Dear Dr. Roach: I am wondering if there is any link between low iron and depression/anxiety. I am a 37-year-old woman, and I started taking Lexapro a few years ago. I upped my dose last year because I wasn’t feeling great, and my doctor and I decided that it was a good step.
During the years that I have been taking Lexapro, I have also been a regular blood donor. I am CMV-negative, so I have blood suitable for newborns. The Red Cross says I am a “hero for babies,” and I enjoy doing something good.
I haven’t donated in about five months, and I am feeling much better regarding my depression. I know that donating blood affects iron levels, but does it also affect the concentration of Lexapro in my body? If not, can low iron be contributing to my depression? I would love to know the answer so that I can possibly continue to donate, perhaps less frequently.
J.M.
First off, thank you for donating so regularly. CMV is a virus most people have been exposed to, and like most herpes viruses, it stays in the body forever. Newborns and premature babies, as well as organ transplant recipients, need CMV-negative blood, and there aren’t many CMV-negative people who can donate.
Depression and anxiety are tightly linked to the neurotransmitter serotonin. Lexapro doesn’t increase serotonin, but makes the transmission of serotonin from one nerve cell to another more effective, by reducing the reuptake of serotonin at the nerve junction. Low iron levels have been shown to reduce serotonin, so this may be part of why your depressive symptoms have been worse.
However, there are many reasons, both inside and outside of your body, that can make depressive symptoms worse. Still, if you do have low iron levels, you can replace iron faster (and keep it normal, despite blood donation and menstruation) with an iron supplement. (It would be best to check on this with your doctor.) If your depression then gets better, this would be pretty good evidence that the low iron does affect your mood. (Note: You can have low iron and not have an anemia at all.)
Find the right donation frequency so you can still help without putting your mental health in danger.
Dear Dr. Roach: I am an 86-year-old male. Several years ago, I had about a third of my prostate removed because I couldn’t pee. After the surgery, all was well with a steady stream until about two weeks ago. During one recent trip to the bathroom, I noticed that I had a hard time trying to urinate, and the stream was stop-and-go. This continues, but isn’t a problem during the day.
Any thoughts on my sudden change in urinating?
D.S.
A sudden change in urination should prompt an evaluation for a urine infection, quite common in men in their 80s, especially those with prostate problems, even after surgical treatment. Your first stop should be your regular doctor for a urine test, and if this doesn’t reveal the problem, it is time to visit your urologist.
Some medicines can dramatically worsen the ability to urinate in men, especially decongestants and antihistamines. Some people use these at night, which might explain why you only experience problems at night.
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