That’s exactly how it was, resting both Saturday and Sunday so I could prepare for the following work week. Even running a low grade temperature wasn’t out of the question, of course this could have just been my RA at work. My hair would always fall out in mass amounts on Saturday and it would lessen as time went by. My eyes would be somewhat bloodshot and I would generally feel less hungry than normal for a few days. I wouldn’t exercise over the weekends. Instead, I would try and “recover” until the week started again and try to summon up energy to get myself to the gym after a few days of shaking off the methotrexate side effects. Heck, I was one of the lucky ones that didn’t throw up after taking methotrexate, a common side effect. As time went on having Rheumatoid Arthritis, I found myself becoming weaker and weaker. Workouts were less effective. My resistance level became less and less on the eliptical machine. I no longer did weights because the swelling of my wrists and fingers made it impossible. I continued to at least work hard at strengthening my knee joints. I figured that was the most important-being able to walk, so I made it my top priority.

When I finally freed myself of the methotrexate hangover, I felt like I was on the right path. And speaking of hangover, being on methotrexate meant you couldn’t drink a drop of alcohol because the drug itself does a # all on it’s own to your liver. Being off the drug meant I could drink again. Though I know alcohol is a poison, I tested my theory out on my own liver….just how bad can it be compared to methotexate? I was getting monthly blood tests because doctors have to keep track of how your liver is functioning and I would closely monitor my tests. At one point in time, just 10mg of methotrexate (a very small dose) elevated my liver enzymes. Yet when I went off this drug, one weekend I purged on alcohol. I came in for my test and didn’t tell them I was off of methotrexate. When the results came in, my liver was functioning better than it ever had while I was on methotrexate. Go figure!!

So truly, the reality is methotrexate is hard on your body. For those of you that take it, I feel for you. If your side effects are bad, giving up your weekends to a drug is a horrible thing to experience. I wish you all the best of luck in your journey with an autoimmune disease, or if you know someone who has an autoimmune disease please be compassionate as I’m sure they could use the support.

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