What's the lowest Hemoglobin level before transfusion??

How low can ones hemoglobin go before a transfusion is necessary?

[GrandOak]

I was down in the 8's and believe nygirl was also that low for awhile.  BeagleBaily was down much lower, and I believe in the 6's or less before getting a red-packed transfusion.  I've also heard of folks near 9 or in the 8's receiving them too though, so I guess it depends upon your doctor who may take other factors into consideration to decide what cellar should be used for their patient.

[B-bunch]

Thank you for responding.
Mine is 8. So I'm going up to 60,000iu of Procrit tomorrow and dose reducing from 1200mg Riba to 600mg.
I'm not happy about it. I'm on week 10 and will get my 2nd viral load result next week.

[GoofyDad]

I was in the low sevens for a while - but my doc was unaware. Afterwards he said he would have transfused...

[alagirl]

B-bunch - Somewhere between 8 and 8.5 is definitely the time to get your doctor involved or go to the ER (if you're doing your cbc's outside your hep doc's office).  The reason is that you can drop dramatically in a short amount of time, and more dangerously perhaps, your potassium can become very unstable causing heart arrythmias.  Those are associated with mortality in a big way.  Its dangerous at that point to kind of go it alone per se, without letting your doc know where you're at so he can check everything.

I've received transfusions twice already in tx.  This is my tenth week of tx.  I DID have a type of normocytic anemia for which I was already taking epogen prior to tx, so I knew this would be a problem, just had no idea the magnitude of it.

The first time I went in was about three or four weeks in when my blood count went to about 8.7
While at the ER, it dropped to 7.9.  They gave me two units of blood and buttload of potassium.  I was upped to 40,000 units of epogen twice per week.

I missed one dose of epogen last Tuesday.  Earlly Friday morning I went in for an endoscopy and colonoscopy.  The doc there failed to freakin' mention that my hgb was only 7.3.  I even asked the bloody man for a copy of the morning's cbc, he said it had been fine.  that they'd fax it to me later.  After we left I kept vomiting and just knew things weren't fine.  Plus the nurse was staring at me so intently while telling me to go to the ER if anything was wrong, kept saying it over and over again, that I thought either something was up, or the two of us were becoming soul sisters and I'd forgotten my lines.

In the end we had to go the ER because we couldnt make the forty minute ride back with me puking.  By the time I got there and even after they got the permission and matched and typed me and put one unit in, my hgb was at 6.3.  I got I cannot even tell you how much IV potassium, then liquid oral potassium the next day.  Then two more units of blood the next day.  My count is up to 11.4 now.  

But I would really say don't let it go below 8 without notifying your doc.  And hey, ask your doc too what he or she feels comfortable with you having as a cut off.  That's my deal with my doc, that I don't go below that without coming in.  The doc I was doing the procedure with was not my regular guy unfortunately.

In terms of technically how low someone's blood can go prior to having to have a transfusion, the answer is, it can sometimes go surprisingly low, but its very risky.  It is safer in people who frequently have low blood counts.  For instance, sickle cell patients frequently do unfotunately get into the 5's and 6's and can perhaps sustain a bit better without going into shock because their body is used to that happening.  In a man used to having an hgb of 16.4. its a different story to suddenly tank down that low.  And again, the risk frequently that is most deadly is the loss of potassium and different metabolites that comes with this loss of volume.  Docs usually will transfuse between 6 - 8 dependent upon the doc, why the hgb is low, and other factors.  They do have to transfuse with hgb sometimes if its very low because you are still taking the hemolytic agent, ribavirin, so even if they put you on procrit, it will still take some time for your body to catch up with production.  So they give you a bit of a head start.

Most of all though, so sorry you are going through issues with your blood count. Whatever we can do to help in terms of advice or support, Let us know.

[evergreensummer]

With a cbc showing a hgb of 7 my 81 year old mother was given a transfusion last year.  Now, almost a year later to the date, she started experiencing the same syptoms (symptoms) of fatigue, shortness of breath, painful night cramping in her legs, etc.  She has lost weight over the last year as well.. and not because she was trying.  She tested at 10 in May, within a month she is now down to 7 again.  She is a diabetic and  had open heart surgery years ago, They say she tests fine on the heart, they find no internal bleeding, and the next step is a bone marrow test which she is having done today. Any thoughts?  

[phillygirl73]

My doc usually transfusses at 8, but really depends on patient. I have been 7.6, 7.5 and am now 7.3, but feeling fine and not transfusing. I have had my counts dropping over such a long pd. of time (10 months), my body has adjusted and compensated.

[smaylea]

For most of my 22 weeks of tx, my hgb has been between 9.0 and 9.5. Last week it dropped to 8.5 and I got the call to reduce riba from 1000 to 800 and put the order in for procrit. I was told if it dropped further we might have to look at transfusion which pretty much freaked me out. I did not want to reduce the riba but once I began to understood the dangers associated with the very low hgb, I did it. Within 4 days of the reduced riba, my hgb went up to 9.6 and boy could I tell a difference. The 8.5 was nearly incapacitating and I did not even realize how bad I felt. Yesterday, started back to 1000 riba and took my first procrit shot, which was not too bad at all.

[BriKauffman]

I'm a little concerned about my hgb levels and what we are going to go about to fix this problem. I am 31 weeks pregnant. When I was 5 weeks they drew my blood and my hgb level was 12. I went in to the doctors this last week (at 31 weeks pregnant) and it's dropped to 8. My symptoms have been vomiting, diarrhea, dizziness, terrible leg cramps (at night especially), sudden rapid heart rate, a feeling of warmth throughout my whole body, terrible FATIGUE, no energy, headaches, and constant nausea. My doctor hasnt really told me anything other than she believes I could have internal bleeding and I've developed pregnancy anemia and she is going to monitor me very closely and she is still trying to figure out what she is going to go about doing. I just think she doesnt want to worry me with the baby and everything, and I didn't ask any questions because I had NOOO idea how serious this is. I dont want to go into anything blindly and unaware of what may need to be done. Can anyone tell me what they think or what may need to be done. I just want a healthy baby, I'd love to feel better, but my little girl is my main focus!!! Thank you so much for your time.

[mystreex]

Im so scared and want to cry. my mom has aplastic anemia for the past 3 years and her hemoglobin has dropped within 1 week from 9.0 to 8.7 last night in emergency to 7.6.  she has been given procrit injections in the past but the doctor gave her a 3 week break and since then her levels are out of wack. we dont want to do a transfusion because i am afraid of the risks associated with it.  has anyone out there had this situation?  can she make it until the procrit injections kick in. scared in sj.

[gauf]

I don't think a transfusion is anything to worry about. Procrit takes a little while to work. Trust the doctor.

[Deb_c430]

Let procrit work, transfusions are  not fun,  I had mine at  8.2 I think.  yes, I think she will be ok, a lot of rest,    Our bodies can adjust to lower oxygen levels.   Try not to worry

[jmjm530]

You really have to lean on the doctors here, but perhaps a consult with a hematologist is in order. Preferably one not affiliated with your current doctor or their hospital. The type of anemia most here are familiar with (none of us are doctors btw) is hemolytic anemia caused by ribavirin during hcv treatment. From that limited knowledge, yanking someone off of Procrit completely for three weeks sounds kind of like bad medicine. In the case of hemolytic anemia, the dose probably would have been reduced gradually and hgb levels monitored. How experienced is your doctor?

-- Jim

[ckras09]

When I had to have an emergency transfusion about two years ago, my hemoglobin level got down to 2.5...they said it is the lowest they have ever seen. I had anemia for a while, as you can imagine, and recently a CBC confirmed that it is now up to 12 and I've been doing pretty good. Definitely if it gets about 8/9 or lower you should take it seriously. Don't take any chances, and transfusions aren't scary. They definitely saved my life!

[lalapple]

i don't know, but i don't like the idea of getting a transfusion bc that's the most likely reason i got hcv when i was a baby.  so try to avoid if you can help it

[kbee82892]

i am 17, and since i was 13 i have been recieving transfusions. i am a notified anemic and a diabetic. i have dedicated my responsibilities to taking my iron and other meds- but for some reason they don't seem to be working- the doctors are starting to doubt that i'm taking my pills but i have damit and the lowest my blood count has gone down to was a 4.5 , now looking and reading that you've reached 2.5 scares me- because recently i am being admitted again to start taking iron iv- in which i heard there are risks but i cannot live breathless and unable to do certain things in my life- its like im a senior i want to enjoy it- but these setbacks are killing me - i have 5 doctors & im just not sure there opinon is helping out my situation, it's gotten to the point where i cannot shower without having to take breaks- so i should i have any conerns other than the many i have now?

[jusjames]

1200 to 600 mg  your funeral my friend drop to 1000 mg max especialy if they give you epo

[jdwithhcv]

I collapsed at home with hgb at 7.4.  They transfused me in ER.

[Wonderful_Sis]

Oh my goodness, I thought I had the lowest hemoglobin record yet, but 2.5???  You got me, I can't believe you survived it, but I'm happy you have!!!

I was just released from the hospital last night beginning with a hemoglobin of 3.2 on Thursday morning (my mom took me to the emergency room).  It was crazy, but this is not the first time for me (it happened 2 years ago to me as well.  Anyway, they released me when it got back up to 9.2 after 4 blood transfusions.  Even though I really didn't want them, they saved my life.  My veins kept collapsing, so there were like 8 doctors in the emergency room and they finally had to stick the IV in my neck.  What a week!  I never knew that I could feel this much better, and really wish that my family and friends could understand more what I went through.  My heart palpitated uncontrollably, and my tonge was like clay.  It was like there was absolutely no blood pulsing through me, and I was so depressed.  I even lost my boyfriend over this thing and Cancer, but I think the Anemia issue was worse (though it was more curable).  Well, just wanted to share.  Glad that you are doing better, I'm home in bed right now drinking molasses, eating liver, and popping iron pills!!! :)

[Wonderful_Sis]

Hello,

I just read your post, and I do understand.  Please see my last post below yours on the forum.  My lowest point was 3.2, and I had to get 4 blood transfusions between Thursday and yesterday of this week.  On my way to the hospital on Thursday, I decided to shower, but, it took everything out of me.  I have been going to work every day like this (I'm 36 years old), and everything has been a drag.  My question to you is, are you bleeding anywhere (internally), or is your stool dark?  Are you craving anything like asprin, or any other non-edible thing?  Have they done any colonoscopy's on you to see what might be going on inside of you?  Also, are you working with a hemotologist to address your issues?  If you are still fighting this, I would be interested in knowing.  I am not a doctor or anything, but I know what it feels like, trust me, it's not fun, and it's stealing your life from you.  You don't deserve that.  You are too you.  In the meantime, God Bless, and remember to take Vitamin C with your iron, and consume iron rich FOODS along with your supplements and shots.  That works well also.  Best of luck to you and God Speed!

[angelgirl282010]

My hemoglobin was 10.2. I went to the ER because of dizziness. I already know I have Thalassemia Minor trait but I have been feeling so tired and fatigued lately. I fall asleep during pretty much every car ride and it's the worst. And I can't seem to keep my eyes open. Even at home sometimes I go to bed early and sleep so much. Is this a bad sign? Plus I had a patch of hair on my head fall out. I didn't know it until my stylist told me that I had a patch missing in the back of my head. That was scary. What can i eat to help give me more energy so I can at least fuction.

[Skye69]

I think it all depends on why your count was so low.  If you have a disease or illness which makes your counts low continuously, your doctor will probably tranfuse more often.  After the birth of my 1st child my count dropped to 4.5 and I refused a blood transfusion.  Took a few months, but with iron pills and a high iron diet,  eventually it was back up to the 10-11 range.  I know someone recently that had the bloodless surgery (for religious reasons) and theirs got down below 2.  She is better now, but it took a long time.  It is scary dangerous to get that low, especially after surgery.  So best bet would be to talk to your doc about it.  If you don't want blood find out how low they are comfortable with it being before forcing the issue.

[James10500]

It's because of medication for Hep C. Didn't you see the post about Ribavirin reduction ? RIBA messes with your blood counts we pretty much all from low blood counts due to medication.  

[beebee55]

hi im sue and im aving lots of problems at the min ive been the docs today my hemo was 6.7 several months ago i didnt know my stools r black at times in colour now ive been back again the doc wants me to go back the hospital asap to get some test she seems to think i ave an enlarged liver ave i got that right bloods in the morning being taken at the clinic she is trying to get the consultant by phone she did say i would be dead in days but never said anything else i never asked im on champix to stop smoking but im anemic after a blood being given me in the 80s after pregnancy i also ave enlarged lungs so im only 49 some of its my fault yes i know but the other i ave no idea wait 4 ur reply nice to see some 1 else is on the other end xx

[nygirl7]

Make sure you get the PCR test to see if you have a viral load then you will know if you have hepc.  If you do and you are predisposed to anemia it is going to be a tricky thing to  manage and most likely you will need Procrit the entire time to keep your body making red blood cells.

All you can do is test then get a heptologist and move on step by step from there.

I hope you dont have it but if you do it's not the end of the world usually there is time to treat.

Good luck.

[Dana2004]

We took my 20 yr old daughter to ER on Friday because iof continuous anemia, and the recent addition of night sweats and digestive issues (more bowel mvmnts than normal, diareah, stomach cramps).  her Hemog level was 9.9 on Friday. They ct scanned and unltrasounded her abdonmen and found both her ovaries have loarge mass on them, and another mass behind that. Did biopsy yesterday and now we have to wait till TUES (holiday weekend) to get results. In the meantime her hemg has now dropped to 8.4 and they are doing a transfusiion.naturally i am not very hopeful that the masses are just cysts. 8.4 seems very anemic, lethargic, seems difficult to even speak much, just laying there dozing ona nd off. I am hoping this transfusion will give her a little xtra energy. So unbelievable. totally healthy otherwise

[diamondgirl1983]

hi,
im 27,  very worried as my hb level is down to 4 and my b12 level is 86, i suffer with heavy bleeding as i have endometriosis and fibroids. im also taking warfarin due to a prevoius blood clot. i had a blood & iron transfusion abt 3yrs ago.
my gp has only given me iron tabllets 200mg.

[nygirl7]

If your hemo is in the 4s I can't imagine that your doctor isn't taking immediate action and that you are even able to type.

[willbb]

Hi there... you have severe anemia ,which can be caused by a number of things...some of which would need immediate attention. Often this type of anemia is caused by bleeding..which you say you have.  The iron and B12 def. could also  be caused by bleeding. You need to be seen by someone to  do  a thorough work up ,,to get to the cause of this.  If your Primary  has not done this ...get to emerg and hopfully they will do the proper testsToo much warifin can also cause bleeding...

Good luck...

[kjk72887]

My mom is currently getting one. She was at 4.7!!!! But shes been receiving them weekly at about 7.5. That seemed to be the magic number (anything below 7.5). And shes been 7.1 6.3 5.9 etc. She was on hep c treatment drugs. Ribaviron will do it!

[spectda]

I was 7.0 and stopped tx and kept taking procrit but did not transfuse.

I have ex-jw inlaws who knew people who went into the 4-6 category because they don't allow transfusions. some of them died as a result and those who survived were completely incapacitated until their hgb recovered.

[sheshe111]

my hemoglobin stays low due to my heavy periods monthly ive had two transfusions already im suppose to take iron it makes me so sick my level is 7.9 now it was in the fives when i had my last transfusion my doctor call me and said he wants me to see a blood specialist.

[becky6419]

I had a problem with heavy bleeding and then I started counting days andI had been bleeding heavy for over a month! I think I was down below 8 and they transfused but it took a week for it to go up to 10. I have an enlarged spleen and I think that has alot to do with. I haven't started any treatment for Hep c because I think they are to worried that my count will plummet. Not sure what to do besides take iron capsules three times a day that my GP perscribed.

[NeedAnswersNow2]

My sister is in the hospital with a very bad wound related to her autoimmune disorder.  Her hgb is 7.5 and the doctor has talked to her about a blood transfer. She has never had a transfusion before and the doctor and facility seem incompetent, which has my family worried.  They were going to release her even though she said that she wasn't feeling well.  During the the discharge process her temp was taken (temp 103) and they checked her labs and her hbg 7.5.  So I'm on this forum looking for answer because I love my sister.  So please any answers would be helpful.  With love.  

[working dog]

thats too bad....i'll bring this to the top ..maybe someone can help....billy

[NeedAnswersNow2]

Thank you Billy

[MedicalMiracle]

I'm 19 years old and have had 28 blood transfusions to date. The lowest I  have been is 2.3. Fortunately I have stopped bleeding in my intestines (I have crohns's disease) and My normal is now around 9 because I am very small. It's very scary to be anemic and my family and the doctors didn't know if I would live when I was 2.3. The doctors  gave me blood too fast without enough hydration which caused a blood clot in my leg. A piece of the clot broke off  during a difficult four hour surgery. It travelled through a hole in my heart up to my brain and cause a stroke. I woke up from survey and could not speak or use my right side. So the lesson to be learned is even though it is not good to be below an 8 you can still live if you get a blood transfusion . And make sure they run the blood SLOWLY!! And with lots of fluids!

[MedicalMiracle]

I'm 19 years old and have had 28 blood transfusions to date. The lowest I  have been is 2.3. Fortunately I have stopped bleeding in my intestines (I have crohns's disease) and My normal is now around 9 because I am very small. It's very scary to be anemic and my family and the doctors didn't know if I would live when I was 2.3. The doctors  gave me blood too fast without enough hydration which caused a blood clot in my leg. A piece of the clot broke off  during a difficult four hour surgery. It travelled through a hole in my heart up to my brain and cause a stroke. I woke up from survey and could not speak or use my right side. So the lesson to be learned is even though it is not good to be below an 8 you can still live if you get a blood transfusion . And make sure they run the blood SLOWLY!! And with lots of fluids!

[Ruthybex]

Hi - I just found out my Hb is 8 and I feel dreadful. My doctor told me to take 600mg Ferrous Sulphate a day and to go  back to her in a month. There was no mention of a possible transfusion. Should I be asking for one?

[uncledudeness]

you might want to start a new thread with your question. i went down to 7 and i had to get 3 pints. did they lower your riba? are you going for weekly blood tests?

[tahsha]

My 5mth old baby boy had a hgb of 2.3
Doctors actually redrew. They were for sure this was a lab error,but to everyones surprise IT WASNT!

[Tkk_2012]

Hi wonder if anyone can help?

My wife is 31 weeks pregant and Iron levels are low (8.7) the midwife said 11 is normal. She said if she was in hospital she would need a tranfusion but they have just given her iron tablets.

Is this right?! Or should she be in hospital?!

[Hec37]

Hello my, my wife is 16 weeks pregnet and her test was 9.2 is that bad or of concern, now that is what she tested at the OB's office but she was sent for more futher blood testing.

[1oftheclub222]

this is a hep C forum, pregnant questions would be a different forum, whole different set of rules

[80mecheng]

I am not a doctor but my GI became alarmed 19 weeks into treatment and my hmg continued to drop to 9.2.  The guidelines he told me was below 9.5 weakness becomes a Quality of Life issue and either Riba should be reduced (or stopped); below 8.5 it could be a Quanty of life issue.  I started Procrit which helped it climbed back to 9.7 and has at least stabilized.

[jerriellengirl]

First thank you all for telling your story. They have helped me very much!!
My doctor told me today to go to ER my hemoglobin is 7.5. I knew I was animic  for years. I went to him because I have swollen painful heels. He thinks maybe Lupus or Arthritis. I am the sole provider for myself and my mother. I'm working 24 hour shifts for 3 more days. My plan is to go to the ER in 3 days. Last night I had heart palpatations . I eat a banana! And have been eating red meat for weeks.
Anyway, again thanks to all of you for sharing your story. If you think you have anything to share with me that may be helpful please do share. This is all very new to me. I'm scared because I'm the sole provider for my house hold. "Errrrr scary!
BTW I'm 58, Female, single for 13 years, without health ins. "Again ERRRRR Scary
Jerri Ellen

[rockymoe]

I was in the 7.s and 8's I have had two. Feels so much better after, It seems as soon as I drop below 10 I crash fast!