Dr. Goswami Parth Rajendragiri
Pathology
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Patient's Query
Hello doctor,
My primary care physician and his PA overlooked at least 10 years of consistently low hemoglobin and hematocrit levels. When recently had flu-like symptoms without any upper respiratory symptoms, I went to a new PCP who ordered the blood test. That PCP noted the low hemoglobin and hematocrit and had me repeat the tests six weeks later. Still small, she referred me to a gastroenterologist to check for bleeding. He had access to all of my blood tests for the last 12 years and was the one who pointed out that the levels had been low.
He concluded that there was no blood loss. The PCP then referred me to a hematologist. I am waiting to be seen by him. Of note, I have been consistently exhausted with low energy and motivation. I also have a multiple-decade history of recurrent aphthous stomatitis that is worsening. My blood results also showed a Vitamin B-12 level in excess of 1000 and a healthy iron level. I am wondering what could be going on. Any thoughts or recommendations you may have would be much appreciated.
Hello,
Welcome to the icliniq.com.
If hemoglobin level and hematocrit low than iron deficiency anemia could be possible, I need to know how much is your hemoglobin value. So kindly attach your CBC (complete blood count) report to give a further comment regarding that.
The B12 can be high due to supplement intake, liver disease or kidney disease or myeloproliferative blood disorder. So apart from CBC, you can investigate with liver and kidney profile reports as well to exclude liver and kidney disease. If all comes clear than no need to worry because B12 is water-soluble vitamin readily excreted through kidney. Kindly attach your reports. I hope I have answered your question. Let me know if I can assist you further.
Patient's Query
Thank you doctor,
I only have the last three blood tests available see attached. The gastroenterologist I saw said that I had chronic normocytic anemia with hemoglobin and hematocrit levels hovering between low normal and mild to moderately low throughout that period. He said that the hemoglobin was as low as before years at a time that may have corresponded with a prostate biopsy I had.
Hello,
Welcome back to the icliniq.com.
I have seen your attached last three reports in (attachment removed to protect patient identity). In the previous two reports your hemoglobin level and hematocrit levels are slight low. However, your iron profile reports are entirely normal. So in such case any bleeding history if present need to be searched for.
Stool occult blood test should be done to check for bleeding from intestine or stomach by any ulcer. Stool routine micro examination also should be done. Stool analysis will reveal any parasite if present if all reports regarding bleeding are normal as you said than mild low hemoglobin could be due to nutritional deficiency. Your hemoglobin level and hematocrit mildly reduced. So need to be concerned but do not worry.
You can take iron-rich foods like red meat boiled, green leafy vegetables, pumpkin seeds, and beans, etc. The B12 is a water-soluble vitamin. Mostly it will readily be excreted through kidney. Kindly repeat B12 after few weeks to check the level. I hope I have answered your question. Let me know if I can assist you further.
Patient's Query
Thank you doctor,
Thanks for the help.
Hello,
Welcome back to icliniq.com.
Welcome. Get well soon.
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Pathology
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