Protein Still Low, Iron Too High

Well my grand experiment is over... I had read something that made me think my protein issues were related to endurance exercise-induced anemia. IOW, I have low protein because I'm not getting enough iron.

Nothing in my labs screamed anemia. All my iron and anemia related labs were in range.

BUT

-My iron was trending down.
-My hemoglobin was the lowest it's ever been and only average when before it had been excellent
-My hematocrit was still pretty good, but also lower than it used to be
-My ferritin was slightly trending down (only a few points a year, but still) and was near the bottom of the range.

So I started supplementing with more iron.

As a result, the following happened:

-My hair stopped falling out if I had a few days of protein under 100 g
-My hematocrit and hemoglobin are back where they used to be
-My ferritin went up 10 points and is the highest it's ever been
-My iron is now over the high end of the range (not good)
-My protein is still low

So I'm not sure what's up with the protein. My PCP and surgeon  have both said not to worry about it because I clearly don't have any signs or symptoms of any of the problem that low protein is associated with, but it BUGS ME.

I think I do have to supplement with less iron. It's a heavy metal and you can get heavy metal poisoning if you aren't careful. I'm only a few points above the upper range so I'm probably fine (the ranges often have some slop built into them) but I was taking Proferrin twice a day for a while there and then Proferrin in the AM and Celebrate's Iron+C in the PM and then the Celebrate Iron twice a day when I ran out of Proferrin, so I think I'll cut back to an iron supplement 1x a day.

Oh and I had a couple of other lab results the last time that were H or L that both my PCP and surgeon said were most likely due to being a bit dehydrated when I got my test done. (Things like Neutrophil and Eosinophil.) Normally, I do my tests first thing in the AM and I don't eat or drink anything beforehand. However, you are allowed to drink clear fluids and it's still considered a "fasting" test so this time I drank a bottle of vitamin water on the way to get my labs done and everyone of those items was right in range. So they were right!

Not that I thought they weren't, but I decided I wanted to get rid of all the noise in my lab results so that I could get a true picture of what was going on with me.

I still have some results to get back. But these are the ones I cared the most about as these were the ones with issues.

Now if only I could figure out what was going on with my protein.

I need numbers for any of this to mean anything to me.

--gina

Well it was more of a rant than a cry for help. LOL

I've asked for help with the protein before and no has been able to come up with anything better than "eat more protein". But at one point I was consuming 125-175 g a day. And still having low protein values.

Here's a little chart from my online records with all my values for iron, protein and other related measures that they've ever taken. The first two columns are pre-op baselines. Everything else is post-op:

Name	Standard Range	11/21/07	9/10/08	12/16/08	9/11/09	1/6/10	4/2/10	4/20/10	9/24/10	9/12/11
HEMOGLOBIN	12.0-15.5 g/dL	13.9	14.1	13.3	13.6				13.5	14.6
HEMATOCRIT	35.0-47.0 %	43.7	45.1	40.4	40.9				40.9	43.3
PROTEIN	6.4-8.2 g/dL		6.9	6.1 L	6.0 L	6.1 L	5.8 L	6.3 L	5.8 L	6.0 L
ALBUMIN	3.2-4.7 g/dL		3.7	3.6	3.5	3.5		3.7	3.5	3.5
IRON	35-150 ug/dL			54	141				95	189 H
TIBC	250-450 ug/dL			334	353				356	370
FERRITIN	8-252 ng/mL				29				24	34
IRON SATURATION %	15-50 %				40				27	51 H

Ok, now what you said makes sense when I see the numbers. Thanks.

That is interesting about the protein and albumin numbers. I know you said you had some kind of problem with whey protein shakes, right? I was thinking more bio available proteins like whey and eggs but you're probably already doing that.

--gina

My problem with the shakes is that they don't taste good enough to have more than one a day. LOL

Actually, I've been *really bad* about using them lately. I've been living off protein bars. (Which are whey protein too.)

It doesn't seem like my protein values are sensitive to my consumption of protein though. They have floated between 5.8 and 6.1 for 3 years now whether I've been averaging 90 g of protein a day or 140 g. Maybe I just need to get 200 g and see what t hat does?

Maybe the protein bars aren't as bio available to your system as shakes?

It's doubtful since it's the same protein source. Also, when I was getting 42 g a day from shakes, my protein was still low. Getting it from food... protein low. Getting it from bars... still low.

So either I need some incredible amount of protein to even make a dent in my levels -- which is entirely possible -- or it's just some weirdness about me -- which is also possible but less likely. Or it's still some other issue that is interacting with the protein, making it not absorbed somehow.

the fluctuations in the hemoglobin and hemacrit aren't that much to make a difference, these can vary from day to day but they are all really good numbers. Normal is from 12.0 and up, so being above 13, is great and 14 is fantastic for a hemoglobin.  I would give anything for that right now.

What is really strange is how your iron is so high but your ferritin is so low.  I know the ferritin is the storage but you would think with iron and iron sat % that high, you would have stored some of it by now.  Do you have any liver troubles? This can affect iron and over absorbtion.

As far as protein, trying to supplement with bars won't cut it.  You need to try to supplement with shakes - keep trying different recipes - here is a recipe of something that I think is absolutely delicious and will give you 45 grams of protein.

8 ounces of milk - I use soy but can use FF/LF reg or lactaid
2 tablespoons of SF chocolate syrup (I use torani or davinci;s)
5 - 6 ice cubes
1 1/2 chocolate protein powder ( I use GNC ProPerformance 100% Whey Protein - you can use Whey Isolate and it will give you even more protein)
2 tablespoons of SF chocolate pudding powder
1 sliced banana

Put it all in a blender for about 45 seconds until smooth. IT is a delicious chocolate milkshake with 45 grams of protein.

Try it, you can also change the flavors around.

You can also add protein powders to NSA hot chocolate, tea and coffee.

I know hemoglobin of over 13 is considered excellent but everyone is different and, for me, mine used to almost always be 13.7 to 14.9. So when after WLS it was always 13.5 or lower, I figured that meant I was not getting the iron that I used to. I'm happy to see it back up in the 14s. That's more normal for me.

My ferritin did go up 10 points from 24 to 34. I don't really know how it works though. Is there only so much that can be stored at a time? Or should more have been stored by now? It is strange that I'm not storing it when my iron is now high.

Is the iron one that has to be covered in foil when they do that tube? Because I had a trainee do my blood draw and she didn't cover any of the tubes in foil immediately after drawing them but did it a bit later. (Actually, the experienced guy who was helping her did it.) I was worried those tests wouldn't come out right because of that.

I'm not really "supplementing" with bars, btw. I am just lazy about preparing food and I tend to grab a bar instead of making lunch or a snack. They are easy and require no prep. Not that I think this is good or anything... I know it's not optimal nutrition. For one thing, my bars have so much sugar!

This is really the same laziness that is causing me not to make shakes any more. I used to make one every morning that had 42 grams of protein but now I do it maybe 2 mornings a week.

I also used to have a protein hot chocolate almost every night. I don't think I stopped that because of laziness though. For one thing, I make dh make it for me. LOL. It's just that it's been hot. I need to start them up again.

I know I need to cut it out with the bars. But not because of the protein. Because when I was doing a shake every morning and a protein hot chocolate most nights and getting lots of protein from chicken, eggs and dairy, I still had low protein.

I do keep wondering about my liver but all the other labs that relate to liver function are fine.

I don't have them all back though. I'm waiting on some of the Bs, zinc, selenium, PTH and Vitamin D. Oh and Vitamin A.

I'm not sure what to say about the iron issue, since I have my own issues with it,.


Maybe, it is a quirk with you, since your  pre-op values were similar. You could also mix protein in with Greek Yogurt, oatmeal, and practically anything that you can think of. I don't drink protein drinks, but mix some Beneprotein in with my daily Greek yogurt. Since I started eating some oatmeal on the weekends, I also mix it in with that. I have put the protein in chili, when I have eaten that, but it has been months since I have had any chili. I get most of my protein from dairy, eggs, salmon, a little beef, and chicken.

Too much protein can be damaging to your kidneys, so keep an eye on your creatinine level.

I think the vial that needs to be covered with foil, is the one for Vitamin A.

Gail