Q. My wife's fitness certificate was put on hold due to low hemoglobin. Can she travel abroad?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
Published on Apr 10, 2017 and last reviewed on: Oct 09, 2018

Hello doctor,

My wife went for a master health checkup. Her fitness certificate was put on hold due to low hemoglobin and other blood test parameters. Her hemoglobin was 8 g/dL, ESR was 25, hematocrit was 26.8, MCV was 62.3, MCH was 18.8, MCHC was 30.0, and RDW was 21.4 %. Can you please check these parameters and suggest if she can travel abroad?

Dr. Parth R Goswami

Hematology Pathology


Welcome to icliniq.com.

I have gone through the reports (attachment removed to protect patient identity).

  • Your wife has microcytic hypochromic anemia. The common causes of microcytic hypochromic anemia are iron-deficiency anemia, sideroblastic anemia, thalassemia minor, and anemia of chronic disease.
  1. Serum ferritin.
  2. Serum TIBC (total iron binding capacity).
  3. Transferrin receptor saturation assay if needed.
  • For iron-deficiency anemia, Ferrous sulfate tablet or syrup can be given for two to three month, after consulting your doctor.
  • The cause of iron-deficiency anemia has to be found so that it can be treated. For example, if there is a complaint of abdominal pain due to parasite egg, then Albendazole is needed.
  • It can also be caused due to vaginal bleeding, then the cause should be searched by pelvic examination and ultrasonogram.
  • Does your wife complain of excess bleeding? Does she take less nutritional food? Does she have abdominal pain?
  • She should consume green leafy vegetables (spinach), jaggery, dry fruits, etc.

Revert with more information to a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

Hi doctor,

Thanks for your response. We have done stool sample test and pelvic examination, and all reports were normal. I would also mention that nutritional intake was less. We would need to travel abroad soon, so please suggest some medication and nutritional supplements.

Dr. Parth R Goswami

Hematology Pathology


Welcome back to icliniq.com.

  • Your wife has iron-deficiency anemia due to less nutritional intake.
  • So, I would suggest taking one tablet Orofer XT (combination of Folic acid and Elemental iron) daily, it contains Ferrous ascorbate, which is equivalent to elemental iron 100 mg. This drug should be consumed for at least two months, then repeat CBC (complete blood count).
  • Take iron-rich food like green leafy vegetables, dry fruits, red meat, jaggery, beans, fortified iron cereal, and pasta can be used in breakfast.
  • Avoid eating outside food.
  • With above advice, your CBC report will improve, and symptoms like weakness will also be resolved. Regularly check serum TSH (thyroid stimulating hormone) level, to adjust Levothyroxine dosage.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

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