I have anemia too and my Rheumy said it was a marker for RA. She told me to take a prenatal multivitamin because it has a higher level of iron in it. I am still anemic even after this vitamin for months and eating lots of iron rich foods.

Tell your rheumatologist that anemia is a possible side effect of methotrexate. He should know that.

There is a new support group that was just formed days ago on DS called Curing Autoimmune and mimics. I think the name needs work. It was started by Narey a respected member on the fibro site and is based on a new Book that a fibro member wrote. Here is what the book says about iron and arthritis. This is from Lita Lee, PhD.

"All forms of arthritis involve abnormal calcium metabolism. Ninety-nine percent of calcium is in the bones and teeth. The other one percent, found in the blood, is just as important because it is essential for blood clotting, muscle and nerve function, and Vitamin D function. Of the one percent of calcium in the blood, half is PROTEIN BOUND and half is ionized. Both require ADEQUATE PROTEIN DIGESTION. If you are deficient in protein, because you can't digest it, you cannot carry protein- bound calcium. If you lack optimum acidity from inadequate digestion of protein, you will not have enough ionized calcium. In either case, you are a candidate for arthritis."

There would be a few reasons why RA patients would not have sufficient iron if they were unable to properly digest dietary protein. B12 and iron are often mentioned together.The dietary sources of B12 and iron are often the same, so that deficiencies in the two may occur at the same time. Vitamin B12 is derived in the diet only from animal sources and is very abundant in meat, red meat in particular. Meat also contains high amounts of iron. Other meats that are abundant in both B12 and iron include poultry, pork and seafood. If you lack the enzymes to break down these proteins, then you would not be able to carry calcium and this could lead to arthritis, nor would B12 or iron be available to your body.

Lack of B12 can lead to pernicious anemia,and low iron can also cause anemia.

You can just about any question and get an answer from this book. Please check out the new group. It was just formed, so there are not many of us there yet. Just join, ask your question and it will be answered soon.

Anemai is very common in chronic diseases - also know in the medical field as ACD - anemia of chronic disease..

About a year after I was diagnosed my Hematocrit dropped sharply. I was pale and short of breath. I ended up having an endoscopy and colonoscopy - negative. Sent to a hematologist who did a ton of blood work and I ended up having hemolytic anemia - my blood was dying off shortly after the red blood cells were made instead of living their average 120 days. It was all found to be related to the sulfasalazine I was taking at the time. I got off that, and my counts came back up.


I would see a hematologist to rule out any other abnormalities. My hematocrit still runs below normal - about 30-32, but the hematologist said that it's now ACD, nothing to worry about.

Oh and he told me iron supplements wouldn't work for ACD, so I don't take any, as all my iron, TIBC and other iron tests are normal.

Thanks for all the info! I would think my Rheumatologist should know more, but sometimes I think my own Doctor knows more. The iron gives me a stomachache. But if I quit taking it I get real anemic. By taking it I stay just under normal. But I think I will ask about seeing a Hematologist. I think it's exactly as you all said. It's not that I'm not taking in iron. It's that my body can't absorb it.

I just wanted to point out the connection to Vitamin D. Protein bound calcium is critical for Vitamin D function. So, if you are deficient in Vitamin D, this could be why.

As the doctor was saying,at the heart of this is the inability to break down dietary proteins. A host of things will happen in your body if you cannot digest protein. You will not be able to make amino acids, which are essential for every function in your body.

Yes I do take a vitamin D with Calcium chew every morning. I used to take a multivitamin also, but I'm trying to take just what the Doctor tells me to. I also take Protonix for a Hiatal Hernia. I may stop this for awhile thinking it may be interfering with my inability to absorb iron. But if I get heartburn back I'm sure going to start taking it again!

Shaferi-- I think you are right about the protonix. It has been shown repeatedly in studies to be an absorption problem, not a dietary intake problem. I am going to make a post on the new site today or tomarrow about acid reflux and the connection to RA.