Get ALL Your Levels Checked

Karen, a nurse who had gastric bypass surgery

As a nurse, I know how to make healthy decisions for both my patients and myself.  Seven years ago I decided to make a major change in my life and have gastric bypass surgery.  In the months following this surgery your body goes through many changes as you adjust to eating less and begin losing weight.  I was still surprised, however, when about three months later I started to feel extremely fatigued and my muscles began to ache. 

My days have always been long: I wake up between 4 and 5 AM every day before working long shifts at an oncology clinic.  By the time I get to bed, it’s usually 10 PM if not later.  Suddenly, as my fatigue and aches worsened, it was all I could do to get through a full shift.  All I could think about was getting home and collapsing in front of the TV. 

I thought my body was still adjusting from the surgery.  Even as a trained nurse, I did not immediately assume something was seriously wrong.  Luckily, a fellow nurse and doctor at my clinic convinced me it wouldn’t hurt to have some labs done.  My hemoglobin, which contains iron, came back a bit low, but it was not too concerning.  What was surprising was my ferritin level, which measures how much iron is stored in your body – the normal level should be between 18 and 160 nanograms per milliliter while mine was only 6.  The hematologist I went to see said my personal level should be at least 30 to 50 nanograms per milliliter in order to sustain my activity level.

My doctors aren’t sure what caused my iron deficiency.  It could have been the gastric bypass surgery – any surgery that impacts your digestive track could limit your ability to absorb nutrients like iron.  It’s also possible I was developing an iron deficiency even before the surgery.  There just isn’t any way to know as I never thought to have tests run before the procedure. 

Because we didn’t know the underlying cause, and my ferritin levels were so low, my hematologist determined we should immediately begin a treatment plan.  Pretty soon the aches in my muscles, particularly in my thighs and knees, were gone and I was back to my normal self.  I keep an eye on my symptoms and make sure to tell my doctor if some of them start to recur.

Having experienced iron deficiency firsthand, I now tell patients who complain about fatigue or muscle aches to see their physician for a thorough physical.  I remind them to be detailed about their symptoms because general complaints about being tired are not necessarily red flags for doctors.  Once the doctor orders tests, don’t just settle for a finger prick.  That only tests your hemoglobin and your problem may be identified through another measure, like ferritin level.  Patients need to insist their doctors paint a full picture of what’s going on through a thorough blood work-up.