Medication induced anemia??

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Date Joined Nov 2006
Total Posts : 1331
   Posted 8/20/2008 3:06 PM (GMT -7)   
I went in to the doctor on Monday because I wasn't feeling well and had blood work done (not my rheumy) and my rbc count came back really low, so I had to go back in and have a test done for folate and B12? She told me I had very large red blood cells as well.. I explained to the nurse on the phone that I take B12 on a daily basis, along with folic acid, so I'm not sure why my count is so low.
Has anyone had this happen while taking MTX??? I take the 400mcg plus what is in my multvitamin every night, so I should have plenty in my system! I'm not sure how much more of both I can squeeze in.
Thanks in advance

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Date Joined Nov 2003
Total Posts : 7122
   Posted 8/20/2008 3:52 PM (GMT -7)   
I'm not sure about MTX causing low RBC counts but I take Imuran and it has caused me to have low RBCs and too many immature, malformed RBCs. My GI tells me it is from the Imuran. Low B12 and/or floic acid can cause the same problem so it's good they are testing that. Also, if a person has chronic illnesses, there is an anemia that desplays low RBCs called "anemia of chronic illness."

While on MTX, it is recommended that people take at least 1 mg folic acid daily. Because imuran can also effect folic acid, my doctor prescribed prescription strength folic acid - 1 mg per day. The pill is tiny. My B12 is low from my Crohn's and I take a supplement for that too - 1000mg daily. It is a sublingual tablet that tastes good and just desolves under the tongue. I was taking a daily multivitamin and my doctors said it was just not enough for my needs. I continue with the multivitamin and the supplements. My RBCs are still low but not as bad as before.
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CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.

Veteran Member

Date Joined Dec 2007
Total Posts : 2113
   Posted 8/20/2008 3:58 PM (GMT -7)   
Are you also taking an NSAID? the combination can make your rbc count very low and can cause excessive GI bleeding I had the exact same thing happen to me after only one dose of mtx. Large red blood cells are actually good (usually) it means your bone marrow has not been suppressed but is trying to create extra red cells and dumping them into your blood stream early.
I talked to my rhuemy every few days for a while we decided to stop the NSAIDS, I increased folic acid to 3 mgs per day, and the b-12 supplement I take is 1000 mcgs.
Oh by the way you can get 1000 mcg (1 mg) folic acid tablets cheaper at GNC then by perscription 100 tablets for 4.99.
My RBC is fully recovered.
Talk to your doctor about what else you can be doing.

Veteran Member

Date Joined Nov 2006
Total Posts : 1331
   Posted 8/21/2008 6:32 AM (GMT -7)   

Thanks to both of you... I'm not taking any of the NSAIDS, and I went in for stomach pain and just not feeling well, ended up having another ovarian cyst and she just ran a panel to check things out. I have a lot of pain on the side that I don't have my cyst on she is still concerned, on the colon side which is strange!! Sht told me if the pain continues she is going to do a colon test shocked

Thank you Ides..I take the 400mcg plus what is in my multi so I thought I was getting plenty of what I needed.  I still feel puney. I have never had this happen before so I may give the rheumy a call and see what he thinks.

Regular Member

Date Joined May 2007
Total Posts : 499
   Posted 8/24/2008 10:06 AM (GMT -7)   

Hi mom!!

Don't know anything about any of this..heehee..just wanted to pop in and say "Hi" and see how you were doing... hope all is well.



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