Anemia fatigue - how to overcome?

Hi Ann..... I have wonderful news.  Anemia should get much BETTER with Taxol. 

The other thing you need to do is get your Ferratin levels checked.  I had the idea I could iron load during chemo, and it really doesn't work.  My Ferratin went sky high, but my Hgb took its own sweet time coming up.  Seems there was only so much my body could process.

What helped with me and the fatigue was exercise.  When I cycled, I got oxygen throughout my system and felt normal again.  I did this throughout chemo and radiation.

As I did six DD AC and then six DD Taxol, my iron levels tanked to 9.8 by the time I started Taxol.  They immediately came up....well about one week later, and continued to rise until I was in the low normal range by #6.

As of January (nine months post final chemo) they still weren't quite where I started, but well within the normal range.  I suspect it is now (14 months out) as I am back to full kick-butt energy after being at 95% for about 9 months.

Good luck.  Just lay off the iron until your body is ready for it.  Your onc needs to check your ferratin.  It will be obvious then that adding more iron won't help.  Time will. - Claire

Hi Anne, one has to be really careful with iron.  My ferritin has been in the 0 range for years and of course my rbc dropped while on chemo, onco tested both and gave me prescription for iron supplements.  I happened to google interactions with the TAC I was on, and discovered that there was a severe interaction between iron and the Adryamicin.  I would strongly suggest you check out interactions if you plan on taking iron supps.  The thread at:

http://community.breastcancer.org/forum/69/topic/767618?page=1#idx_1

Good luck with the Taxol, what you are already doing can't hurt 

Ann, I don't know why the link didn't work, sorry, I had checked it too before submitting post .

Here's my O.P. on the thread :

"Hello - I just read in some posts that doctors had prescribed iron supplements for IDA.  While on TAC, my onco gave me such a prescription as my ferritin was (and has been for a long time) in the 0 range.  Browsing, I discovered a severe interaction between the doxorubucin and the iron supplement prescribed.  When I showed it to my onco, he read it 2X, shrugged and told me he was not aware of this.  Needless to say, I immediately discontinued taking the iron supplement.  Found the article on http://www.ncbi.nlm.nih.gov/pubmed?term=Potentiation%20of%20Doxorubicin%20cardiotoxicity%20by%20iron%20loading%20in%20a%20rodent%20model

Potentiation of Doxorubicin cardiotoxicity by iron loading in a rodent model.

Panjrath GS, Patel V, Valdiviezo CI, Narula N, Narula J, Jain D. Division of Cardiology, Drexel University College of Medicine, Philadelphia, Pennsylvania 19102, USA.

Abstract

OBJECTIVES: The role of iron toward doxorubicin (DOX) cardiotoxicity was studied using a rodent model of dietary carbonyl iron loading.

BACKGROUND: Doxorubicin, a commonly used anticancer drug, is known to cause serious and potentially life-threatening cardiotoxicity. Doxorubicin cardiotoxicity is thought to be mediated through free-radical injury.

CONCLUSIONS: Dietary iron loading resulted in a substantially increased DOX cardiotoxicity in rats. Body iron stores as well as its bioavailability in tissue may be important independent predictors of susceptibility to DOX cardiotoxicity in man. Further clinical studies are warranted.

_______

The study mentions dietary iron loading....personally, I did not take the iron supplement, too chicken....Am extremely wary of iron, as it can be extremely toxic, as cancer feeds on iron, but also vital.  I believe our bodies try very hard to keep us in homeostasis, so if ferritin is low it's because iron is not being retained but excreeted so as not to feed the beast.  Just my amateur opinion.....

I asked my onc to give me the special med. for low RBC, I forget the name of it, but will try to find it for you and he told me that my status did not warrant it...he's a j*&?% anyways   

Did you get your Ferritin checked, because that's the real indicator of iron status.  I have loads and loads of research info, not organized yet, soooo much to research about...!!!

http://scholar.google.com/scholar?q=dietary+carbonyl+iron+loading&hl=en&as_sdt=0&as_vis=1&oi=scholart

Thanks Toomanycocktails.

Ann, the med (actually an injection) I was talking about is Epoetin, but was not aware of what Toomanycocktails said in her post.

http://www.medicinenet.com/epoetin_alfa/article.htm

Claire, had never heard of Larabars, they look delicioooouuuuus !

I agree with upping the protein intake.  Read we need to increase by at least 50%

Some women just seem to be more susceptable to chemo affecting their red and white cells.  I'm one of them.  Since I had Sutent added to my Taxol protocol I hit my first transfusion about 2 months into the tx.  Unfortunately I didn't forgot the nutritionist's comments about needing extra protein so it wasn't until the AC that I finally started adding protein bars to my diet.  And since Taxol affected my taste buds so bad it was hard to eat well.  Chicken soup was palatable (ie I could get it down without gagging) but it doesn't have a huge amount of nutrition.

I'm not exactly the model to work from since I ended up with 6 transfusions (most were two units but a couple of times I had to have 3 units) but my counts were going down into the 8's and had a low of 7.2.  The fatigue didn't really bother me because I still felt OK emotionally.  I would just try to do as much as I could.  If I needed something from the kitchen then I tried to get it myself.  If I felt good enough to go for a walk, even if it was only two blocks, then I did it.  Encouraged the hubby to park in the back of the parking lots just so I could get the extra walking in.  So I think that is why my emotions didn't get zapped with such low counts.  But the day that I hit the 7.2 mark was the appointment where I couldn't even talk to the onc because I couldn't stop crying.  My DH had to do all the talking.

My onc felt that iron supplements just were going to be effective so he didn't want to add to the cocktail of drugs I was already getting.  As for the EPO, he would only give me that if I refused getting transfused.  There is a study that indicates it can stimulate the cancer and we didn't want to take the risk.

If I had to do it all over again I would have started the protein bars earlier (we were already trying to keep our meals balanced) and looked harder for the iron rich food.  Move around as much as you can to keep the O2 flowing and your emotions stable.

Good luck!  It feels so good (and I mean that physically and emotionally) when you finally get the lab results and your RBCs are back above 12 all on their own!

It's really hard to get very low iron levels up through dietary measures alone.

I didn't have chemo, but had severe anemia due to excessive & prolonged menstrual bleeding (fibroid removal corrected this). I had iron shots ($$$ and not covered by my insurance) in my butt. That did the trick — tho it still took my body a year for my iron stores to get back to normal levels on its own after that.

Anemia def. affects mood, and also puts added stress on the heart because it has to pump that much harder to get us the O2 we need. I actually developed arrhythmia because I let my anemia get so low before I got help. Be careful about over-exercising.

Listen to your body and talk about it with your doctors.;-)

Im not sure I'm posting in the right place but I continue to have anemia. Even tho last tchp treatment was December 18. Still get herceptin every three weeks. Rbc 2.64 on match 12 and hgb 8.7. I had needed three NL of transfusins and one platelets transfusion during chemo which went from September 18 UNTil December 18. They are saying body is taking a while to rebound from chemo tchp but this seems excessive. Anyone have any thoughts?I had a lumpectomy Feb 6and had a complete pathological response. I a! 65 years old. Thanks!!