I'm new here and wondering if someone could please help me. I've just had a blood test done last Friday as I was feeling dizzy and exhausted a lot of the time. I asked for a full blood count and most of the result is showing below range especially the haemoglobin concentration. The doctor has said I have severe iron deficiency and it has been suggested I need a blood transfusion. My vitamin D level was also very low. The result I am most worried about is my vitamin B12 as I had a blood test done a few years ago and I was told it was low then but just to take some tablets and I don't have a copy of those results. On this recent test my ferritin level is well below the low range at 5ug/L. So far the GP has given me iron tablets and vitamin D tablets and told me to come back for another blood test in a month. I'm just asking for some advice as to what other test I could ask for to determine what is the cause of all this. Please could somebody help?
Thank you.
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Cn13
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I would suggest you have any further blood tests BEFORE any blood transfusion 'coz otherwise the transfusion will skew any results.
If your GP/Doctor is agreeable/persuadable, MMA and Homocystein levels, are likely to be raised in B12 defiency, would also be good indication for requiring treatment
Bare in mind, I'm not a professional, just someone trying to get treatment
Are you sure the doctor said you need a 'blood' transfusion? This wouldn't do much good for an iron deficiency anaemia. It is fairly common to treat very low iron with an iron infusion.
That sort of infusion won't affect any test results for various vitamins.
Ask for a B12 and folate test as well, just in case. But it wouldn't be at all surprising if fixing the iron and Vit D deficiencies fixed your problems.
What sort of iron tablets are you on? If it's iron sulfate then you'll find they work better if taken with citric acid and ascorbic acid (Vit C). Tesco do a good effervescent Vitamin C tablet that has both of them. Swallow the iron sulfate then glue the fizzy orange (or lemon) afterwards.
Interesting information, so thanks. When is the best time to take iron/vit C supplements? I take thyroxine (T4 - 100mcg and 75 mcg on alternate days) first thing in the morning, an hour before breakfast, so am wondering whether a certain period of time is required before taking any iron supplement? Thank you if you can help.
Have insisted GP explains why my RBCs production is above range... On 2 previous occasions she said "it was what to expect with my health issues" (not really scientific nor acceptable explanation, but many other issues were being discussed within a short period of time) and when I raised the issue I might have a form of anaemia she repeated 3 times i was not anaemic (that was when I was asking to have B12 injections, which I have finally now)... So a week ago I told her I needed a clear explanation for overproduction of RBCs.... she finally said my RBCs were smaller.... which makes some sense to me as I feel cells are not getting enough oxygen (poor uptake of usable haemoglobin) and just told her that must mean the RBCs are microcytic... she agreed but NO solution given as how to increase binding of haem to oxygen in order for my metabolism to function better. Does that mean I may have microcytic anaemia after all? Advice much appreciated from you and any other member of the forum. Thanh you for any help and support.
If your red cells are too small and you don't have enough haemoglobin then you have microcytic anaemia - that's the definition. And being iron deficient is the most common cause of microcytic anaemia.
Getting your iron levels up should fix that - once you've got enough working red blood cells. That can take a while (several weeks).
Thank you once more. Indeed I did tell GP a month ago or so I thought I might have macrocytic anaemia which she vehemently denied ! So back to see her next week and will insist on getting iron sulphate tablets. It should not be so difficult to get help from GP but ...
Thank you Gambit62 for confirming it is macrocytic anaemia rather than microcytic form. So what treatment is required for macrocytic anaemia, and should GP recommend further investigations? Thanks again.
sorry what you have described is above is microcytic anaemia - there was a typo in fbirder's response to you which has now been corrected but his explanation that the most likely cause is iron deficiency and getting levels of iron up so you body has enough iron to make normal sized red blood cells would be the way to go. however this doesn't happen over night as existing red blood cells are replaced as they come to the 'die' and they tend to live for 4 months.
Indeed what confusion! However an overproduction of RBCs being of smaller size has to indicate microcytic anaemia. I understand from my research that this form of anaemia, in men and postmenopausal , should not be treated by iron supplement before any underlying cause is found, only then should a treatment be given.
I would appreciate any useful and accurate comments from members of the forum.
Also is it possible that microcytic anaemia be a symptom of pernicious anaemia?
Will need to press GP to give the correct diagnosis... which she has not done so far although she has agreed to prescribe B12 injections, syringes and needles long term, and I will be taught by a nurse to do the IM injections.
Thank you for correcting the error, much appreciated.
not aware that and can't think of a mechanism that would enable B12 to cause microcytosis - as fbirder says usually iron deficiency - which would mean either a bleed or an absorption problem. It is possible to have both iron and B12 deficiency and to be B12 deficient with microcytosis.
Am seeing gastroenterologist on Monday evening. So do hope to find a way forward with diagnosis of microcytic anaemia and possible underlying cause. It is only a consultation but at least consultant should refer me for appropriate investigations, I hope... thanks again.
it may be a gynae thing but I have a friend who has problems with iron levels because of heavy bleeding and when it became so bad that she was fainting she was given an blood transfusion - followed by iron tablets and others to help slow the bleeding (though not sure what they were).
What dose of VitD were you prescribed ? Often too little an amount is given by GP's which means it will take forever to raise. 5000IU's is a reasonable amount to take - often the GP will prescribe something like 800 When taking VitD - calcium uptake from food is improved and in order to direct calcium away from the arteries and soft tissues - it is advisable to also take VitK2 MK7 - Magnesium too is another co-factor.
Hi, Thanks for the replies so far. In response to Clive I had taken a few tablets containing Vitamin B12 about a month ago but only about 4 or 5. I did ask for a serum b12 test to be done and the results that I got yesterday say the vitamin b level and folate levels are ok but my ferritin level is very low at 5ug/L when their lowest range is 10.0 - 204.0. They are definitely talking about a blood transfusion but they do want to do another blood test in a month to see what is going on. I am just extremely stressed and worried as I don't know what the cause of all this is. I am on anti-depressants too.
The iron tablets are the sulfate ones so thanks fbider I will buy the vitamin C tablets too. It seems like the GP would be agreeable to do any test to find out what is going on I'm just finding it all very confusing.
Do you think I should wait and see if the Iron and Vitamin D tablets work and what the results of the next blood test are and I could ask for the B12 to be checked again?
any tests you want done in respect of B12 would need to be done BEFORE any blood transfusion.
Best thing would be to ask for a copy of the test results that have already been done to see what they are like with reference to ranges.
In terms of diagnosing a suspected B12 deficiency the tests would be MMA and homocysteine.
Please be aware that the symptoms of iron deficient anaemia have a huge overlap with the symptoms of B12 deficiency so unravelling the two - if both are present will be difficult, and the likelihood is that your symptoms are being caused by the iron based anaemia. Did your GP offer any explanation as to what might be causing the iron deficiency? Its either absorption or bleeding.
Tests in relation to absorption would be IFA (for PA), coeliacs. probably others but not sure what they would be.
The GP thinks it might be a bleeding problem and I have been given some other tablets to take at the time of the month. The vitamin D3 are 10,000 and I can take 5 in a month. I have got a copy of these test results and will ask for a copy next time too. I could ask for the MMA test and the other one just because I am worried I might have the B12 deficiency also. Hopefully I will start to feel better with all the tablets they have given me so far.
In relation to Vit D3, having had the 'intensive' course of D3 a couple of years ago, due to being low, I now take 5,000iu D3 every day, which keeps me around mid-range. I say this because 10,000 iu weekly (or there abouts) seems rather low if you are already low.
I have to admit, I don't go out in the sun much at all, probably why I tend to be low without suppliments.
Thanks everyone for your replies. Which is the test for the folic? I'm just so worried about what the cause of all this might be and want to try and find out the reason. I was diagnosed with fibroids in my uterus a few years ago maybe I should ask for a scan? I'm only 44 and not sure if this is too early to be the menopause and could that cause all these problems. I just feel so tired all the time and can barely do anything. I do tend to stay inside a lot in winter so that could be the reason for the low vitamin D3. The doctors just seem to be asking me what I think the cause is rather than suggesting anything themselves. I'll need to make another appointment but need to know what I should ask for. My red blood cells are larger than normal. Please help with any more suggestions. Thanks.
Would posting a copy of my test results be helpful in telling me what test to ask the doctor for the next time I go in a couple of weeks. They have already said I need to book another blood test. Should I ask for the B12 serum test again? I'm just worried as I was told I had PA a few years ago but didn't get any proper treatment.
I have made an appointment with the GP in 10 days time. I would like to sound like I know what I'm talking about as before I asked for this recent blood test the doctor was saying my symptoms were due to stress and depression. I want to ask for the MMA test, homocysteine, and IFA test as I think I have a lot of symptoms of PA. They also did a thyroid test and said this was normal. I'm just wondering what could be causing the iron deficiency if it's not B12 and worried I will have to convince the GP to do the above tests. I seem to have a lot of symptoms similar to a b12 deficiency. Please could someone advise or help with what I should read up on.
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When taking VitD - calcium uptake from food is improved and in order to direct calcium away from the arteries and soft tissues - it is advisable to also take VitK2 MK7 - Magnesium too is another co-factor.
New to all this, please help with test results
Please help me with understanding blood test results!
