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Anemia of chronic disease in ME/CFS?

Discussion in 'Autonomic, Cardiovascular, and Respiratory' started by Emootje, Apr 19, 2012.

  1. Emootje

    Emootje Senior Member

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    Hurwitz study shows that patients with severe CFS have a 13.26% shortage of red blood cell volume (RBCV) and patients with non-severe CFS have a 5.82% shortage of RBCV. I think that this anemia could be explained by the inhibitory effect of cytokines on the erythropoiesis.

    Anemia of chronic disease is is a form of anemia seen in chronic illness, e.g. from chronic infection, chronic immune activation, or malignancy.

    acd2.JPG

    Weiss and Goodnough did an excellent review on the anemic effects of inflammation.
    http://www.med.unc.edu/medclerk/medselect/files/anemia2.pdf
    They describe the effects of different kinds of cytokines on iron metabolism and EPO production/erythropoiesis:

    TNF alfa:
    *Degradation erythrocytes?
    *EPO production?
    *Erythropoiesis?

    Interferon gamma:
    *EPO production?
    *Erythropoiesis?
    *Ferroportin-1?
    *Divalent metal transporter-1 (DMT-1)?

    Interleukin-1:
    *EPO production?
    *Erythropoiesis?
    *Ferritin ?

    Interleukin-6:
    *Ferritin?
    *Hepcidin? >
    Fe2+ absorption?
    Ferroportin-1?
    Erythropoiesis?

    Interleukin-10:
    *Ferritin?
    *Transferrin-receptor expression?

    ACD1.JPG

    So if you have low iron or low transferrin or high ferritin or high hepcidin, you could have an anemia of chronic disease!

    Note: In ME/CFS hemoglobin and hematocrit are unreliable markers for anemia. The only way to make sure you are anemic is by a red blood cell volume determination.
     
  2. nanonug

    nanonug Senior Member

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    This is a great post and a great article. Thank you for posting this.
     
  3. ramakentesh

    ramakentesh Senior Member

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    another great post. I have been reviewed for this a few times because I also have Ank Spond.
     
  4. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    Do you know if there is any treatment for anemia of chronic disease? I would not want to pay for a test if it did not lead to some treatment.
     
  5. taniaaust1

    taniaaust1 Senior Member

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    Thanks for that article. It may explain my blood test results (anemia of chronic disease)
     
  6. ramakentesh

    ramakentesh Senior Member

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    I think the traditional tests may not pick up low blood volume perhaps the result of EPO deficits.

    Astragalus and chinese angelica can supposedly boost EPO production.
     
  7. Emootje

    Emootje Senior Member

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  8. nanonug

    nanonug Senior Member

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    What you want to do is to actually fix the underlying issue (the chronic disease). Adding iron to one's body might be counterproductive as it will make it easy for pathogens to both grow and establish biofilms.
     
  9. aquariusgirl

    aquariusgirl Senior Member

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    The anemia of human chronic diseases is particularly interesting because it occurs under conditions such as infection or inflammation, which involve decreased circulating iron, increased reticuloendothelial iron and decreased intestinal iron absorption, all features of iron disorders that could be explained by up-regulation of hepcidin. Fleming and Sly (21) already predicted such an inflammation-induced increase in hepcidin, and this increase is now under investigation with mouse models of inflammation. The putative role of hepcidin in inflammation is reinforced by the interesting finding by Pigeon et al. (7) that lipopolysaccharide, a classical inducer of acute-phase proteins involved in response to inflammation and infection, is able to induce hepcidin gene expression both in vitro and in vivo.

    http://www.ncbi.nlm.nih.gov/pmc/arti...tool=pmcentrez
     
  10. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    My dietician said that the primary dietary source of cobalt (in which I am very deficient) is cobalamin (vitamin B12). I wonder if it would also help anemia of chronic disease. Quite a few people with ME are benefiting from taking B12.
     
  11. Daffodil

    Daffodil Senior Member

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    i always assumed my low iron was cuz of anemia of inflammation.....as far as i know, the only treatment is to take iron right? i mean.other than to treat the cause of the disease. do they do something else?
     
  12. xchocoholic

    xchocoholic Senior Member

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    Does this explain why blood draws are so hard on us ? Actually, I'm ok for a non fasting draw as long as
    I'm well hydrated and well nourished. My last fasting blood draw, 9 tubes I think, promoted pre seizure activity. I HAD to take klonopin.

    But it normally takes me 3 days to recover from the weakness. Taking iron didn't help tho. Nothing but rest helps.

    Does anyone else here have Paget's of the bone ? I've been reading recently that may be from a
    bone infection or virus. Btw, this doesn't normally show up until people get older but it's suspected to he from an old infection.

    I'm considering asking my doc for some antibiotics, keflex, I think ... Tx .. X
     
  13. nanonug

    nanonug Senior Member

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    If your body is withholding iron due to infection, supplementing with iron is only going to make things worse for you. You need to identify and get rid of whatever infection is causing the problems.
     
  14. SaraM

    SaraM Senior Member

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    it was deleted.
     
  15. xchocoholic

    xchocoholic Senior Member

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    Hi Sara,

    Um, what was deleted ? lol ... I keep talking to people about how blood draws make me weak for days afterwards but never thought to ask why or how to stop it. I thought this theory might explain it ... Increasing water intake and taking iron never helped.

    tc ... x
     
  16. nanonug

    nanonug Senior Member

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    Maybe your body has difficulty building new red blood cells, for instance. This would be consistent with some kind of cobalamin or folate deficiency.
     
  17. Emootje

    Emootje Senior Member

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    This old study found that cobalt supplements are more effective in rats than vitamin B12:

    "The present data thus indicate that the daily administration of relatively large doses of vitamin B12 to the rat does not produce a polycythemia, as does cobalt under similar conditions. It is possible, of course, that the dosage of vitamin B12 employed in the present investigation was too small to elicit a striking increase in erythropoiesis"

    Vitamin B12 has only 4% cobalt so I think that a cobalt supplement is preferable. I have ordered this one: http://www.mineralifeonline.com/pd-cobalt-8oz-60-day-supply.cfm#main
     
    Little Bluestem likes this.
  18. ramakentesh

    ramakentesh Senior Member

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    I guess the difference is that conventional anemia of chronic disease is quite measurable, but perhaps in some conditions we are talking about a volume deficit that matchs the blood cell reduction so that if measured it appears normal, but in POTS in particular there is effective anemia, worsened by postural stress?
     
  19. Emootje

    Emootje Senior Member

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  20. xchocoholic

    xchocoholic Senior Member

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    After taking sublingual mb12 and adb12 and I "think" metagenics vessell care, both my b12 and folate were
    significantly above normal and I couldn't sleep at all. I react this way to excitotoxins.

    I think the infection angle may be what I've been missing. I've read that Paget's could indicate an underlying infection. I need to research it more. I didn't show signs of paget's until I'd been sick for at least 17 years. I've had regular cat scans for years so we would've seen it before. I'm 56 now.

    And I read that keflex can help with skin, lung and bone infections. I have lung scarring too. My skin is always erupting in some fashion.

    I sure wish this was easier. tc .. X
     

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