My blood reports show low iron, hemoglobin, hematocrit, etc. Should I see a hematologist?

Hi,

Welcome to icliniq.com.

I hope you are safe and sound in the pandemic. I reviewed all of your investigations in the past couple of months (attachments removed to protect the patient's identity).

1) You have developed iron deficiency which later leads to anemia (low hemoglobin).

2) You donated blood, a couple of bags in consecutive two months, which is against protocols of blood donation. You can only donate twice or thrice a year.

3) Your WBC (white blood cells) are also high with neutrophilia. This shows either some stressful condition or some infections. You did not give history indicative of these.

4) Now, you are taking an oral iron tablet. Your hemoglobin would be corrected in another three months. So you got to take iron orally for another 6 to 9 months to replenish the iron stores in the body.

5) Investigate if there are any infections or inflammations in your body. Get ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) tests to rule out any.

Low hemoglobin is also called anemia.

1) Grade 1 anemia is when hemoglobin is less than normal up to 9.9 g/dL. This is mild anemia. No investigation is needed. Just improve diet, give hematinics. Rule out renal disease, liver disease, thyroid disease, thalassemia minor, or any drug-induced cause.

2) Grade 2 anemia is when hemoglobin range is from 8.9 to 9.8 g/dL. This is moderate anemia. Investigate the cause, which might be combined nutritional deficiency or other causes mentioned above. No blood transfusion is needed at this level.

3) Grade 3 anemia is when hemoglobin range is from 7.9 to 8.8 g/dL. This is moderately severe anemia. Causes may be hemolysis, acute or chronic blood loss, along with the causes mentioned above. No need for transfusion at this level unless a surgical emergency is there. Treat the cause.

4) Grade 4 anemia is when hemoglobin range is from 6.9 to 7.8 g/dL. This is severe anemia. However, no transfusion is needed even at this level unless there is some surgical emergency. Causes include thalassemia intermedia or major, G6PD deficiency (a genetic disorder), hereditary spherocytosis, and the causes mentioned above.

6) Grade 5 anemia is when hemoglobin range from is 5.9 to 6.8 g/dL. This is very severe anemia. A blood transfusion may be needed according to the cause. If there is a production disorder, transfusion is needed. Transfusion is also required in thalassemia major. No need for transfusion in mere combined nutritional deficiency or renal disease. Also, assess the cardiovascular system at this level.

7) Critically low hemoglobin or grade 6 anemia is when the hemoglobin level is less than five g/dL. Transfusion is needed regardless of the cause. Consider PRCA (pure red cell aplasia), thalassemia major and aplastic anemia.

The workup for anemia includes:

1) CBC (complete blood count) with red-cell indices, platelets, reticulocytes, and peripheral blood smear report.

2) LDH.

3) Hematuria work up.

4) Melena or hematemesis or hemoptysis work up.

5) Bone marrow biopsy report.

6) Ferritin report.

7) Vitamin B12 and RBC folate levels.

8) RFT (reanal function test).

9) LFT (liver function test).

I hope this was helpful. Please get back if you have further queries.

Hello,

Welcome back to icliniq.com.

I have got three laboratory results from different samples on different dates all weeks apart. Blood physiology changes with time, and parameter results are also changed. The results explain your condition very well no need to worry. You are on a track to getting better.

I hope this was helpful.

Hi,

Welcome back to icliniq.com.

Your reports from the 7th of this month show recovery from iron deficiency. Keep taking Iron, Folic acid, and Vitamin B12 tablet a year-long because micronutrient deficiency reoccurs if stores are not replenished.

I hope this was helpful.