Can Anemia Cause Hypovolemia?

[margiebee]

Or vice versa? I was trying to find any similar topics to this but nothing came up.

I have on and off low hematocrit tests that point to anemia. Basically, I become anemic during and after menstruation, something that I have tried to address with other doctors to no avail. I try to supplement with iron during those times but I'm careful not to take large doses because it upsets my stomach and I know too much iron can be bad for you. Regardless of if I take the iron or not, my hematocrit levels do eventually return to normal. But during the times when it is low I experience a worsening of symptoms, as well as new symptoms most notably horrible headaches that last for days. I personally feel that this issue may be contributing to the hypovolemia I experience, especially because iron supplements alone aren't really helping much.

Basically I am wondering if anyone else has dealt with this, and what you have done. I think that IV saline would probably be helpful just once a month along with the iron supplements but I'm not sure any of my doctors will go along with that.

[MomtoGiuliana]

Yes, I believe low iron would make our symptoms worse, typically. I have been anemic at times and my orthostatic symptoms and exercise intolerance worsened due to it.

If your iron is low it can be corrected w supplements as you note. If you are unsure how much supplement to take, your doctor should guide you on this.

If you are losing a lot of blood during menses, this could contribute somewhat to hypovolemia, IMO. Also, in general we tend to retain fluid prior to our periods and then lose it afterwards. I know when I have a heavy period I feel worse for a couple of days afterwards and I don't think losing iron is the only explanation. I take regular iron supplements and my hematocrit has been normal recently.

IV saline has helped me greatly in the past on a temporary basis. A specialist would understand that this would help, but many doctors don't have that knowledge. Hopefully you can find a dr who would agree to trying it, if you are really feeling badly at that point in your cycle.

[JamieRN]

From my understanding, if your menstruation is so heavy you become anemic then yes this can lead to hypovolemia. Basically if you are losing your RBCs or any electrolytes , proteins, etc this throws the concentration of solutes in your blood out of whack. When that happens the delicate balance of concentration differences between your vascular system and the interstitial fluid is also thrown off. This can lead to the H2O in your blood moving over to the interstitial fluid to balance things out. Because you've now lost RBCs and fluid =hypovolemia. If that's happening a hypertonic IV solution should theoretically help. However, I'm not sure that is commonly prescribed for anemia. Disclaimer though, I am only studying to be a DNP at the moment so please take with a grain of salt as I could be wrong. I will try to check out some of my textbooks.

[MomtoGiuliana]

Thanks Jamie for the explanation!

[margiebee]

Jamie that was a really good explaination, thank you! That honestly explains a lot about what's going on. It seems like stopping my periods would be ideal honestly but I don't tolerate hormonal BC pills well so I'm going to ask about getting fluids. I have a blood volume test coming up so if that shows it to be as low as I think it is, hopefully that'll help make the IV fluids thing happen.