What could cause delayed periods postpartum?

Question

Hi doctor,

I am four months postpartum and currently breastfeeding. I recently had my annual bloodwork done, which showed elevated levels of red blood cells (RBC), hemoglobin, and hematocrit. All other parameters in my bloodwork were normal.

I have been consuming a diet rich in vitamins, iron, and red meat, and I have not yet resumed menstruation. Additionally, I have been experiencing significant stress and anxiety during this period.

I am seeking insights into whether these factors could be contributing to my bloodwork results and what steps I should take to address this.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Elevated hemoglobin (Hb) levels can have many causes, and it is important to assess the situation carefully.

Possible causes in your case could be:

Normal variation: Elevated Hb levels can sometimes be completely normal. If your previous Hb levels were similar and within a consistent range, there is likely no cause for concern.
Dehydration: As you are breastfeeding, dehydration is a common cause of elevated hemoglobin and hematocrit (Hct) levels. It is essential to ensure you are consuming sufficient fluids to stay well-hydrated.
Nicotine use: High Hb levels can also result from nicotine intake. If you are using tobacco in any form, it is important to stop immediately.
Reactive polycythemia: This condition can cause elevated hemoglobin and hematocrit levels and should be ruled out with follow-up testing.
Laboratory error: Occasionally, abnormal results may occur due to laboratory errors. Repeating the test at a reputable lab can help clarify any inconsistencies.

I suggest a few recommendations, which include:

Stay hydrated: Make sure you are drinking plenty of fluids, especially while breastfeeding.
Get enough rest: Adequate sleep is essential for overall health and well-being during the postpartum period.
Avoid nicotine: If you use tobacco, stop immediately, as it can contribute to elevated Hb levels.
Monitor blood pressure: If you have high blood pressure, manage it appropriately, as it can be related to your results.
Repeat CBC test: Have another complete blood count (CBC) done in about a month. This will help assess whether your Hb levels are stable, increasing, or decreasing and establish a trend.

At this point, your Hb levels are borderline and not high enough to be overly concerning. Most likely, with proper hydration and rest, your levels will normalize.

Take care, and lots of good wishes to you and your baby. Relax and try not to worry too much. Everything will likely resolve with time and care.

I hope this provides help on your concerns.

If you have further questions, feel free to reach out.

Thank you.