What is the treatment for microcytosis with low reticulocyte and hemoglobin?

Hi,

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I am here to extend a helping hand to you.

Based on your query and attached report (attachment removed to protect the patient's identity), my opinion is as follows:

1. Low reticulocyte count percentage and reduced hemoglobin indicate ongoing deficient production.
2. Looking at moderate microcytosis and mild macrocytosis, it appears it could be more of nutritional cause.
3. Correcting iron levels for microcytosis and Vitamin B12 and Folic acid for macrocytosis is essential.
4. I would suggest you to start on Ferrous Fumarate along with Vitamin C for better absorption. Also, Vitamin B12 and Folic acid supplements is essential. Consult your specialist doctor, talk with them, and then take the medications as per their suggestion.
5. Need to improve the diet rich in iron and vitamins also to sustain the improvement. Avoid coffee or tea intake with iron supplements, as it can reduce absorption.
6. Any further fall in hemoglobin or breathlessness should be viewed seriously and blood transfusion will be necessary to maintain good cardiac status.
7. At present, reduced work or more rest is essential to avoid increased cardio pulmonary load.
8. Improve nutrition and take supplements and check reticulocyte count after 15 days, it should be increasing.
9. If not sure about nutritional cause, Vitamin B12, Folic acid and serum iron assay can be done.

I hope it helps.

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Thank you.