AP and iron IV

[wildschild]

I am going to have a knee replacement in Dec. I am very anemic because of my RA so I have to have an iron IV done every Saturday for 5 weeks. Does anyone know if this will affect my AP? I am taking mino MWF and Azithromycin Tues & Thurs.
Thanks,
Nancy 🙂

[Maz]

@wildschild wrote:

I am going to have a knee replacement in Dec. I am very anemic because of my RA so I have to have an iron IV done every Saturday for 5 weeks. Does anyone know if this will affect my AP? I am taking mino MWF and Azithromycin Tues & Thurs.
🙂

Nancy, that’s a really good question and one I haven’t seen asked before here. What does seem a bit odd with RAers who suffer from anemia is that Brown found that iron replacements don’t often do much good. He comments in the book that the anemia improves over time with AP, but that iron supps really don’t have much effect on the anemia. As for IV iron, I don’t know if the same applies, as it’s a different route of administration, and it might also depend on the type of anemia you’re experiencing.

What is usually recommended for oral mineral supps is that they be taken a good 2 hours spaced well away from minocycline or other tetras being taken, because the tetras are highly chelative and bind to the minerals in the gut, rendering the abx ineffective so that they pass right out. IV mineral supplementation, however, might be a different kettle of fish, as it is not taking a first pass via the gut. Something you could perhaps ask the adminstering doctor?

As you’re only having 5 rounds of weekly iron IVs, my best fellow RA patient guess is this shouldn’t alter the overall course of your AP treatment by too much, if some or even all of mino’s efficacy is lost. Sometimes, breaks are needed with AP (as in cases of hypersensitivity) and I’ve personally discovered that a break up to a month didn’t affect my labs by too much at all. What you ‘might’ find (and, again, this is just speculation) is that after the iron infusions are done that there might be a little herxing. If that is the case, then you’ll know that you did lose some of your abx’s effects during the iron therapy and your AP is just kicking back in again. As you’re also on pulses of zith, this abx shouldn’t be affected much, if at all.

Do you take a Vit C daily supp, by any chance?

[wildschild]

Maz,
Thank you so much for your reply. Another reason they are doing the IV for iron is that when I had my other knee replaced I lost alot of blood and had to have a transfusion so they are trying to get me prepared so I wouldn’t have to have the a transfusion or defer any complications. I knew I read in the book about not taking iron at the same time as taking the abx. I am glad you think it will not effect the AP. I really don’t want to go through any more herxing. I went through a bad October but I feel maybe I am improving. Hard to say as one day I will be better the next worst.
I don’t take any vitamin C right now. I am taking as supplement fish oil, iron, bromelain, probotics, Vitamin D, folic acid, zyflamend. I was taking a multivitamin but ran out and not picked up anymore yet.

Thanks so much for your information. I really appreciate any help on this journey I can get. I just started AP in September.
Nancy 🙂

[Maz]

@wildschild wrote:

I am glad you think it will not effect the AP. I really don’t want to go through any more herxing. I went through a bad October but I feel maybe I am improving. Hard to say as one day I will be better the next worst.

I don’t take any vitamin C right now.

Hi Nancy,

The reason I mentioned Vit C is because there is some speculation that because minocycline is so chelative (binds to minerals, like iron) that this may be one of the reasons that some folk get the blue/gray/black skin patches that look a bit like bruises or freckles. It’s a cosmetic nuisance, mostly, but unpleasant if it occurs in the eyes, gums, face, etc.

Patients here have reported that after they’ve been on minocycline for a while that if they bump themselves and get a bruise, the bruise doesn’t go away (until they switch out to a different tetra and its reabsorbed by the body eventually). Well, to my layman mind, this makes all the sense in the world…if blood is rushing to an injury site (blood rich in iron) or to highly vascularized areas of the body, then minocycline would bind to the high concentrations of iron in those sites and appear as these patches.

Vit C is well-known for being needed in the body to help properly catalyse and transport iron around the body in the shape of hemaglobin. This is why it’s surmised that daily doses of Vit C might help to prevent these blue/gray/black deposits in the skin and mucosa. (For SD folk Vit C is controversial, as it may promote too much collagen build-up).

This is not a recommendation, of course, as I’m just a fellow patient, but I just wondered if Vit C might be a useful supplement you could ask your doctor about prior to your iron infusions and knee surgery, checking with him that it’s okay to try it, of course. Some supps are definitely contraindicated prior to surgery….even green tea, which thins the blood.

PS. I hope you don’t need to go thru a new round of herxing, either…just put it out there in case you do lose some of the benefit of your mino and, if it does occur, it won’t be too much of a surprise. 😉

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