Anemia, have been in post surgical menopause for 11 months

[Mich1111]

Need some help with a health issue.. Hysterectomy nearly 11 months ago, full, post surgical menopause. Went to the family doctor today (floater doctor)  and am slightly anemic... well my level is 11.8. Yes, that's not major but it's slipping. It was 12.4 in November. Why would my hemoglobin be dropping if I am now post surgical menopausal? I didn't see my regular doctor and will next week. I don't know what is causing this, if I have a bleed somewhere, or a chronic disease or the intestines not absorbing. or if this actually turns out being nothing. I am scared.

[Mich1111]

Sorry, this is the full complete blood count:

WBC 6.8 4.0 - 11.0 10e9/L
RBC Count 4.30 3.8 - 5.2 10e12/L
Hemoglobin 11.8 11.7 - 15.7 g/dL
Hematocrit 34.6 35.0 - 47.0 %
MCV 81 78 - 100 fl
MCH 27.4 26.5 - 33.0 pg
MCHC 34.1 31.5 - 36.5 g/dL
RDW 12.2 10.0 - 15.0 %
Platelet Count 305 150 - 450 10e9/L
Diff Method Automated Method
% Neutrophils 51.2 %
% Lymphocytes 38.8 %
% Monocytes 6.5 %
% Eosinophils 2.5 %
% Basophils 1.0 %
Absolute Neutrophil 3.5 1.6 - 8.3 10e9/L
Absolute Lymphocytes 2.6 0.8 - 5.3 10e9/L
Absolute Monoctyes 0.4 0.0 - 1.3 10e9/L
Absolute Eosinophils 0.2 0.0 - 0.7 10e9/L
Absolute Basophils 0.1 0.0 - 0.2 10e9/L

[Mich1111]

I should take that back, the radiologist noted a tiny spleen cyst during both cat scans in Jan and June. But said it wasn't significant.

Here is my cat scan:

CT ABDOMEN/PELVIS WITH CONTRAST 6/6/2013 8:35 AM

HISTORY: Donnell and intestinal pain and cramping. Recent hysterectomy in October 2012. Previous cholecystectomy
and appendectomy.

TECHNIQUE: Scans obtained from the diaphragm through the pelvis with
oral and IV contrast. 96 mL Isovue 320 injected.

COMPARISON: 1/23/13.

FINDINGS: Diffuse fatty infiltration of the liver again noted. Tiny
cyst in the spleen. Liver, spleen, pancreas, and both kidneys are
otherwise negative. No abdominal or pelvic adenopathy. Colon and
small bowel are normal. Remainder of the scan is negative. No change
from 1/23/12.
Impression

IMPRESSION:
1. No acute abnormality.
2. Fatty infiltration of the liver.
3. No change from 1/23/13.

JEFFREY LUKENS, MD

NA 143   (Sodium/Salt)
POTASSIUM 3.8
GLC 90  (Glucose/Blood Sugar/Diabetic Screen)
CAL 9.5  (Calcium)
CR 0.74  (Kidney Function)


WBC 6.8  (white blood cell count)
HGB 11.8   (hemoglobin)
PLT 305   (blood clotting cells)
HCT 34.6   (% blood that is red blood cells)

% Neutrophils 51.2 %
% Lymphocytes 38.8 %
% Monocytes 6.5 %
% Eosinophils 2.5 %
% Basophils 1.0 %
Absolute Neutrophil 3.5 1.6 - 8.3 10e9/L
Absolute Lymphocytes 2.6 0.8 - 5.3 10e9/L
Absolute Monoctyes 0.4 0.0 - 1.3 10e9/L
Absolute Eosinophils 0.2 0.0 - 0.7 10e9/L
Absolute Basophils 0.1 0.0 - 0.2 10e9/L

Iron 43 35 - 180 ug/dL
Iron Binding Cap 350 240 - 430 ug/dL
Iron Saturation Index 12 15 - 46 %

=======

Questions:

1. Can a tiny spleen cyst cause anemia?
2. If GI bleed is causing the anemia, couldn't the can scan being entirely normal showing no tumors rule out anything significant?
3. Could this be a different cause of anemia?

[Mich1111]

Thanks.
I had two cat scans of the abdomen and pelvis since my hysterectomy... one in November and another in late June. Both completely normal.

What would that rule out?

I am very scared over this. I thought I was done worrying about my health after the hysterectomy and now this.

[Dr. Kokil Mathur]

Hi!
Low hemoglobin is seen in low iron (can be low in diet or due poor absorption or increased loss), kidney diseases, cancers (leukemias, Hodgkin's lymphoma's, myeloma, and other blood cancers), aplastic anemia and myelodysplastic syndromes (bone marrow disorders), cirrhosis of liver, lead poisoning, and in vitamin deficiency. Low hemoglobin can also be due to increased destruction of blood or its components as seen in spleen disorders, sickle cell anemia, thalssemia etc. It can also be due to increased blood loss as seen in bleeding in your gastrointestinal tract, either due to esophageal varices, polyps, gastric bypass site, hemorrhoids or an ulcer.
You need a complete CBC, hemogram, occult blood in stool (hidden blood), and may be a CT scan, endoscopy and colonoscopy. Please discuss with your doctor.
Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.

[Mich1111]

41 years of age.