Labs now showing anemia???

[Nanc72]

Please excuse my ignorance. I have PA, and had a CBC done on February 18, (with other tests) but no iron. All the labs were in normal range, except for the ones diagnosing me with PA. Almost 2 weeks later my Hematologist ran a CBC with full iron tests (minus folate). My CBC is showing as follows:

RBC 3.49M/ul (4.2-6.3)

HGB 11.1 g/dl. (12.0-18.0)

HCT 32.0% (37.0-51.0)

RDW ratio 16.5% (11.5-15.0)

MONO# 1.1 10*3/ul (0.2-0.8)

And so here is my ignorant question. (I apologize I just don’t get this) If I am now slightly anemic, where I wasn’t before, will the b-12 injections correct the anemia or do I need to supplement given the iron levels are normal? Also since all the iron levels are normal does the folate still need to be checked? Thank you in advance😊

[wedgewood]

If you have Pernicious Anaemia, then you will be B12 anaemic not necessarily iron anaemic , until you get treatment in the shape of B12 injections in sufficient regularity to keep the symptoms of B12 deficiency at bay . You will need theses injections for life, as PA cannot be cured . Yes , you should continue to supplement with Folic acid ( vitamin B9), unless you eat good quantities of green leafy vegetables, peas etc. which is the natural form of B9 , known as folate . This vitamin works together with B12 , so this is very important .

[Nanc72 in reply to wedgewood]

I don’t currently take folate, and I do eat vegetables, but probably not enough. Can I take folate without that lab ever being done? He did the full Iron panel, but that was not included.

[wedgewood in reply to Nanc72]

If you take a modest 400mcg tablet of Folic Acid , you will be fine . But do try to take in some folate - rich veg and fruit . They not only supply the folate , but other valuable nutrients .

[Nanc72 in reply to wedgewood]

I sure will. Love them, so it won’t be a problem.

[Gambit62 Administrator]

The raised RDW could indicate that you have both microcytic (iron based) and macrocytic (B12/folate based) anaemia.

The other indicators above show that you have iron deficiency.

B12 will not cure iron deficiency

PA and other absorption B12 absorption problems can also cause problems absorbing iron.

What has your GP said about iron deficiency. As you can overdose on iron please speak to your GP, or at least a pharmacist before supplementing iron.

[Nanc72 in reply to Gambit62]

My Ferritin, Iron, Iron binding capacity, Iron binding capacity (unsaturated) and Iron sat percent were all normal. 2 weeks ago all the labs that I posted above were normal. He did these Iron tests because of my physical exam and because my earlier CBC showed normal/no anemia. Now it’s showing anemia. Folate still was never drawn. All I am currently taking is Hydroxocobolomine 1ml per week (IM) for 4 weeks and then every two months there after. That may or may not change based on the new labs.

[Nanc72 in reply to Nanc72]

P.s As I am newly diagnosed I have only had one injection. I did it 2 days ago.

[Gambit62 Administrator in reply to Nanc72]

macrocytic anaemia will mask microcytic anaemia and vice-versa so the existence of both won't be obvious from a full blood count unless it includes RDW.

Iron deficiency can be caused by dietary/absorption problems but it could also be the result of an internal bleed so it can develop very suddenly.

If you haven't yet had the chance to speak to your doctor about the above results then you need to do so.

[Nanc72 in reply to Gambit62]

Ok, thank you.

[Nanc72 in reply to Gambit62]

I called the Dr’s office this AM and there is a possibility I had some bleeding from my endoscopy biopsies and that is what caused the labs to change. I think some of those #’s changed a lot, but I am not a Dr so...waiting for them to speak to the Dr and then they will call back. Thanks to all of you and all your information