Endoscopy

[Pixielula]

Hey guys further to my earlier post I have attached my FBC these were done once I had started on iron tablets 644 mg per day F Fermerate after 4 months hope they make more sense to you.... Only bloods I have ever requested I'm afraid thanks

[Galixie]

I should preface this by pointing out that I am not an expert. That said, here's what I see: Your mean cell hemoglobin (MCH) and mean cell hemoglobin concentration (MCHC) are both low. That means your red blood cells don't contain enough hemoglobin to properly do their job. The high red cell distribution width (RDW) means that you have cells that vary widely in size. That's abnormal because normally a persons red blood cells tend to all be pretty close to the same size. Small cells contain less hemoglobin, so if your body has some regular sized cells and some small sized cells, it would show as an increase in the RDW and a decrease the MCH.

I can see why they may be looking for microcytic rather than macrocytic anemia based on the low MCH and MCHC.

However, I would think more tests would have been ordered to pinpoint the actual problem. Tests for serum iron, ferritin, total iron binding capacity (TIBC), and saturation percent would give a better picture of how much iron you have and if your body is using it correctly.

Finding out your serum B12 and folate levels would also be useful.

A lot of doctors skip over it, but the reticulocyte count test would also be helpful. That test gives information about how many brand new red blood cells are circulating in the blood.

Based on these results, you're not technically anemic. Your hematocrit is normal and, surprisingly, so is your hemoglobin estimation. Your total red and white blood cell counts are also both normal.

I'm guessing, since you mention being put on iron tablets, that previous test results must have shown a more clear case of iron deficiency anemia and that these newer results are probably indicating a mild improvement.

[Pixielula in reply to Galixie]

Yes was first diagnosed two years ago, then a year ago started b12 loading doses, maybe I've been on the iron tablets for nearly a year now I can't even remember!!! I have no idea what my b12 or iron levels were before supplements. It's only since I joined this forum I have had bloods printed,

[Pixielula in reply to Galixie]

I think my dr did a lot more test and said I wasn't storing the iron, but this was before I knew to have them printed out. I wonder if I can get them retrospectively

[Galixie in reply to Pixielula]

It wouldn't hurt to ask. They might charge you a copying fee, but the results should be in your records so they can probably get you copies.

[fbirder]

You say you were put on B12 injections. Does this mean you may have Pernicious Anaemia? PA is caused by problems with cells in the stomach. One of their jobs is to make stomach acid - which helps with absorption of iron. If you're low in stomach acid then you won't absorb iron as easily.

When you take your iron tablets try taking them with some vitamin C and citrus juice (ascorbic and citric acids). These not only increase the acidity in the stomach, they actually bind loosely to the iron atoms, helping them to be absorbed.

[Laura5]

The high RDW is expected after you've started treated iron deficiency anaemia as the newer, iron-rich cells should be bigger than the old, iron-deficient ones. Do you know what your ferritin level is?

It is interesting that your lymphocyte count is low - mine has always been low too (although not as low as yours) with no explanation. I haven't been able to find anything which links a low lymphocyte count and iron deficiency.

Are you being treated for your thyroid?

[Pixielula in reply to Laura5]

Yes thyroid being treated ...ironically with T3 only!!! This was my latest argument with my GP I would expect at least my t3 to be in range as that's all I'm treated with.... THS 4.98 she tells me I'm "fine" I just smile and say oh ok, then come home and increase my meds 😩

[Pixielula]

Yes it is poss, but have not been tested for IF or parietal cell antibodies and haven't had any diagnosis of PA. I have hypothyroidism and type 2 diabetes so have been on metformin for 15 years and omeprazole for about 4-5 years. I have tried coming off the ppi but life is miserable with constant acid reflux the most I managed was three days.... So could be meds could be autoimmune.....

[Sleepybunny]

Hi,

I noticed that in all the blood tests that have an exclamation mark(!) next to them, you appear to have low levels eg T3, FBC, MCH, MCHC, red blood cell disrtibution width, lymphocytes.

I have read that low iron levels can mask the affect of low B12 and/or low folate.

patient.info/doctor/macrocy...

patient.info/doctor/pernici...

patient.info/doctor/iron-de...

patient.info/doctor/full-bl...

patient.info/doctor/folate-...

Apologies if I've asked you before but have you ever had a full iron panel (a set of iron tests not just ferritin)?

labtestsonline.org.uk/under...

I am not a medic just a patient who has struggled to get a diagnosis.

[Pixielula in reply to Sleepybunny]

Hi sleepybunny.... I think dr did them but I don't have a copy of those. Having found a copy of my referral for endoscopy, it says microcytic anaemia and b12 def... Anyone know what a D2 biopsy is?

[Laura5 in reply to Pixielula]

I think that is probably a biopsy from the duodenum - needed to test for coeliac disease. Hopefully you will also have had biopsies from the stomach.

[Sleepybunny]

If you have microcytic anaemia it may mask (if you have it) macrocytic anaemia which can be caused by low B12 and/or low folate.

gponline.com/clinical-revie...

Have you ever had a "blood smear" also known as "blood film". This may show both microcytic and macrocytic red blood cells in the same sample if a person has both conditions.

patient.info/doctor/periphe...

labtestsonline.org.uk/under...

If the results for a full iron panel came to the GP it should be possible to get a copy. If they were done at a hospital it can be more difficult to get a copy and may involve a visit to hospital records office.

nhs.uk/chq/pages/1309.aspx?...