Medical Mysteries


Everybody likes a mystery right? Especially a medical mystery – whether it’s a crime show based on forensics, like Bones or CSI, or a doctor show with an irascible but brilliant main character like House, medical mysteries are great fun for all involved.

Well, except the patient. Or corpse. And if you are the patient, it’s no fun at all.

Recently, I’ve been feeling tired. A lot. My doctor suggested I drank too much wine (and I have dutifully reduced my consumption by a quarter – though it is still a lot) but also ordered a lot of blood tests. There was a lot of good news – almost everything was normal, including, by the way, liver function. My glycerides were high but that’s fixable by cutting out some carbs. My bad cholesterol, to quote the doctor, “looks like it would if I were taking drugs to control it.” Which I am not – so go me.

My B12 is low – low enough that diet won’t fix it, so it’s a daily supplement from here on in and a re-test in a couple of months. Low B-12 can lead to fatigue and may also cause a certain amount of poor moods. And I thought that was being caused by work.

Usually, low B12 is also a sign of anemia. But, mysteriously, my iron levels are abnormally high; high enough that the doctor will consult with a blood specialist. Because, right now, there is no explanation for this result – and it’s not one prone to false positives. Nothing in my diet explains it, I don’t take iron supplements (I actually take almost nothing on a daily basis) and I haven’t recently been blood doping. Not since my days as an Olympic sprinter. So low B12 and high iron is a bit of a mystery.

Big deal, you might think, high iron can’t be a bad thing right. Iron helps oxygenate your body and high iron should give you a real energy boost. Actually, according to my other physician, Dr. Google, high iron is just as bad as low iron when it comes to energy – so it might be contributing to my fatigue. And, when really high (I’m not – I don’t think) it can cause liver damage (or cancer), heart disease and, not surprisingly, premature death. More horrifying, it can even cause impotence! Fortunately, I’m like Donald Trump that way – no problem in that department. No, seriously. I wouldn’t kid you about something like that.

Strangely, the cure for high iron is quite simple – though somewhat medieval. There are no drugs or dietary changes that will help. The solution is to give blood every six weeks or so and, if for some reason you can’t give blood, that’s okay they’ll just take it. It has a fancy name – phlebotomy – but really it’s bloodletting. Like in the Middle Ages. With leeches or vampires or something.

I’m sure all this will work out fine. In the meantime, I’ll keep analyzing the clues and stay away from large magnets.

And that’s ten minutes.

3 thoughts on “Medical Mysteries

  1. Hmmm. First, low B12 is often because the vitamin cannot be absorbed due to a lack of intrinsic factor in the stomach (in which case oral supplements may not fix it; monthly IM injections often required). However, there are many cases where fairly large oral doses are successful. Lack of B12 can indeed lead to anemia (NOT the iron deficient kind which has small red blood cells, but B12 or folate deficiency which has fat red blood cells), as well as low levels of other blood lines (platelets, white blood cells) but more importantly neurologic abnormalities.
    Elevated iron depends on which substance you measure (iron, transferrin, ferritin) and some of these, particularly ferritin, can be elevated by other problems (often, any inflammation). Iron deficiency is often hard to sort out without a bone marrow test to look for iron stores.
    Iron overload, on the other hand, can lead to liver and heart damage as well as other endocrine damage, and the definitive diagnosis, if needed, requires a liver biopsy. This can often be an inherited abnormality, or can be related to other forms of liver disorder (which normal liver function sort of suggests is not present).
    Bloodletting is really only required for the genetic abnormality, hemochromatosis.
    Some specialist might be wise, depending on persistence of these abnormalities. And I’m out of date. I have not treated these diseases for twenty years.


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