Dr. Mubashir Razzaq Khan
Hematology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am eight weeks pregnant. This is my first pregnancy, and I have nausea and constipation. Early pregnancy blood work showed an increased transferrin saturation, mild anemia, and higher B12 level in blood. I was diagnosed with hereditary spherocytosis a few years ago, so my spleen is mildly enlarged. I also had my gallbladder removed five years back. I had been taking Naturobest prenatal tablets twice daily but have cut them down due to the blood results. In the meantime, should I be concerned? Is there something I could do to manage my blood levels better? I no longer take vitamin B12 supplements and iron tablets.
Kindly help.
Hello,
Welcome to icliniq.com.
Thank you for your query.
I read your query and understand your concern.
You need to keep your vitamin B12, folic acid, pyridoxine, vitamin D, and iron within the upper limits of reference ranges. As hereditary spherocytosis is a high-utility state of the body due to erythroid expansion, I suggest you to continue the supplements containing the micronutrients mentioned above and monitor your blood levels yearly or twice yearly.
I hope this has helped you. Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I am still confused by the lower transferrin saturation to the higher ferritin. Can this cause a higher risk of gestational diabetes? Is the increased transferrin saturation due to a lack of iron stores? Or is it iron overload like hemochromatosis (I have no family history)? My doctor told me that I need to stop the extra vitamin B12 and iron supplement tablets. I am still a bit confused.
Kindly help.
Hello,
Welcome back to icliniq.com.
Sometimes pyridoxine (vitamin B6) deficiency leads to decreased delivery of iron from ferritin or other storage sites to macrophages, erythroid cells, and energy production cells. This leads to the results mentioned above. Your B12 and Folic Acid are not sufficient or high. It should be abundant or higher than the upper limits for hereditary spherocytosis patients. Hereditary spherocytosis is a high turnover state of the body. Your blood profile does not indicate hemochromatosis.
I hope this has helped you. Thank you.
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Hematology
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