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Palpitations And Low Iron

Dear Dr. Roach: I had palpitations for several years. I eventually went to a specialist, and I spent two weeks in hospital to no avail. Then my doctor said, “We have never checked your iron.” The next day I had a blood test for iron. Within 24 hours, I had received two pints of blood and felt great! It seems that my iron content was nearly nonexistent. I had iron injections for a while and felt great. Now, 18 months later, the palpitations are starting up again, with another blood test showing low iron that’s getting lower.

I was getting weaker every day until I finally was able to get a four-hour iron infusion at the hospital. This apparently takes a few weeks to have a full effect, but I can say that today I feel about 80 percent, which is really good. But I still have no actual reason as to why this is happening. I am trying to eat and drink foods high in iron. Any advice? — J.H.

Answer: While it sounds like the iron replacement is going well, you still need to figure out the cause of your iron deficiency.

I’d start with malabsorption, which means your body isn’t absorbing iron properly. One common cause of this is celiac sprue. It’s also possible that you are losing iron (the usual place is through the GI tract, such as a polyp or inflammatory bowel disease). You should be checked for both possibilities, with a colonoscopy if you haven’t had one recently, and with a look for malabsorption if the colon looks OK.

Dear Dr. Roach: I am very concerned about my 71-year-old husband, who has chosen not to have his teeth cleaned in more than 10 years. When I urge him to do so, he does not take the suggestion well. I do not know the reason for this. He’s basically healthy other than having had a triple bypass 10 years ago.

He is very active around our property. He seems to think brushing twice a day (and rarely flossing) and rinsing with Listerine twice a day is enough.

I seem to recall hearing about gum disease and heart-related illnesses being linked. Can you set my mind at ease about this? I am choosing not to have World War III over this! He did quit smoking 33 years ago, and for that, we are grateful. But I’m so afraid that this lack of dental hygiene is going to have negative effects. — A.

Answer: There are many good reasons to see a dentist and hygienist. Poor hygiene may lead to tooth loss. People with tooth problems from poor hygiene often are less self-confident. The data on vascular disease (including both stroke and heart disease) remain controversial.

It is clear that people with poor dental hygiene have higher risk of disease, but it’s not clear whether the gum disease is causing it.

I suspect there actually is a higher risk of heart disease in people with periodontal disease, but even if there isn’t, I still recommend regular dental hygiene by a professional.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible.

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