⁸Low Haemoglobin

[Queenie1901]

My latest blood test showed low haemoglobin so my GP ordered a whole raft of additional tests to check B12, thyroid, etc as well as a stool test to check for internal bleeding. Stool test negative. Other test results outstanding. Could end up having the up AND down camera tests! Been reading all I can on here and elsewhere about low haemoglobin/ anaemia. Looking back I can identify 2023 with 2 bouts of additional illness ( Covid in Jan with long cough for 6 weeks and heavy cold at Easter with another 6 week cough) , poor nutrition due to feeling rough and change in diet to assist hubby with Type 2 diabetes eating plan. Probably put myself at bottom of the pile. I have been more focused on an iron rich diet over last 3 weeks plus better dietary consciousness. My question after reading lots of posts... various people have had low haemoglobin and gone through the barrage of tests only to find the results inconclusive. I realise they are trying to eliminate anything more sinister so am happy to undertake all tests. But is it also part of taking pred for a long time? What more can I be doing? (Currently on 2.5mg Pred per day using DSNS taper. Tapering gone smoothly all this year and to be honest I have felt noticeably better this year than during the whole 4 years on pred! Not noticed any of the more obvious symptoms of low haemoglobin that my GP asked me about)

[SheffieldJane]

I think steroids are used to treat a low haemoglobin count. I think it may be unconnected. Good luck with those tests. What a challenging time you’re having! X

[PMRpro Ambassador in reply to SheffieldJane]

That's anabolic steroids - not pred.

[Queenie1901 in reply to SheffieldJane]

Adjusted to the sensible approach....better to have the tests than ignore it (She says bravely?!)

[nallufl24]

my hemoglobin was extremely low before I was diagnosed with GCA. Once I started prednisone it went up. I’m assuming it was the constant inflammation that caused the low blood count

[PMRpro Ambassador]

Anaemia can be part of chronic longterm illness. Possibly due to inflammation but it isn't sure. You need more than just the Hb level - why is the total HB low, is it because you have fewer red cells or because each red cell has less Hb in it.

[Queenie1901 in reply to PMRpro]

Thank you for that detail. I will ask. I am still waiting for the full details. Have only been told over the phone so far and can't get any more until GP authorises issue ....I have been told!

[Exflex]

My Gp at the time referred me to haematology for persistent anaemia. I can’t remember if the haematology said it was due to the inflammation or due to the Pred, but it should improve as the illness or dose of Pred got better. I’m on less than 1mg and a recent FB showed haemoglobin was back to normal.

[PickyQ]

You are certainly being well tested however annoying it's worth persevering. Are you staying at 2.5mg Pred or do you plan to go lower? I have been on 2.5 mg for 12 months and I don't plan to reduce yet as I feel I have reached the correct level for me at this time. To add useable iron to your diet have you tried Floradix.? Just a thought. Take care.

[Queenie1901 in reply to PickyQ]

I did a DSNS taper from 3 mg to 2.5 mg and have been on 2.5mg now for last 3 weeks. No return of symptoms at all. Was intending to stay at 2.5mg for the full month before considering a drop to 2mg but longer may be sensible in view of tests to come.

[MrLogical]

Please look up anaemia of chronic inflammation. Chronuc inflammation causes serum iron to be low hence low Hb. May need to increase Pred dose to bring inflammation down(CRP/ESR) , this will increase serum iron and thus improve Hb.

[Queenie1901 in reply to MrLogical]

Thank you for this. I will take a look. Just wondering why if the inflammation is severe enough why am I not aware of any symptoms. No increase in aches or stiffness etc. But they did include a blood test for CRP/ESR and am awaiting the result this week. So that may reveal more.

[PMRpro Ambassador in reply to Queenie1901]

In the anaemia of chronic illness it doesn't have to be severe, just present long term. I did mention it in my reply.

[Queenie1901 in reply to PMRpro]

Sorry, I should have re-read it. I have been reading so much before my appointment tomorrow, probably too much! Thank you anyway.

[MrLogical]

Best to get iron studies test which includes ferrentine and serum iron, your GP or specialist should get a clear picture of wether it is due to long-term chronic inflammation or dietary/absorption issue. Low haemoglobin could also be due to low bone density mass.

[Queenie1901]

Thank you. Having test to include that as well I think