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Forum Name: Hematology Topics

Question: iron&b12 low


 allycat - Tue Jul 12, 2005 8:37 pm

I am very active run about 20-25 miles a week. I have been overly tired for 2 months and finally went to my doctor when I couldn't hold my arms up to blow dry my hair. I am 29 year old female , 123 pounds.
I had CBC drawn 7/5
My labs: wbc -5.3 /rbc 4.9/hgb 10.0/hct32.8/mcv 68.0/mch20.7/mchc 30.5/plt 331/rdw 17.0/mpv 9.7 diff poik 2+ hypochro1+microcyte1+ovalcyte2+
Iron 12/ retic0.8/tibc387/iron sat 3/b12 192/folic acid 4.4/ferretin 6

Since those labs I have had four days of iv iron infusion and 4 b12 shots. My labs were redrawn on7/11, only cbc:
wbc4.6/rbc4.1/hgb9.2/hct28.1/mcv68.5/mch22.4/mchc32.7/plt250/mpv9.1/rdw16.9/
anisocytosis1+/microcytes3+

Dr. dosen't seem to know why there is a drop in wbc&hgb&hct. Says I need two more weeks and then will need bone marrow biopsy if retic isn't up to 2-3. What is this just an iron defiencent anemia or something more?
 Dr. Safaa Mahmoud - Sat Jul 29, 2006 3:41 pm

User avatar Dear allycat,

I can not suggest a certain diagnosis for your medical problems, however I would recommend you to go for the bone marrow biopsy as your doctor advised.

Persistent changes and the presence of abnormal cells despite adequate therapy are indicative of bone marrow biopsy. In such cases bone marrow analysis is a mandatory test to reach the diagnosis.

The reticulocyte count (N:40,000-100,000 /muL of blood) is very important to determine the need for bone marrow examination; normal or elevated reticulocytic counts indicate adequate Bone marrow function and extrinsic cause for the anemia. Persistent low level despite of adequate regular treatment is another indication for bone marrow biopsy.

I advise you to follow up with your doctor. Keep us updated.
Best regards,

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