Iron deficiency anaemia

[apapuchi]

Hi everyone,

My DH went for a Men's Health check yesterday as he recently turned 40. Despite him (well, us both) drinking and smoking socially a bit more than we should... he is very fit and eats well. His BP, glucose etc which we thought may show up some unexpected thing were all normal. He's had a call this evening 24 hours later to say his bloods show iron deficiency and they want him to attend tomorrow morning for a physical exam (abdomen palpation from what he told me he was told). We are trying to be sensible but have read that iron deficiency and/or anaemia in men is rare and potentially significant.

He has had haemorrhoids for several years now which mean he bleeds after a BM (significant blood in the toilet pan but not between BMs) but this is the only health issue that could seem relevant. He does have approx three BMs daily which is normal for him and no changes to the stool which doesn't have (obvious) blood and is normal. Or appears so. His dad died of stomach cancer last year but at 71 so obviously far older but this is still a worry, I suppose the biggest elephant in the room is the worry of bowel cancer.

I guess nobody can say anything reassuring really but I just wondered if anyone had experience of anything similar and what they might do. Having read the NICE guidelines about the iron deficiency it seems as he's male and has rectal bleeding it would be likely they'd consider a two week referral so I am guessing he should push for that if they don't immediately suggest that's what they'll do? Is a colonoscopy likely? Appreciate any thoughts or shared experience and I hope those of you going through difficult times - or supporting those who are - are all doing ok, sending love to all.

Infuriatingly he didn't ask HOW low his iron was, and the details of that, although I suppose that would have just fuelled more doctor Googling and worry. Obviously they'd call for anything outside the normal range, but it would be good to know.

So sorry to read this, I'm in exactly the same situation as your DH is now. Can you check his NHS app for the blood test results? They should be there and you can see his haemoglobin and ferritin levels.

I'm sorry to read this, too. I hope you get answers soon and you're alright, it's such a worry.

Neither of us have set up the NHS app I don't think. I mean we had that COVID-related bit but I imagine this is more like Patient Access which needs a code from the GP? Or at least did when I looked at it and quickly gave up as it seemed like a headache, will definitely get that set up now though, off to check.

Hi I'm sorry you are going through this worry. I had the same over 40 test a couple of months ago and got the same result. I was very worried, they asked me to do a FIT test (it's a poo test that is used to find traces of blood in your poo) and it was clear . They didn't say anything else after that, other than it's probably diet related. So now I try to eat more iron rich foods.
Hopefully you will have a similar experience. Just commented to say it's not always the worst outcome. Hope you can take some comfort from that.

Thank you for sharing, I'm glad your test was normal and hopefully your changes to diet will make all the difference. I'm sure you were so worried going through the process and it's good to hear positive outcomes.

It's my husband rather than me which is why the iron issue is so concerning as it's rare in men of his age. I'm hoping it's nothing serious and we can just both take a good look at our diets and lifestyle and improve things. Obviously any further tests or investigations he's offered will be taken up, it's such a worry of course.

Oh gosh OP I'm sorry I didn't realise it was rare in men. Didn't mean to sort of make light of it. Will keep you both in mind and hope for a positive outcome swiftly.

No worries at all, I didn't have a clue either. Apparently it's rare in males over 5 and over 60. So it's a concern in men between those ages and post-menopausal women as I suppose that group have fewer reasons to have lower iron reserves. Thank you for your well wishes, I appreciate it ❤️

*under 5

Argh no, rare in males over 5 and UNDER 60. Total brain fart, I'll blame the stress!

If you can access apps, you can get one called AIRMID which is linked to your NHS number and has all or nearly all of your medical info on it. I can't remember how much info you need for it, but probably your nhs number amongst other things. Hopefully that will give you and him a better idea of what the test results are and I hope the appointment goes well tomorrow

Iron deficiency isn’t massively common in men, but neither is it rare, nor does it point towards a huge problem. It could simply be malabsorption, maybe something like coeliac disease which is addressed by going on a gluten free diet. I wouldn’t get worked up yet, it could have a fairly simple cause.

Thank you! I managed to get him set up with the NHS app in the last ten minutes (bit of a rocket up the bum moment, no pun intended). His MCV, Hb, MCH and Haemocrit are all low. Maybe a couple of others. All just below the lower normal number except haemoglobin which is 90. I imagine you'd normally feel crap but he feels fine and is very active. I suppose we'll wait and see what they say tomorrow. I really appreciate your help.

All men and post menopausal women should be investigated if they are found to have iron deficiency anaemia. This is usually camera tests both ends
, which your gp will probably request on an urgent basis. The cause isn’t necessarily cancer. Try not to worry in the meantime ( easier said that done).

That's good to hear, I know it is likely to be something less sinister and he does have regular bleeds which surely impact even if to a small extent. Hard not to worry but we just have to see what tomorrow brings I suppose and take any further diagnostic tests or treatment they offer. He seems really healthy, hopefully it will be a small and treatable issue. Thank you.

My DH had this, it was caused by a stomach ulcer from H pylori (I might not have spelt that right) so it was reasonably minor and easily treated

I hope it turns out to be something similar for your DH

Thank you, I'm glad your DH was treated and is ok. Was he symptomatic with the ulcer? He doesn't have any abdominal pain or stool changes (bar the issues with piles I mentioned before, but the stool itself is normal TMI sorry) so I had read about stomach ulcers being a cause but discounted in my head as he's not symptomatic. I guess he'll ll just take all the investigation they offer and cross our fingers. Is H pylori diagnosed through stool sample? I have been asking him to take a sample tomorrow but he says they haven't asked for that yet so he'll wait for it to be requested. My thinking is if he takes one tomorrow they can get it sent off sooner, I suppose I'm as controlling as he says I am 😂

He was getting a little more indigestion than usual when he thought about it but only very mild and he'd basically not really noticed it so it was fairly asymptomatic

He only found out because he was having bloodwork done for some thing else, although he had been very tired but we had moved house so wrongly assumed it was stress

I think he had to breath or spit into something for the h pylori, it definitely wasn't a stool sample

He was treated with some antibiotics and was fine afterwards, I think it took a couple of rounds to clear it up for him but nothing major

Yes probably wait for them to ask, they'll give you a QFIT test at the surgery, that's a special kit to test the stool.

Coeliac disease is definitely a possibility. I was diagnosed after suffering from anemia. Coeliacs is hereditary and it's possible that his Dad had it but was never diagnosed.

Yep. Undiagnosed coeliac disease leads to stomach cancer in the long run. Could be what caused his dad’s cancer. He needs a blood test to diagnose.

Thank you for the responses, I really appreciate them all and the knowledge and experience you're sharing.

He had a TTG test yesterday at the GP which has come back negative and he's been advised he'll hear from the hospital team in the next fortnight which I am guessing is the 'two week referral' pathway without actually saying as much. My husband isn't from the UK so I don't think this has clicked although obviously he knows the fact they're investigating means something is wrong and potentially something serious.

His haemoglobin was 90 which I've looked into and seems incredibly low for a fit, active and strong 40 year old male. By all accounts he should need to be peeled off the sofa but he's as active as usual. He is also vitamin D deficient so I'm off to pick up those tablets and I am also getting him to take vitamin C as it helps with iron absorption of course although it seems like this is more of a serious problem/deficiency than could be explained by that. He does have darker skin (Hispanic) so I am wondering if he needs more Vitamin D than any of us are likely to ever get in the UK, let alone in winter, but even so that doesn't explain everything or even anything really.

Not sure what the point of posting is as we have to just wait for next appointments now. I am surprised they haven't asked for a stool sample (realise I sound stool sample obsessed) although he did provide a urine sample yesterday to check for blood which I think has come back clear. I suppose it's just a hand hold. We have been through hell the past few years with our older son's disability and the effect of that on him (son) and the rest of us, with parental deaths, job issues, it almost feels like something like this was just lurking in the wings to complete the set. I realise that is just me feeling down and negative about things. I am going to be as supportive as I can to my husband in every possible way, I just hope and pray it's something that can be explained and treated. Thank you for reading if you've got this far.

Wishing you all the best on this journey. It's good that he is getting all the tests GP advises. Look it could be something very simple, it might not be, we don't know. The waiting and fretting about what if etc. is very hard to deal with. Been there, done that.

In my case (and I know I'm female but some things cross the sexes), similar to a pp's description, I was low in most things, particularly haemoglobin. Was not feeling very good at all. Had all the tests and it was H. Pylori. I never noticed anything odd in stools etc. But one day after the tests were complete and I was on H Pylori treatment I had a scary episode of black stools. GP sent me straight to the hospital and had endoscopy and colonoscopy. I had a perforated ulcer, and a bleeding polyp in the bowel. All found at the last minute AFTER H pylori was detected with a stool sample. They obviously didn't test it for the presence of blood!

I was very scared as you can imagine. Anyway I had blood transfusions, and some time later had iron infusion. Thankfully nothing more sinister than ulcer and polyp all samples were tested for cancer and all clear (knock on wood). So it is not always the bad thing we first think. But there is no way around the anxiety of waiting to hear what's going on.

I'm holding your hand.

Thank you @couicouiza I appreciate you sharing all of that and the hand hold most of all. He did ask about H Pylori after I told him to on the basis of this thread, but I'm not sure if they're thinking of that as no test right now. Unless they do that when he's next contacted.

Hoping for a similar story here, not that yours was pleasant either of course! Also continued health for you 💕

Keep chatting on here, it's good to share xx

Thank you, I will and I know that nobody can say anything for sure. I suppose it's helpful just to get it all out even if nothing else.

At present he has gone onto 20,000iu of Vitamin D as that was also low and is waiting for news of appointment through upper and lower GI clinic through the urgent 2ww. We were supposed to travel out of area on Monday as we are looking at residential schools for our older son who has SEND but I may go alone in case he gets called in for anything last minute. Obviously colonoscopy isn't going to be lazy minute due to the prep etc.

I am trying to stay positive on the basis of him having no symptoms other than the iron deficiency (which he isn't symptomatic of at all, he has a huge amount of energy considering he has a haemoglobin count of 90 and all other RBC related figures low) and the bleeding from haemorrhoids. Now we have access to his NHS APP he visited the GP in January 2022 and 23 about haemorrhoids and bleeding but all was assessed as being ok, I still wonder about this. I'm hoping even if it is something more complicated it's early days as he isn't experiencing any symptoms, no pain, no weight loss etc. I suppose I just can't even bear to consider the alternative could be possible. He's currently laughing his head off on WhatsApp chat with his friends from his home country, watching stupid YouTube videos and his normal self. Please keep him and us in your thoughts, what a worry!