Why is my 6-yr old anemic? Update #25

[AquariusHome]

As background, this all started in infancy.  He had food intolerances with bloody stools, became anemic then but even after test after test failed to show any blood in his stool and we were supplementing with more and more and more iron he was still anemic.  Finally when he was about 2 his hemoglobin was normal and his iron stores had finally gotten barely into a normal level.  The GI we were working with had worked him up for everything you can check short of a colonoscopy, which he felt was too invasive and unlikely to show us anything useful.  His advice was leave him alone- he's probably going to be fine.

When he was 4 we did another blood test and he was anemic again.  I can't recall if that was the first time we had checked him since we had decided he was okay.  I know there were at least a few tests done to see if he dropped back down after he got to the normal range and he seemed to hold steady for a time.  But anyway, at 4 he was anemic again, although only very slightly.  2 months on a multivit + juice plus had him back to the normal range.  Since then we've been spotty with the multi and slighly less spotty with the JP.  He doesn't do well with daily supplements - gets bored of them quickly.  And aside from that I am of the opinion that a multi shouldn't be necessary and if it is there is something else going on.

So last week I asked the pedi to recheck his iron.  He's been exceptionally grouchy, prone to tantrums especially at  meal and bedtimes lately and his hands are always freezing.  His hemoglobin was 11.1 (normal range 11.5-15.5) so not terrible but not normal.

We're going back to the GI but I expect they will again find nothing.  We see no indication of blood in the stools and have tested several times.  He's a meet eater.  Doesn't eat fruits and veggies to my preference but certainly his diet better than most kids his age I would think.  Basically none of the typical reasons are true for him.  So I'm looking for the atypical reasons - things your standard MD or GI wouldn't think of (malabsorption most likely, but why?)

As an aside, which may or may not be related, we found out of the same day that my 3 yr old DD is also anemic but I'm more suspicious of blood loss through the GI track with her - she is still very milk and soy intolerant and has had visible blood in her underwear once recently which is why we checked her iron.  And she also is a hard one to get to eat.  So the common risk factors are more at play in her case.

[kjbrown92]

have they been checked for celiac? I know that's one thing that can lead to anemia.

Have you done anything like a stool test that would show you what's going on, since that's non-invasive?

[Pookietooth]

One other possibility is heavy metals toxicity. Has he been tested for them? By an alternative providor?

[AquariusHome]

Originally Posted by kjbrown92 

have they been checked for celiac? I know that's one thing that can lead to anemia.

Have you done anything like a stool test that would show you what's going on, since that's non-invasive?

Hi Kathy.  Yes, they have both been checked for Celiac.  DD is checked routinely as her chromosomal abnormality puts her an increased risk for it.  DS was checked when he was around 18 months and was negative.  I asked the pediatrician about it when he was anemic last time (age 4) and she did not feel there was justification to test for it I guess and I didn't feel the need to push for it then.  He doesn't have any of the hallmark symptoms (diarrhea, growth issues, distended abdomen, etc).  But he does have tooth enamel abnormalities,  frequent constipation, and this recurrent anemia.  I imagine the GI will test him again this time.  My gut is that gluten is possibly an issue for him.  Or maybe not my gut but when he was a little guy and we were trying to figure this out I took him to a chiropractor who did a lot of alternative stuff that I was totally unfamiliar with at the time and he tested positive for a gluten sensitivity on MMT.  I'm not sure how much I believe in the accuracy of MMT, but it has stuck in my head.  We did try a gluten elimination on him about a year ago but it was so miserable for everyone that we didn't get very far before giving up.

His stool has been tested by our pediatrician 2 yrs ago and the GI several times earlier than that with nothing showing up.  I haven't taken him yet to our ND for the Genova stool test but plan to unless something obvious comes from the GI testing.  DD has been down the road of stool testing and addressing all those issues though.

As an update - I called back to the GI re: DD's testing because I had never gotten numbers on her.  Turns out she is not anemic - I miss understood.  It was the serum iron that was low, so not sure what that means but I'm waiting for instructions.  So I guess it's primarily DS that is a concern.
 

[babygrant]

My son was anemic until we eliminated dairy.  We were trialing dairy and we noticed he was eating dirt again (at the age of 3 and 4!) and turns out he was anemic again.  Took him off dairy and within months he was no longer anemic.  Odd.

[Panserbjorne]

Originally Posted by babygrant 

My son was anemic until we eliminated dairy.  We were trialing dairy and we noticed he was eating dirt again (at the age of 3 and 4!) and turns out he was anemic again.  Took him off dairy and within months he was no longer anemic.  Odd.

not really.  it's even accepted by the mainstream docs that milk allergy/intolerance is a leading cause of anemia.

[AquariusHome]

Originally Posted by Panserbjorne 

Originally Posted by babygrant 

My son was anemic until we eliminated dairy.  We were trialing dairy and we noticed he was eating dirt again (at the age of 3 and 4!) and turns out he was anemic again.  Took him off dairy and within months he was no longer anemic.  Odd.

not really.  it's even accepted by the mainstream docs that milk allergy/intolerance is a leading cause of anemia.

I saw that when I was refreshing my mind and researching it again last night.  But what I saw was that heavy consumers of dairy can be anemic due to it's tendency to cause GI bleeding but didn't saw "in some people".  In light of my knowledge of food intolerances acquired since this DD's birth I got to wondering whether most people, if they consume enough cow's milk, would have some level of GI damage.  And if this is the case why in the world is cow's milk so touted as a main nutritional source.  Or is it just people who are sensitive?  And can sensitivities (to cow's milk or gluten or whatever) cause malabsorption issues even if there is no bleeding?  Because we have abolutely no reason to suspect he is having GI bleeding - we've checked several times, never see blood, he doesn't have mucous or even loose stools at all that might indicate irritation/ inflammation in the gut. 

The other thing about the mainstream docs is that milk intolerances are believed to be almost always outgrown by toddlerhood so how does that mesh with the theory that milk consumption can lead to anemia?

When DS was a baby and breastfed I suspected a milk allergy/ intolerance and I eliminated it.  I thought things were better some, but he still was having diarrhea most of the time and bloody stools occassionally.  The GI told me not to chase it - that he would outgrow it.  I listened to him and never did figure out whether milk was the issue (in hind site I might not have really eliminated all sources of dairy) or something else or a combination.  And his stools improved and so we thought we were good.  So anyhow, the food intolerance question has been out there for a long time with him but as I said, we have tried various eliminations on a very short term basis without luck at identifying whether foods are in fact an issue or not with this child. 

[Panserbjorne]

I think it's more just that they acknowledge it-beyond that I take it with a grain of salt.  That's looking for pathology, not acknowledging what happens before the pathology is registered.  Something is going to be detected as a subclinical problem (if you're looking) first.

They do say kids grow out of it.  You have to research that and made your own call with that.  What is more likely (from my perspective) is that they grow out of that symptom, which is not the same thing.  It's pretty widely acknowledged too that eczema when suppressed can lead to asthma-the skin clears up because the reaction moved deeper.  I believe that is what happens.  We are programmed to watch for symptoms, we don't see the body as being interconnected so when that symptom goes away, they grew out of it.  When something else appears it's not at all linked to what preceded it.

Anyway, just my two cents.  But if you have been questioning, there's a reason.  I'd never throw aside mama instinct.  If you think something is amiss, it's best to keep probing when you don't like the answers you're getting.

[AquariusHome]

Originally Posted by Pookietooth 

One other possibility is heavy metals toxicity. Has he been tested for them? By an alternative providor?

Somehow I missed your post earlier.  I haven't thought of it from this angle before, although the same chiropractor that told me DS was gluten sensitive also said he needed a copper supplement.  DH was very unconvinced of the chiro's methods for determining this and veto'ed the copper.  We're much more open to alternative methods now than we were then.  So anyhow, how would heavy metal toxicity cause poor absorption of iron?  Or would it cause anemia in a different way?

[Panserbjorne]

heavy metal toxicity impairs nutrient transport.  Different metals can affect different nutrients.

[AquariusHome]

Originally Posted by Panserbjorne 

I think it's more just that they acknowledge it-beyond that I take it with a grain of salt.  That's looking for pathology, not acknowledging what happens before the pathology is registered.  Something is going to be detected as a subclinical problem (if you're looking) first.

They do say kids grow out of it.  You have to research that and made your own call with that.  What is more likely (from my perspective) is that they grow out of that symptom, which is not the same thing.  It's pretty widely acknowledged too that eczema when suppressed can lead to asthma-the skin clears up because the reaction moved deeper.  I believe that is what happens.  We are programmed to watch for symptoms, we don't see the body as being interconnected so when that symptom goes away, they grew out of it.  When something else appears it's not at all linked to what preceded it.

Anyway, just my two cents.  But if you have been questioning, there's a reason.  I'd never throw aside mama instinct.  If you think something is amiss, it's best to keep probing when you don't like the answers you're getting.

This gets to the heart of one of my struggles in this food intolerance thing.  Kathy and some of the other mom's on the allergy forum I imagine bang their heads against the wall trying to get through to me on this issue but here's my struggle:  DS 1, in hind site, probably had some food intolerances as a baby.  DS 2 certainly did.  DD absolutely did to a major degree and still does.  Because we didn't figure out the food intolerances for DS1 or 2 while they were babies, and because I have heard this theory from many, many very intelligent women on this forum who I respect, I have thought both the boys probably still have intolerances manifested in a different way.  But when we eliminate various things from their diets we don't see changes that last.  Their bowels might be different for a day or 2 and then they go back to the norm.  Their behavior changes for a few days, but then it reverts back.  I can't say with any real confidence that there has been a significant change in them.  We had DS1 tested for IgG allergies and we eliminated everything on his list for 2-3 weeks and at first we were really optimistic but by the end he was pretty much the same kid in every way.  And I can't justify in my mind or to DH keeping the kids off major foods on a hunch without something more to back it up.  In the case of DS2 we have the anemia but no obvious GI symptoms - his stools are just firmer than most peoples.  And going on the theory that he was food intolerant as a baby and he still is intolerant to those same foods but the symptoms have changed - let's say his symptoms now include bedwetting - if the symptoms aren't GI anymore then why is it affecting iron absorption?  I can believe that it is possible for symptoms to change.  I've seen it in DD - her reactions are much more behvaioral now and less GI.  But I guess I'm not convinced yet that it is impossible to outgrow them.

If anyone can give me an explanation for how malabsorption can occur as a result of food intolerances in the absence of other GI symptoms I think that theory probably makes the most sense given our history. 

[AquariusHome]

I also wonder if maybe what we're all dealing with, as a family, is not IgG intolerances but some other type of reaction to foods.  Because none of our testing has seemed very accurate.  About the only thing that I am really sure was true was DD's 3+ reaction to soy.  But I had many things come up on my test that I eliminated for months and then reintroduced with no obvious change.  And DS, as I mentioned, had similar results with his IgG testing.  DD's dairy issues didn't really show up on testing. 

[AquariusHome]

Or maybe something else is at play - like heavy metal toxicity - beyond the food issue.  Is there something else anyone can think of that would make it difficult to see changes with elimination of foods? 

Thinking back about my journey I have to say that the whole experience of eliminating foods and going through the stool testing and working on rebalancing the gut has helped.  Overall I am healthier than I was before I believe.  And I think it has helped DD's GI system as well although she is still intolerant.  So it is possible that elimination of the foods that we tested positive for was necessary to start the healing process but now we are able to handle them better.  There are still foods that both of us react to obviously within a few days and that is the piece I'm missing with the boys.  They both have chronic health issues that I think could be food intolerance related, but no symptom to tell me we're on the right track with elimination and I would really like to have that before forcing them to make major life changes.  The one thing that i think could make another elimination trial easier this time though is we can all do it together - I've been considering re-elimination of DD and my foods from testing to see if I notice anything since it has been awhile, and the boys would likely have an easier time knowing that the other boy is doing it too. And my mom, who lives with, recently got her testing back and is in the early stages of an ED.  So now is probably a good time to try again.

[2xy]

Quote:Originally Posted by LaurieG 
In light of my knowledge of food intolerances acquired since this DD's birth I got to wondering whether most people, if they consume enough cow's milk, would have some level of GI damage.  And if this is the case why in the world is cow's milk so touted as a main nutritional source.

Because there are 65,000 dairy farms in the United States. $$$.
 

[kjbrown92]

I'm not banging my head against a wall. Don't worry.

Where do you live? Just curious because my osteopath's theory is that lyme disease caused my kids' intolerances.

Personally I don't think anyone "outgrows" a food intolerance. As Elizabeth said, they can change symptoms. The other alternative is that people can HEAL. Outgrowing just "happens", healing means you're doing it on purpose.

For milk, my DS went from projectile vomiting to screaming all night long to rash on his butt to leg cramps to bedwetting to stomach cramps/bedwetting/screaming all night long. He's 10 yo. DS, DD2 and I were all tested for lyme in the last year and are all positive. Since DD1 is healthy(ish), she hasn't been tested.

Have you heard about the pebble theory with food intolerances. If you are intolerant to 6 foods, for example, and you take out 1 or 2 of them, it's better, but it still hurts. Or if you take out one, then put it back in and take out another, you're not seeing any improvement, so you may conclude there aren't any food intolerances. Where if you could identify all of them and remove all of them, they're would be a significant change.

If you're seeing a difference for 2-3 weeks and then it reverts, I'd look to see what changes after 2-3 weeks. Do you figure out how to make different things so are adding some foods in that you weren't having before? are you getting lax at reading labels because you've seen an improvement? are you increasing another food because you've taken out other ones?

I'm certainly not saying that everyone has food intolerances. But I do believe that a fair number of people do have them and don't know it.

I don't know much about malabsorption except that my brother had it in the 70s and something wrong with his villi  (and probably still has both today). It was before celiac testing was common in the US. And he won't go get tested now. He's 6 feet tall and about 140 lbs soaking wet. And has always had digestive issues. And other issues. But it stands to reason that if you have inflammation in your gut that you're not absorbing things well.

[AquariusHome]

Originally Posted by kjbrown92 

I'm not banging my head against a wall. Don't worry.

Where do you live? Just curious because my osteopath's theory is that lyme disease caused my kids' intolerances.

Personally I don't think anyone "outgrows" a food intolerance. As Elizabeth said, they can change symptoms. The other alternative is that people can HEAL. Outgrowing just "happens", healing means you're doing it on purpose.

For milk, my DS went from projectile vomiting to screaming all night long to rash on his butt to leg cramps to bedwetting to stomach cramps/bedwetting/screaming all night long. He's 10 yo. DS, DD2 and I were all tested for lyme in the last year and are all positive. Since DD1 is healthy(ish), she hasn't been tested.

Have you heard about the pebble theory with food intolerances. If you are intolerant to 6 foods, for example, and you take out 1 or 2 of them, it's better, but it still hurts. Or if you take out one, then put it back in and take out another, you're not seeing any improvement, so you may conclude there aren't any food intolerances. Where if you could identify all of them and remove all of them, they're would be a significant change.

If you're seeing a difference for 2-3 weeks and then it reverts, I'd look to see what changes after 2-3 weeks. Do you figure out how to make different things so are adding some foods in that you weren't having before? are you getting lax at reading labels because you've seen an improvement? are you increasing another food because you've taken out other ones?

I'm certainly not saying that everyone has food intolerances. But I do believe that a fair number of people do have them and don't know it.

I don't know much about malabsorption except that my brother had it in the 70s and something wrong with his villi  (and probably still has both today). It was before celiac testing was common in the US. And he won't go get tested now. He's 6 feet tall and about 140 lbs soaking wet. And has always had digestive issues. And other issues. But it stands to reason that if you have inflammation in your gut that you're not absorbing things well.

Your example of your brother is a classic example of why I'm confused about DS2's anemia.  My mom, myself, and DD all have obvious GI stuff going on.  My mom has IBS, I've never been diagnosed but have to be very careful about stress management and what I'm eating to keep my GI track normal and DD is the same - whenever anything stresses her body it shows in her stools.  So if any of us had malabsorption issues (which we probably all do, although we're all making progress through gut healing stuff) I wouldn't be surprised.  But DS2 doesn't have digestive issues really - no gas, no mucous, no loose stools, no reflux, rarely has stomache aches, ....  And he is growing great.  He is at nearly the 90th percentile for height and 75th for weight.  He's a slender kid, but by all standardized ways of measuring he is in the "normal" range for his age.  I wonder whether his tendency for harder stools is a "symptom" of something going on in his gut, but it is just as likely to be that he doesn't drink enough water or eat enough fruits and veggies (this is my least fruit/ veggie loving kid we're talking about).   So it's confusing.

He has other, non-GI things that I have wondered if they are symptoms of food intolerances that I've posted about previously - most notable is his bedwetting.  He wears Underjams and they are soaking wet every morning.  He is nowhere close to being dry at night even occassionally.  His last ED we were trying to see about the bedwetting so there was more focus on the bedwetting during that time and he made a point of going to the bathroom right before he fell asleep and not peeing when he woke up (he generally gets a lazy about it because he knows he's wearing the Underjams), and DH would wake him before he went to sleep to take him to the toilet.  So there were other interventions going on at the same time and the symptom that we were looking for improved.  But with time and laziness his behavior became terrible (as he became more resentful of the restrictions) and the wetness eventually reverted back.  Did he sabatoge?  Maybe.  DS! was similar - for him we were looking at behavior as well as some very mild physical things.  We pumped up the testing and had rewards and such so he thought it was great fun in the begining and we a happy, happy kid making it look like we were on the right track.  But over time it was less fun and he became angry at what he couldn't have and his behavior eventually was worse than baseline.  So its hard to say.  Which is why an accurate test would be really helpful.  So far the Genova IgG one we've tried I'm not too sure has been real accurate for us.  I'm considering trying the ALCAT instead for DS2 but it is a lot of money to spend for something that I'm not sure will be very helpful.  And there is just no way a long, drawn out experiment pulling various things for weeks at a time and journaling, etc would go over.  The kids would revolt and DH would back them and I have nothing but a hunch on my side.

[kjbrown92]

For DS and DD2, bedwetting is a definite food intolerance symptom. DD2 also drank/peed a ton during the day as a symptom of one of her food intolerances (apple).

[Panserbjorne]

I'd say bedwetting is a symptom of FA and candida.  They are kind of intertwined...but yes.  It's not always foods, but it certainly can be.

[janinemh]

As a nutritional therapist, one of my first suspicions  with anemia would be low stomach acid because proper acidity in the stomach is essential for digesting protein, iron, and B-vitamins (among many other vital nutrients).  After that, you could look at gut healing further south.  Removing stresses like food intolerances is just the first step in healing the gut.  You really need to follow a gut healing protocol.  We did the GAPS diet.

[AquariusHome]

BTW, Kathy, we live in central Illinois so Lyme disease is a possibility but not one that I had considered previously.  Interesting.

Also to everyone please excuse the typos.  Every time I sit down DD has been immediately finding me to NAK.  Weaning today though so hopefully the typos improve.

Originally Posted by janinemh 

As a nutritional therapist, one of my first suspicions  with anemia would be low stomach acid because proper acidity in the stomach is essential for digesting protein, iron, and B-vitamins (among many other vital nutrients).  After that, you could look at gut healing further south.  Removing stresses like food intolerances is just the first step in healing the gut.  You really need to follow a gut healing protocol.  We did the GAPS diet.

Thanks for your perspective.  I appreciate the tip about the GAPS diet and I'm looking in to that, along with the theory of heavy metal toxicity.  The low stomach acid thing is of particular interest to me because with DS1, my 8 yr old, we are currently trying to balance his stomach acid.  He has chronic inflammation in the trachea which led to 6 episodes of croup last school year and 2 so far this school year (although thankfully they have been less severe as we have been trying to boost his immune system).  But I'm kind of stuck on the stomach acid piece.  I suspect reflux may play a role because he tends to get stomach aches (although, again, not as many recently) but I'm not sure what to do about it.

Another thought for general discussion - is it possible to do gut healing without removing trigger foods?  Or is that piece absolutely essential to the process?