Type 2 Type 2 and anemia

[add19]

I've been on Metformin for about 3 years since my diagnosis. My HBA1C was 9.0 % (not familiar with British Measurement) and intially my doc prescribed 500 mg twice a day. 3 months after he reduced it to once a day as I managed to bring my A1c down to 5.6%. Then successively every 3 months the results were mostly on average staid around 5.5. lowest 5.0 highest 5.7. I moved out of state and for a little over a year didn't get my A1C checked until a month back when I got tested. It was 5.2. Everything else(lipid panel and all) is Ok except my new doctor told me I was mildly anemic and that could distort the A1C readings a bit. I may have had a higher reading but he said nothing to worry about. in fact he told me to stop taking medication and do a regular BG monitoring at home. A month after(today), when I saw him the test he took for anemia didn't show improvement and even that number slipped down by 1. I believe normal should be above 14. Mine was 13 first and the second test came and it was 12.6. What concerned me the most is, I may have other problems I don't want to know. He scared me a bit. Anyways I heard being on Metformin for a long term can induce Vitamin B12 deficiency hence cause anemia but don't know if it's scientifically supported. Any of you gone through this experience? Let me hear your opinion

 

[chalup]

My doctor told me to take B12 sublingual when he stared me on metformin. It is a simple blood test to find out if you are low. It is a cheap and easy supplement to find in any drug store. I believe the sublingual part is important for absorption. Hope this helps

 

[add19]

My doctor told me to take B12 sublingual when he stared me on metformin. It is a simple blood test to find out if you are low. It is a cheap and easy supplement to find in any drug store. I believe the sublingual part is important for absorption. Hope this helps

Thanks, Chalup. I am 5'8" tall and weigh 105 pounds(don't know in stones) and that's mainly because I don't meet the daily required calorie intake to gain more. For a skinny guy like me with less carb in diet is harder to achieve that goal. I wonder if my weight and diet has some contribution to my anemia. Besides all diabetes friendly food are not easy to digest and absorb because of higher fiber content in order to help reduce blood sugar spike. My doc didn't say anything to start the supplement yet but discussed the possibility. He just said he wanted to keep an eye on it. I've stopped taking meds and probably he wanted to see the impact on my next visit and test result.

 

[chalup]

B12 certainly wont hurt you and as I said it is cheap and easy to find. Are you wanting to gain a bit of weight? If so increasing your proteins and fats might help. Things like sausages and full fat dairy. Cheese and heavy cream. Nuts is also a lower carb but fat and calorie dense food. Macadamias in particular. Many people who struggle to lose weight on low carb find that cutting nuts and dairy way down helps with weight loss so it stands to reason that eating more can help with weight gain.

 

[add19]

I agree chalup. I recently started adding organic butter in my cookings. I also eat an XL avocado/day. almonds, walnuts, pecans, cashews(moderately) are all in my meal plan. mostly for snack. I like tree nuts and yes I heard they can help gain weight. Mono unsaturated fat is good for heart health too. But not sure about heavy cream. I mean seriously? what about LDL and heart decease ? I thought doctors tell patients to cut down bad fats. Diabetes is a disease of knowing ones limit and am struggling how much I can eat without raising BG and no medication. anyways I look forward to what you have to say about heavy cream.

 

[chalup]

Heavy cream is low in carbs and high in calories. Milk is full of carbs. Cream also gives you a feeling of being satisfied. Doctors tell patients to cut down on so called bad fats but they also tell diabetics to eat hundreds of grams of carbs per day and then hand out pills to deal with the consequences. The medical system here in Canada is the same as the UK in the decades old low fat high carb mantra that has caused so much havoc. It is interesting to know that the food pyramid with all those grains as the base was developed by the grain farmers. I bought in to low fat at one point. I starved myself into a 100 lb weight loss. As soon as I began eating again I gained all of it back and discovered that the extreme low fat had destroyed my gall bladder and now I have to deal with the aftermath of having lost it. Another thing to consider is that a lot of the vitamins and minerals we need for health are fat soluble. We need the fats to absorb and use them properly. This is just my opinion and I am not a doctor, just someone who has been dealing with a multitude of serious health issues for years. Sometimes successfully, sometimes not so well, but I pick myself up and keep trucking. And as for me eating low carb and high fat brought my cholesterol and blood pressure down. Butter, cream, coconut oil, olive oil, full fat cheese, cream cheese, and my new favorite creme freche. Never margarine. Sorry for the book lol. I hope there is something in this to help you find your own way. Good luck

 

[add19]

Chalup. I know hydrogenated fat is bad. It's used in baked products for longer shelf life. Margarine is also bad and am glad I was very young when I gave up eating it. But knowing full fat cheese, cream cheese and butter are Ok is a music to my ears. I mean dealing with hypertension and diabetes and treating it with such a restrictive diet made my meal tasteless. What do you think of whole grains? They say white bread, rice, pasta . . . spike you but I think whole grains can have the same impact too. OMG did you say you lost 100 1b by reducing fat from your diet and it affected your gall bladder? How do you cope up eating high fat if your gallbladder is destroyed. I thought it helps to break down fat in our digestive system and people with gallbladder problem are recommended to eat less fat.

 

[chalup]

The gall bladder stores bile from the liver and contracts to release it into the intestine to help digest fats when eaten. If you don't eat any fats for a very long time, in my case well over a year, the bile just sits there and thickens until you end up with gallstones. When you start eating fats again the gallbladder tries to do its job and the stones plug up the ducts. The pain from a full gallbladder attack is incredible. My gallbladder has been removed so no gallbladder problems any more lol. If I eat fats, and I do, I get diarrhea which can be controlled with meds designed for this exact type of diarrhea or left to run its course so to speak. If I choose to eat high carb it helps the diarrhea to a point but blood sugars in the 20's are worse than diarrhea. On the upside for me, metformin seems to have a constipating effect, (I know I am weird lol) so it all tends to mostly balance out. I eat NO grains of any kind. Whole grain is still grain and still turns to glucose in your system. I am very low carb because that's what my system needs. I am trying to lose that 100 lbs again lol. You are trying to gain weight so you might want to experiment a little with your meter and see what your body will tolerate. It is different for each person. You might be ok with whole grain or you might spike. There is really only one way to tell and that is to try a small amount and test before eating and at 1 hr, 2 hr, 3 hr. Also mixing carbs with fat can slow the spike. Maybe a peanut butter sandwich? If you decide to experiment with a few more carbs let me know how it goes.

 

[chalup]

A question. Were you underweight when you were diagnosed? If you were, were you tested to see if you were really type 2 and not a slow onset type 1?

 

[sud5nala]

for a little over a year didn't get my A1C checked until a month back when I got tested. It was 5.2. Everything else(lipid panel and all) is Ok except my new doctor told me I was mildly anemic and that could distort the A1C readings a bit.

A month after(today), when I saw him the test he took for anemia didn't show improvement and even that number slipped down by 1. I believe normal should be above 14. Mine was 13 first and the second test came and it was 12.6.

I heard being on Metformin for a long term can induce Vitamin B12 deficiency hence cause anemia

"Anemia" distorts the reading in your favor. Your blood glucose would actually be slightly better than the test result.

I'm not sure what precise term the doctor used. But we have to understand that there are many anemias (of red cells, white cells, etc.) and that when doctors say plain "anemia", they usually mean red blood cell anemia (I once spent time browsing some hematology textbooks to pin down this fact. But just have a look at this Federal govt. page). Doctors don't use the full Latin or Greek name they could use that means "red blood cell anemia". When they mean Vitamin B12 anemia, that condition is called "pernicious anemia". Maybe the doctor's office could clarify which anemia it was. Looking up B12, its normal range is in the hundreds of pg/ml, but you cited values of 13 and 12. While you are waiting to get verification, it sounds like you're in the clear on B12. Metformin can indeed deplete B12.

Using values of 13 and 12 seems to refer to the "hemoglobin test" (total hemoglobin), whose normal values are given online, eg at the Mayo Clinic Website. For men, 13.5 is the low end of "the normal range". Anemia is measured using the red blood cell count and the hemoglobin level. I don't know the difference in practical implications between red cell count, hemoglobin, and hematocrit.

Again, low red cell count and hemoglobin mean the A1c overstates your blood glucose level. By looking up "interferences" to the A1c (or HbA1c) test, you'll find anemia on the list. Not just full anemia, but being in the low half of the reference range (nobody knows exactly what fraction of the low half). I don't think there is any information in the medical literature as to the size of the distortion (is your true value really 5.1, 5.0). I spent a lot of time looking for it, in vain.

 

[add19]

A question. Were you underweight when you were diagnosed? If you were, were you tested to see if you were really type 2 and not a slow onset type 1?

Chalup, I was around 145 1bs when I was diagnosed. I don't think it progresses dramatically to type 1 anytime soon(I hope). My diet and lack of exercise contributed to insulin resistance. I used to be a heavy sugary drinks consumer and never exercised.

 

[add19]

"Anemia" distorts the reading in your favor. Your blood glucose would actually be slightly better than the test result.

I'm not sure what precise term the doctor used. But we have to understand that there are many anemias (of red cells, white cells, etc.) and that when doctors say plain "anemia", they usually mean red blood cell anemia (I once spent time browsing some hematology textbooks to pin down this fact. But just have a look at this Federal govt. page). Doctors don't use the full Latin or Greek name they could use that means "red blood cell anemia". When they mean Vitamin B12 anemia, that condition is called "pernicious anemia". Maybe the doctor's office could clarify which anemia it was. Looking up B12, its normal range is in the hundreds of pg/ml, but you cited values of 13 and 12. While you are waiting to get verification, it sounds like you're in the clear on B12. Metformin can indeed deplete B12.

Using values of 13 and 12 seems to refer to the "hemoglobin test" (total hemoglobin), whose normal values are given online, eg at the Mayo Clinic Website. For men, 13.5 is the low end of "the normal range". Anemia is measured using the red blood cell count and the hemoglobin level. I don't know the difference in practical implications between red cell count, hemoglobin, and hematocrit.

Again, low red cell count and hemoglobin mean the A1c overstates your blood glucose level. By looking up "interferences" to the A1c (or HbA1c) test, you'll find anemia on the list. Not just full anemia, but being in the low half of the reference range (nobody knows exactly what fraction of the low half). I don't think there is any information in the medical literature as to the size of the distortion (is your true value really 5.1, 5.0). I spent a lot of time looking for it, in vain.

sud5nala, I really appreciate the depth of information you've provided me. The more I dig into reading about this matter the more I get worry some. Whatever terminology they use in the medical literature is only understood by the authors and their students. As far as my case is concerned my doctor said he'll keep an eye on it. That means more tests. I got a stool test done but there was no blood. Which means there was no internal bleeding. I used to have a higher content of potassium detected in my blood in the past but now it's normal. At one time there was some issues with my liver but that too is on the clear. Am just hoping the same happens to my anemia and become in the normal range again. You're right it was the total hemoglobin which was 12.6 and my doc said it was mild. Surprisingly a year ago when my A1C was 5.0 I wasn't anemic. Since then I almost eliminated red meat from my diet in favor of poultry. But recently restarted eating grass fed red meat in case if it helps to treat it. I heard liver is good too. Thanks again.