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Fatigue and AnemiaFatigue and Anemia
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Take Iron with infections?
Dec 11, 2000

Dear Bob, I have Selective IGA Deficiency, Anemia, Bronchiectasis & constant recurrent Bronchitis & Sinusitis. HGB=10.3, HCT=31.3, WBC=3.6, IGA=<10. I take antibiotics avg 15 days/month. I've read that iron should not be taken with infection & antibiotics. I feel so much better when taking iron but don't want to increase vulnerability to infection. What is your opinion? Also, any new treatments for Selective IGA that you know of?

Response from Dr. Frascino


Selective IgA deficiency is certainly associated with recurrent sino-pulmonary tract infections which would account for your bronchial and sinus tract problems, but why are you anemic? There are many potential causes that should be evaluated so that proper therapy can be administered. Iron deficiency is one possibility that can be evaluated by a simple blood test. However there may well be something else going on here. Your physician should be able to help you sort this out. You first need to determine if 1) you are loosing blood (perhaps through the gastrointestinal tract), 2) you have decreased red blood cell production (your bone marrow isn't producing enough red blood cells), or 3) you have increased red blood cell destruction (red blood cells are being destroyed before their normal life span of 120 days).

Once your anemia is well characterized, treatment will become more obvious. If you are deficient in iron or certain minerals, supplementation is warranted. If you have decreased red cell production, treatment with Procrit may be helpful as this medication stimulates your system to produce additional new red blood cells. It has been show to be very effective in HIV-related anemia of chronic disease.

To answer your question about iron and antibiotics, iron should be taken 2 hours before or 4 hours after certain antibiotics -- for instance quinolones, tetracyclines, and some cephalosporins. Your pharmacist or physician will give you specific instructions based on exactly which medications you are taking.

New treatments for selective IgA deficiency?? None that are ready for prime-time yet. But HIV-related research has opened up amazing new and very exciting avenues for understanding and treating the immune system. Also the field of immunogenetics holds great promise. Continue to follow this site for future developments in the field of HIV medicine. Hope this helps!

Dr. Bob

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