Dd has very low iron, protein and white blood cells

[capelmustard]

For background dd, 19, had anorexia a couple of years ago, but has made a good physical and mental recovery and eats well.

Despite looking like her old self again, she never really regained her energy and we recently asked for blood tests. GP rang her the next day sounding alarmed, said that her iron was very low and prescribed Galfer 1 tablet twice a day. We've tried to increase the iron rich foods in her diet but she was eating most of these anyway.

I week later GP rang again to say her protein and white blood cells are very low. Unfortunately I wasn't there when she got the call or I would have asked more questions, but they said to just take the iron as prescribed and retest in 3 months.

I'm going to get dd to email and ask for a copy of the results as it's all a bit vague and I'd like to know what we're dealing with. From googling it seems she'll have very little resistance to infection which explains why she had a cold constantly all winter. She's exhausted and despondent.

Any advice on how to get those numbers up? Thanks

OP I discovered recently all my test results etc stored in the NHS app, if your daughter has access to that and is happy to look and share it might be a quick way to see full results.

I would be very keen to bolster her iron and general health as much as possible (bearing in mind the thresholds for the NHS might already be low) iron tablets, spatone, iron rich foods and nutrient dense foods in general.

How is your daughter doing? Her MH in relation to her eating disorder and general life?

Get her to take the iron with a fizzy vitamin c tablet

Unfortunately not in the UK as they would be so helpful to see everything @Alwaystired2023

Generally she's well, she see's her therapist regularly, she's enjoying uni and doing well there. She has a great, supportive group of friends and is very sociable.

It's really just the physical aspects that are getting her down. She often comes home early from nights out as she's so tired. She has a part time job but usually has to go for a nap after working a short shift.

Her diet is good. I cook everything from scratch, she eats regular meals, and has been for over a year. Obviously no diet is perfect but I'm struggling to get extra nutrients in there.

Good idea about the spa tone, and the vitamin c, thanks @spikeandbuffy

I suppose what I'm worried about is that she did so much damage during the anorexia that she might not fully recover her energy. Her bmi was 14.1 at one stage.

Trying to be positive with dd of course

I'd get her some B12 injections to start and a Vit D (will last through summer now then another in 3 or 4 months for winter - I paid for Vit D privately). B12 is a really common deficiency and affects absorption, so do that alongside the iron supplements. I am also anemic and was prescribed loading of B12 because I was under on FBC (6 injections over a week). I am hopeful i'll get prescribed folate or something once they re-test levels in a few weeks. In the meantime I'm on Spatone daily to try to get levels up but it's slower than using folate pills (had about a year ago and noticeably worked within 2 weeks). You do have to keep on GP's as you never see the same one twice so once the B12 is done you'll likely have to push again for the folate/ferritin which really affect tiredness and breathing I find.

what are her b12 levels?

The iron tablets as well, current advice is to take every other day as it lessens side effects and otherwise it's more than you can absorb

I was told by a GP to take Spatone sachets as it's less strain on the stomach and doesn't cause constipation. It also raises folate and ferritin unlike plain iron tablets,

Spatone has virtually nothing in it though
5mg I think vs the 335mg tablets

www.thelancet.com/article/S2352-3026(17)30182-5/abstract

@capelmustard really worth checking her thyroid (anything above tsh 3 is likely to be an issue)

elevated tsh is renowned to cause low NK cells (type of white blood cells)

DS had this and treated this naturally with two specific vitamins; in any case worth checking (very simple blood test)

I thought that when you account for absorption it was the best option - as I say was a GP who told me this and I took 2 daily when pregnant...Will read the link anyway.

That isn't about spatone vs iron tablets and absorption though, just that taking one every other day optimises absorption of a tablet. Tablets are notoriously hard on the stomach. Spatone absorption rates are higher because it is easier to break down in the body :
"Spatone® Liquid Iron has been shown in a study to have a higher absorption rate (from 10 to 40% absorption, with an average absorption of 23%2) than conventional iron supplements. You only need a small amount to supplement your dietary iron intake towards meeting your Nutrient Reference Value (NRV) of iron."

Yes sorry linked that to show the every other day
Spatone is about 5mg that can be absorbed and iron tablets are about 35mg I think from what I remember, if you're badly low then it won't do anything except maintain or maybe a slight increase
You can take both though which would probably cover all bases!

Thanks all, I'll get the spa tone. She's been taking the Galfer for a week now, no constipation so far.

I'll read the links, the world of iron absorption is a confusing one for sure.