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Family Medicine (Expert Forum)
Anemia
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Anemia
by olly, Dec 07, 2006 12:00AM
I am 64 and until the past year have had great energy. 5 years ago at my healthiest I had a hemoglobin of 11, After each of my children were born 30 years ago it would be between 9 and 10 and after a few months I could get it back up to 11.
Three years ago on an insurance examine the hemoglobian was down to 10.5 All other tests were perfect. My blood pressure is usually 110 over 70.
A year ago I began to not feel as strong. Couldn't pick up the TV or chase after my four year old grandson. Two weeks ago I felt even more tired after a walk.
Last week I had a large battery of tests done. The hemoglobian was 6.2 The WBC was 4000. The diff. was normal, The rest of the tests except the RBC's was normal..(Sugar, Thyroid, Cholesterol etc.) My heart tests (echo cardigram, electr cardiogram, ) bone density etc. were all normal.
My questions are:
1. Should I move a January 12th follow up appointment with my physician up to next week ? In other words with such a low hemoglobian am I likely doing damage to anything (heart etc)by trying to complete the holidays without bad news. I did buy liver today and cooked it and made a committment to eat two little pieces each day. Also bought vitamines and B12 tablets. My idea is if the hemoglobian goes up in three or four weeks the physician won't push for a mass of unneeded tests. If not then the bad news can come after the holidays.
2. Do you think these online home tests for occult blood could be done ? If they are positive I could call for an emergency appointment. (I am a retired med tech)
Lucky for me I have not been ill and not been in a hospital for anything except when I had my children. Not had any medical problems and only seen a physician for check ups and poison ivy every few years.
Ther is no history of cancer in my family. My Mom is 88 and my dad 87. My brother is in excellent health except a bad knee.
Three years ago on an insurance examine the hemoglobian was down to 10.5 All other tests were perfect. My blood pressure is usually 110 over 70.
A year ago I began to not feel as strong. Couldn't pick up the TV or chase after my four year old grandson. Two weeks ago I felt even more tired after a walk.
Last week I had a large battery of tests done. The hemoglobian was 6.2 The WBC was 4000. The diff. was normal, The rest of the tests except the RBC's was normal..(Sugar, Thyroid, Cholesterol etc.) My heart tests (echo cardigram, electr cardiogram, ) bone density etc. were all normal.
My questions are:
1. Should I move a January 12th follow up appointment with my physician up to next week ? In other words with such a low hemoglobian am I likely doing damage to anything (heart etc)by trying to complete the holidays without bad news. I did buy liver today and cooked it and made a committment to eat two little pieces each day. Also bought vitamines and B12 tablets. My idea is if the hemoglobian goes up in three or four weeks the physician won't push for a mass of unneeded tests. If not then the bad news can come after the holidays.
2. Do you think these online home tests for occult blood could be done ? If they are positive I could call for an emergency appointment. (I am a retired med tech)
Lucky for me I have not been ill and not been in a hospital for anything except when I had my children. Not had any medical problems and only seen a physician for check ups and poison ivy every few years.
Ther is no history of cancer in my family. My Mom is 88 and my dad 87. My brother is in excellent health except a bad knee.
Doctor's Answer
by Kevin Pho, MD, Dec 08, 2006 12:00AM
, Dec 08, 2006 12:00AM
To answer your questions:
1) A hemoglobin of 6.2 is emergently low. I would see care about this ASAP (i.e. the ER) to discuss possible transfusion.
As for possible causes, GI would be first to rule out. An upper/lower endoscopy should be considered. If negative. B12 deficiency as well as a hematology evaluation can be considered.
2) With a hemoglobin that low, I would bypass the occult blood test and go straight for endoscopy.
Discussion of these lab tests should be done with a physician immediately.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
1) A hemoglobin of 6.2 is emergently low. I would see care about this ASAP (i.e. the ER) to discuss possible transfusion.
As for possible causes, GI would be first to rule out. An upper/lower endoscopy should be considered. If negative. B12 deficiency as well as a hematology evaluation can be considered.
2) With a hemoglobin that low, I would bypass the occult blood test and go straight for endoscopy.
Discussion of these lab tests should be done with a physician immediately.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
