Update 1.3.26 - Upper Endo and lab results. Gastritis & ferritin drops lower (21)

 Upper endoscopy showed I have chronic gastritis.  This can cause low ferritin, bloating, burping, reduced stomach acid.  It can also trigger how the liver to change how it handles fat.  Chronic gastritis can cause high triglycerides and lower HDLs.  So sounds like fixing gastritis first would snowball the healing effects. 

Given that you know you have gastritis and a negative H. pylori test, your low iron has a very logical explanation:

• Absorption Block: Gastritis creates a "hostile" environment for iron absorption. If your stomach isn't producing the right acid/environment, you won't absorb iron, even if your small intestine is perfectly healthy.

• No "Leak" Evidence: If your hemoglobin and hematocrit (other parts of a CBC test) are stable and not plummeting rapidly, you likely don't have a "bleed," just a "low intake" issue.

The "Test Drive" Approach

Before jumping to a capsule endoscopy (which can be expensive and sometimes requires a lot of insurance paperwork), most doctors suggest a 3-month trial:

1. Treat the Gastritis: Use the "bland" diet and bone broth strategy for 60 days.

2. Gentle Iron: Supplement with a non-irritating iron (like Iron Bisglycinate).

3. Re-Test: Check your Ferritin after 90 days.

• If Ferritin rises to 40+: The capsule is unnecessary. You’ve proven it was just an absorption issue in the stomach.

• If Ferritin stays at 21 or lower: The capsule is necessary. You’ve proven that despite taking iron, it’s either not getting in or it's "leaking" out somewhere else.

 If I start the 'gentle iron' here's how I should proceed:

The "Gastritis Strategy" for Iron

Even with the best chelated iron, your stomach is sensitive. To guarantee your ferritin goes up without making the gastritis worse, follow these "Golden Rules":

• Avoid the "Empty Stomach" Rule: Most labels say "take on an empty stomach for best absorption." Do not do this. For a gastritis patient, the risk of irritation is too high. Take it with a small, bland snack (like a piece of toast or a few crackers).

• Add Vitamin C (Gently): Vitamin C is the "gasoline" for iron absorption. However, orange juice is too acidic for your gastritis. Instead, take your iron with a buffered Vitamin C supplement (like Calcium Ascorbate) or a small serving of steamed broccoli.

• Space it from Meds: Take your iron at least 2 hours away from your BP meds and Ezetimibe.

• The "Every Other Day" Trick: New research shows that taking iron every other day actually raises ferritin better and causes less stomach upset than taking it every day. This gives your stomach lining a 48-hour "rest" between doses.

• The "Buffered" Snack: Take the iron with a small amount of cooked/pureed pumpkin or a soft-boiled egg. This provides a "buffer" for the stomach lining while the protein in the egg actually helps carry the iron

• The Iron-Ezetimibe Gap: Ezetimibe works in the small intestine to block cholesterol. By taking Iron at night and Ezetimibe at lunch, you give your intestine plenty of time to process each one separately.

• The "Bedtime" Iron Trick: Many people with gastritis find they tolerate iron better right before sleep. Since you aren't moving around, the iron "settles" better, and you sleep through the period where minor nausea might occur.

📉 How to Measure if it’s Working

You shouldn't have to guess. Here is the timeline for your results:

Timeline	What to Look For
Days 1–7	Tolerance: No new stomach burning or "acid" feeling. (If it hurts, stop immediately).
Days 14–30	Energy: A slight lift in morning fatigue.
Month 3	The Blood Test: Your Ferritin should move from 21 to 35+.

Insulin resistance, Pulse Pressure & Ezetimibe

 More research is starting to point that I have insulin resistance and that could the cause of high BP and cholesterol.  Makes sense, I eat refined carbs (bread and white rice) and sugar.  Metroprolol is also known to cause insulin resistance and I was on it for about 5 years, 2017 - 2022.  Same for HCTZ.  Geez...  Amlodipine on the other hand improves insulin sensitivity and lowers inflammation.  That's a relief.

Reversing insulin resistance takes time tho, so I'll stay on my meds for now.  Hopefully I can reverse it can get off the meds eventually.  But I feel like I'm getting close to solving the puzzle.  This one makes a lot of sense.

More info:  Pulse Pressure.  The difference between systolic and diastolic numbers.  40 is good (120/80), 60 and higher suggests arteries are less flexible (stiff), common with aging or conditions like atherosclerosis, increasing risk for cardiovascular events.  Less than 25 point to heart failure, aortic stenosis, or cardiac tamponadeMine's around 38 so a little weakened heart output.  But glad it's not 60 which means it's
stiffening.

Started Ezetimibe 5 days ago.  Been feeling tired the last two days.  It is a common side effect
tho period is about to start in 4 days so it could be that as well.  First couple days I felt some
rumblings in my tummy so I took a Seirogan which helps.  Seems fine after that.  Took a short
neighborhood walk this morning and had to turn around cuz I started feeling tired.  I remember
hearing some complaints about the tiredness. No muscle aches tho.

Stress Test today.  James says they are useless.  We'll see. 

Update 11.27.25 Cardiology appt, new cholesterol med, ENT

Saw Dr Bagheri and he doesn't want to order me a CT angiogram.  Says it's 'unnecessary' and insurance doesn't care. My cholesterol is high so he's going to put me on Ezetimibe which is supposed to block cholesterol absorption in the small intestine.  So if the high cholesterol is due to diet, this should work.  He thinks its genetic since Jiji had his heart attack in his 50s.  Hide sight, Baba may of had high cholesterol too, related to pancreatic cancer.  We'll see at my lab follow-up in March.  In the meantime, getting a Stress Test 12/10 and Carotid Ultrasound 12/17.   The stress test is supposed to give an idea of how much blockage there is.  That's kinda my main concern, how bad is it?

He said a drink a day is ok, so feel a little better there.   Had a tequila soda last night, felt it in my head and then slept 9+hrs.

ENT said no need for septoplasty since I can still breathe out of my nose, it's not completely obstructed.  Using nasal spray and Flonase before bed has been helping.  Necessary surgery is not a good thing.  Tho I kinda wanted it done so maybe my oxygen level might improve.  But I see his point.  Things can go wrong during surgery too, and probably not worth the risk.

Update 10.20.25: Coronary Calcium Score, Thoracic Outlet Syndrome, BP doing well, upcoming appts with ENT, Endo

 With BP still high, cardiologist NP tried putting me on a Clonidine patch.  Reading about it kinda scared me, especially the fast that I can't just stop since the patch stays on.  Decided to go back to bystolic/hctz and see if they'll start working again and it did.  Except that I noticed my max heart stayed before 130, even when hiking hard.  And also felt lightheaded, tho not sure if it was related to the lower heart rate.  Talked to cardiologist NP and said I wanted to lower dose from 20mg to 7.5mg.  Something about being less than 10mg has a lighter effect on max heart rate.   New dose started Sept 27, 2025.  BP still staying somewhat low and max heart rate's gone up a little to about 140.   Until the body gets used to this and stops responding, I think I'll stay with current med combo (with Amlodipine at night as well. )  

Went and got a Coronary Calcium Scan, my score was a little high, 166 in the Left Anterior Descending (the one that goes into the heart), the other three were ZERO.  Being 100-400 means I could have a coronary event in the next 3-5 years unless something changes.  Statins being the first line of treatment, but we'll see.  BP has been somewhat low, dunno if its because I've been hiking more, and really haven't been drinking since Abby left end of May.  Maybe a handful since then.  My next follow-up with Dr Bagheri isn't till January 2026, will call and see if there's any other tests they want to run to do it this year.  This score scares me. 

Went up to Kernville last week and my left shoulder arm started hurting on the drive up.  I've noticed it happening in the past when I drive at least 45min.  I think it might be thoracic outlet syndrome.  I have a chiropractor appt on Monday, I'll see what Chip says. Could also be related to that rib that's popped up.  I had Election Officer training today and after sitting in the chair for may 40 min the left side started to hurt.   Sitting at the table on the laptop now, there is mild pain.  I think it has something to do with sitting and how I sit.  

I have an endocrinologist appt coming up on Nov. 6, will ask about Primary Aldosternism.

Dec. 9 - Upper Endoscopy, I have low ferritin (iron storage) and iron deficiency with anemia (RBC and hemoglobin high).  Will see if I'm bleeding inside?  This is resulting from talking to Taylor from GI about my last lab work which still showed antibodies for Crohn's without symptoms so she thinks I'm the 5% who does this.  

Tomorrow is ENT appt, will see if my chronic sinusitis is still there (been regularly using Flonase and nasal saline spray) and feel like my nose breathing is better.  When on CPAP, I usually only have 1-2 events/hr.  Less than 5 is good.  And if surgery is still recommended and if so I can opt out of the caudal part. 

Sept 30:  routing mammogram.  All good.

Period was 10 days late this cycle.  Dunno if I'm getting closer to menopause or all the hiking has been affecting it.

Colonoscopy - Nov 2024

 Saw a different GI, Taylor Altun, who ordered some tests.  Fecal test (fat, pancreatic elastase, calprotectin), all normal. Celiac Disease (negative), t-Transglutaminase (tTG) IgA, total IgA (normal), C-reactive protein (normal).   And a colonoscopy even tho I tested negative with the Cologuard, because of the Crohn's Disease antibodies that showed up in the IBD panel two years ago.  Overall, colonoscopy was normal, no polyps, etc, however the biopsy taken at the top (toward the small intestine) showed "prominent lymphoid aggregates" none in the middle, and some towards the end.   She says they are 'white blood cell clusters'.  So she is ordering an MRI of the small intestine, just because of the Crohn's Disease antibody.   Appt on December 23, 2024.  I don't have any symptoms of Crohn's Disease, tho it says it won't go away.  So maybe it'll be something I'll have to deal with as I get older.   It may be in its 'early stages', 'silent,' or 'asymptomatic.'  We'll see what the MRI says. 

Prominent lymphoid aggregates are lymphoid tissue in the gastrointestinal (GI) mucosa that are larger than normal. They can appear as polyps during an endoscopic exam. 

Prominent lymphoid aggregates can be associated with:

• Infections and immunodeficiency disorders

  These include Giardia infection, celiac disease, Helicobacter pylori infection, common variable immunodeficiency (CVID), and selective IgA deficiency. 
• Ulcerative colitis, Crohn disease, or lymphoma

  When lymphoid aggregates are accompanied by other specific features, they can indicate these conditions. 
Chronic lymphocytic leukemia (CLL)
A colono-scopic appearance of prominent lymphoid aggregates in the colonic mucosa is called the "red ring sign". 

In the colon, lymphoid follicles and aggregates are usually considered a normal component. However, when they are present in increased numbers, they can be a sign of one of the conditions listed above.   

SI Joint Flare-up?

 Lower back had been tight.  Some aches along the spine.  Stretched some and did some upper body twists to loosen lower back tightness.  That night I wake up with hip pain on both sides and ache on SI joint.   I think that's what it is, it's the area where the spine connects to the pelvis.  Flare-up can be caused the repetitive twist motion (golfers) so I think that's what caused it.  Pain can radiate down butt, leg, hips.  Putting Salonpas on it for now, seems to be getting a little better.  Just need to remember for next time.  This area gets tighter with age so as with most things, exercise, stretching, avoiding sugar seems to keep it in check. 

Woke up with Pinched Nerve 2.4.24

Slept downstairs Saturday night.  Slept on my side as usual when I sleep with Pa.  Woke up with pain with movement in hip and left leg.  First thought was my hip misaligned.  Pain was tolerable, still walk Roscoe.   Next day pain is way worse.  Still go to work, luckily it was just for ROV so I could take it easy.  Pain all day.  Decide to see Chip, something told me it was not a hamstring strain but possible nerve issue.  And it was.  He said it was "rotated and tight"  I'm guessing lower spine.  He cracks me and says to come back if not feeling better in 2 days.  His guess was that my left leg came across when I was sleeping and because I may have staying in that position for a long time that it caused the pinch.  Next time, I can try rotating my body the other way.  For now, "light exercise and moist heat."  Tues, Susan tells me about this stretch she did when same thing happened to her.   So I try at night and get a 'pop' which along with pain pills, Tiger Balm, and finding a good position for sleep, I feel better the next day.  It gets better each day.  Now about 10 days later, feeling 95% normal.  Some tightness, and a feeling my leg length is uneven, feeling like I wobble when I walk.  Have another chiro appt in 1.5 weeks, hopefully he will fix then.   The first five days were really painful, no fun at all.