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SGBotsford t1_j93liee wrote

Yes. Not all the iron is reabsorbed. One of the marks of a bleeding ulcer, or injured gut is that your crap turns black from the extra blood. Indeed you can bleed to death from a stomach ulcer if it perforates into a vein.

But even if the leak is slow: The average blood cell lives about 6 weeks. Then it's broken down, the iron salvaged and rerouted to make more blood. So if you are bleeding at a rate faster than 1/6 of your blood per week, or aobut 2.5% per day, your body will fall behind.

It's never that easy. If the change is slow, your body can ramp up blood cell production some. So you might be able to keep up with 3% per day. But not likely 5%

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somehugefrigginguy t1_j93nqxq wrote

Blood is also a laxative so it tends to travel through the intestines quite quickly reducing the opportunity for absorption.

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_CatLover_ t1_j94234y wrote

Do vampires have constant diarrhea? Would have made the twillight series a lot more interesting for sure.

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shawnikaros t1_j95eriv wrote

They're not humans, so, no. Even though it would be quite funny that in every vampire media they'd be constantly going to the toilet. Would definitely make Buffy's job a bit easier.

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bam13302 t1_j95muo7 wrote

Also, I always assumed the vampire teeth sucked the blood either directly into the bloodstream of the vampire, or into some special processing organ

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Yaver_Mbizi t1_j95zh4g wrote

>sucked the blood either directly into the bloodstream of the vampire

That seems evolutionarily suspect: blood-to-blood pathogens from ("near-"?)conspecifics sound like a huge threat compared to any foodborne pathogens that have to go through the digestive system.

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bam13302 t1_j961cpy wrote

Agreed, but i have yet to see a vampire vulernable to a disease or created via evolution, so...

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whatkindofred t1_j97vrq3 wrote

But don’t bats have an extremely strong immune system?

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DrRob t1_j97zj2n wrote

Bats have immune systems which are relatively under-reactive compared to us. They happily harbour all kinds of wild, nasty viruses that they don’t bother mounting a big immune response to.

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notsocoolnow t1_j95w4a5 wrote

If vampires are undead I would imagine that their absorption of blood might not involve actual digestion.

But I find the idea of vampires running to the loo every hour to be hilarious so that's now canon for me forever.

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SponnKing t1_j97komz wrote

That topic is a running gag in the books The Iron Druid. It does get revealed but pretty late in the series. Its also a really good read or listen.

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toastar-phone t1_j9hpfnd wrote

I'm DM'ing a VTm campaign.

Generally you can't eat food, your stomach doesn't work. You throw it up immediately. There is a "merit" you buy called "eat food" This allows you to hold food down until I more appropriate time to throw it up.

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muddytree t1_j93usre wrote

And even if you could quickly absorb lots of iron, it takes a long time to make more hemoglobin/red blood cells. (Also too much iron at once would be toxic, so it’s good that it’s not absorbed too well.)

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Robbeee OP t1_j93n620 wrote

Interesting. Thanks! Is there a reason why iron from iron tablets would be more readily absorbed or is it that only a certain percentage of any orally consumed iron is?

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mumtathil t1_j93vgo4 wrote

Iron absorption from tablets is actually quite poor. High dose iron supplementation just tends to cause more side effects (constipation, abdominal discomfort) without a significant improvement in iron levels and subsequent rise in haemoglobin levels.
Vitamin C helps improve absorption and the tannins in tea makes it worse. Generally taking Fe supplements with food is better than on an empty stomach.
Often with profound Fe deficiency giving the iron as an IV infusion is more effective at gaining a boost in Hb levels.

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FngrLiknMcChikn t1_j9549d7 wrote

Me, a hospital pharmacist who spends his days checking Venofer bags (iron sucrose for laypeople): Meh, probably right

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Celegantly t1_j95ur8e wrote

Absorption is actually better 30 minutes to 2 hours before food, not with food. If patients cannot tolerate the GI side effects they can take it with minimal food. But especially not with caffeine, milk, high calcium foods, or anything high in fiber.

You absolutely want to take the pills with orange juice, something high in vitamin c.

And although absorption percentage is low, the high dose of the pills means I absolutely see positive effects in terms of correcting anemias that outweigh the side effects.

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Bax_Cadarn t1_j95fmwc wrote

And that is why we can't differenciate between taking Tardyferon and a GI bleed - the stool is black in euther case, and the tests for blood in stoll post a positive.

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bounddreamer t1_j93o989 wrote

Only a certain percentage can be absorbed daily. Iron tablets are to help out if your diet isn't particularly full of iron-rich foods or your body has a hard time deriving the iron from what you're eating.

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vc-10 t1_j95hdck wrote

Also important to point out, that one of the common reasons people find out about gastric or bowel cancers is that they are anaemic. Iron deficiency anaemia is an urgent referral for endoscopy in the over 60s here in the UK, under the '2 week wait' cancer pathway.

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LivingDegree t1_j93yrje wrote

Yes! This is actually how you can pick up on chronic internal bleeding within the digestive tract (along with constitutional systems like black tarry stools/dark stools); it’s called anemia of chronic disease. You see this occur in your inflammatory bowel diseases. On routine labs you can see an anemia and it clues you into a long term inflammatory process if you can rule out diet deficiency or other hematological pathologies.

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beyardo t1_j94jip4 wrote

Should be noted that anemia of chronic disease is separate from chronic blood loss anemia, although IBD can cause both. Anemia of chronic disease is a result of chronic inflammation decreasing your body’s synthesis of RBCs, while blood loss anemia like that seen in chronic bleeding is a result of losing blood

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Bax_Cadarn t1_j95fqtg wrote

That's why chronic disease is normocytic while with blood loss is microcytic. Unless with long term small bleeds the body adapts to eventually make them normal size too.

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beyardo t1_j9anb0e wrote

ACD often eventually becomes microcytic as well, as the inflammatory stuff eventually sequesters the iron until you get a relative iron deficiency

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giskardwasright t1_j94uub2 wrote

To add to this we can tell on lab tests if it's chronic or acute anemia through red cell morphology. A slower chronic condition genetally results in red cells smaller than average size with less hemoglobin (microscopic hypochromic) where in an acute bleed situation the cells are normal sized and filled properly, just not enough of them. We can also tell how hard the bone marrow is working to replace cells by the presence and number of nucleated or immature rbcs.

I know you didn't ask, but I don't get to nerd out about this stuff often and I find it fascinating.

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beyardo t1_j95g0o9 wrote

Depending on the cause, chronic anemia can be normocytic or even macrocytic, it’s not always microcytic

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Lostnumber07 t1_j95so6r wrote

Yup. For anatomy purposes the lumen of the digestive tract is external the body(debatable I am sure). It’s a bit confusing but kinda makes sense considering the anus and mouth both open to the external environment. If you think about it a step further you also have blood in an area where it cannot deliver oxygen and remove waste, rather it gets digested. At this point the blood is not doing it job and the person can be considered anemic because low Blood levels are based of serum concentration.

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buddha3434 t1_j94n6bn wrote

GI tract, yes, the blood will mostly leave your body. Other “internal” bleeding (say, subcutaneous hematoma from trauma to a blood vessel), you can become anemic but the iron is mostly reabsorbed, so you will not be iron deficient.

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grewupnointernetmom t1_j96qck8 wrote

Yes you would still have anemia, dependent upon the rate of the bleed. The lost blood won’t be oxygenated and returned to the tissues, the pump (heart) will have to speed up to try to compensate, and other organs such as the kidneys, the brain, etc., will suffer temporary or perhaps permanent damage from a lack of sufficient blood supply.

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