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Fatigue and AnemiaFatigue and Anemia
           
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Iron? Procrit and what are you doing next Saturday night?
Nov 8, 2001

Dr. Bob, You are one very special guy -- do you know that? Smart sassy, and sexy as hell. I did as you suggested and encouraged (read insisted) my doctor evaluate my fatigue. She wasn't pleased but we did determine (just as you predicted) I was low on testosterone and I was anemic. I'm now on andro-gel daily and procrit weekly. Energy level improved, sex drive much improved but my anemia only slightly improved. I just read some of your other responses -- entertaining and informative as usual -- and noticed you mentioned the need to measure iron stores while on Procrit. My doctor doesn't think it's necessary but I trust you not her! What tests should I request and what values should I be aiming for? Lastly can I take you out on a date?--did I mention my sex drive is much improved? Q

Response from Dr. Frascino

Hello Q,

Smart, sassy, sexy? Oh, I bet you say that to all the experts on these forums. I am pleased you're feeling better and so "up."

Regarding your anemia therapy with Procrit, yes, iron stores do need to be checked. I recommend prior to and during Procrit therapy, evaluation of transferrin saturation (serum iron divided by iron binding capacity) and serum ferritin. Transferrin saturation should be at least 20%, and ferritin should be at least 100 ng/ml. Nearly everyone will eventually require suplemental iron to increase or maintain transferrin saturation at levels that will adequately and optimally support new red blood cell production stimulated by Procrit. The odds are pretty good this is why you haven't quite responded as expected. Also, you might need to have your dose of Procrit increased. But before you do that, definitely persuade your physician to check your iron stores.

As for your last question about a date . . . ahhhhhhh, just how much AndroGel are you using anyway?! Maybe we need to check that dose as well!

Stay well.

Dr. Bob


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