• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To register, simply click the Register button at the top right.

Anemia of chronic disease in ME/CFS?

Emootje

Senior Member
Messages
356
Location
The Netherlands
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.
 

Little Bluestem

All Good Things Must Come to an End
Messages
4,930
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.
 

ramakentesh

Senior Member
Messages
534
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.
 

Emootje

Senior Member
Messages
356
Location
The Netherlands

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
Do you know if there is any treatment for anemia of chronic disease?

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.
 

aquariusgirl

Senior Member
Messages
1,732
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
 

Little Bluestem

All Good Things Must Come to an End
Messages
4,930
A more natural approach (but I don't know if it's safe) would be the EPO inducer cobalt:
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.
 

Daffodil

Senior Member
Messages
5,873
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?
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
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
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
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?

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.
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
it was deleted.

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
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
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.

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

Emootje

Senior Member
Messages
356
Location
The Netherlands
A more natural approach (but I don't know if it's safe) would be the EPO inducer cobalt:

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.

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
 

ramakentesh

Senior Member
Messages
534
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?
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
Maybe your body has difficulty building new red blood cells, for instance. This would be consistent with some kind of cobalamin or folate deficiency.



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