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Forum Name: Hematology Topics

Question: Anemia question


 lady2917 - Mon Aug 06, 2007 3:57 am

Hi, I am a 42 year old female. About 9 months ago I started having alot of acid reflux and went to my GP. He prescribed an antiacid tablet I also had a blood test which showed I was anemic. I was then also prescribed a course of Iron tablets. After alot of tooing and froing the reflux improved and so did my iron levels. I was then asked to have a further blood test in three months time which I did. I was again showed to be anemic hb 10.9 I was then asked to have a further blood test a week later and go back to the GP a week after that. I did this last Friday and was told my HB was 5. I had two further blood test one for celiac disease and another I can't remember the name of I think it was to see if there were any bugs in my stomach? He also prescribed another course of iron tabs 1 three times a day for 6 weeks then one a day for 6 weeks I have another iron test booked for 10th sept. GP said he would refer me if things do not improve as he doesn't know why I am losing iron. I eat a very healthy varied diet and weigh approx 61kg

Thanks.
 Dr. Chan Lowe - Sat Aug 11, 2007 12:12 am

User avatar Hi Lady2917,

There are a few things to consider. First, with severe reflux there can also be ulcers or gastritis which can cause some bleeding. Bleeding leads to ongoing loss of iron as well as directly leading to low hemaglobin levels. I would recommend that you have your stool tested for heme that would indicate bleeding into the GI tract somewhere.

If they have not been, I would also suggest that you have your iron levels tested to see if they are actually low. It may be that your iron levels are fine but your red blood cells are being destroyed.

If they are low, you should also discuss with your doctor about the possibility of Crohn's disease (one of the inflammatory bowel disease). With Crohn's disease the area of the intestine that absorbs iron can become inflamed blocking the iron absorption.

Having a peripheral blood smear is also helpful to look at the red cells under the microscope to see if there is any evidence of red cell destruction (such as may occur if there is an antibody attacking your red cells). It can also reveal any red blood cell abnormalities such a spherocytosis. These are less likely if your anemia is just now presenting. These often present in childhood.

You may need to see a hematologist or GI specialist to help work this up.

On a slightly different note, a hemoglobin of 5 is quite low. If you are experiencing any shortness of breath, rapid heart rates, or other ill feelings you should see your doctor to be evaluated. If the red cells get too low, oxygen delivery is compromised.

Best wishes. Keep us updated if you don't mind.

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