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Anemia indication of liver disease?
Hi, I am 27 years old. I have been a heavy drinker on and off for 8 years. Anyway, I started experiencing hair loss in October, and I finally went to see a doctor last month. They did comprehensive blood work and called to say that I was just iron deficient..I started taking iron supplements and continued to drink for a couple more weeks. I received my lab results in the mail, and I discovered that I have three different types of anemia. My MCV value was 103.4! I realize that can be related to heavy drinking, alone, or it can be related to liver disease. My vitamin B levels were great....And, my transferrin level was very low at only 189. Normal range is like 240-400 or something like that. All I can read is this is seen in liver disease, but usually iron is super high, while mine was low.. Anyway, my liver function tests all looked good, I think:

AST: 26
ALT: 29
Bilirubin: 0.6
Albumin: 4.7

I don't know why my doctor didn't mention my MCV and transferrin levels. I haven't read anywhere that's it's normal to have low transferrin, and again, all I can find is it being related to liver problems, really. I'm so concerned. I haven't drank since discovering this, and that was 19 days ago. I called the doctor back, and they are referring me to a hematologist. Has anyone discovered liver problems from this type of anemia? Any experience with this or knowledge about whether this is a good indicator of liver disease? I have myself convinced I have it, pretty much. How all were you diagnosed with liver problems, and did any of you have symptoms that prompted you to be seen by a doctor for diagnosis?


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When I say liver problems, I mean disease, specifically.. I don't have any physical symptoms other than hair loss.. I feel good, otherwise.
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Hello and hope you are doing well.

Anemia in liver disease can be due to many causes. Macrocytic anemia could be due to lack of vitamin B12 or folic acid which could be due to nutritional causes. Low transferrin can be due to poor production of transferrin by the liver, due to liver disease or excessive loss of transferrin through the kidneys into the urine. Also, in liver disease there could be excessive bleeding leading to anemia. What was your hemoglobin level, this will indicate anemia.

Hope this helped and do keep us posted.
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My hemoglobin was good. It was 14.7 (normal range:12-16)
My vitamin b-12 level is good. It was 628 (normal range: 180-914)

So, the high MCV wouldn't be caused by a deficiency. I'm assuming it's related to my heavy drinking, directly, or to liver problems.

Is liver disease or loss of transferrin through kidneys the only cause for low transferrin? My kidney function looked good, too, from my understanding, not sure.

BUN: 8
Creatinine 0.6
Estimated glomerular filtration rate: 120
Calcium : 9.7

I haven't been diagnosed with liver problems yet. I'm just afraid that the high MCV and low transferrin both indicate a problem with my liver.. Would that sound like a possible liver problem?
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Hello and hope you are doing well.

Low transferrin and MCV could be indirect indicators of liver disease. Did you have liver function tests done? The enzymes are elevated if there is damage to hepatocytes. Also an ultrasonography could show fatty liver changes, which occurs due to alcohol consumption.

Hope this helped and do keep us posted.
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If I  may add:  I have developed cirrhosis and my "LFT" numbers have ALL been within normal range for many years..and remain so to this day.  Not to frighten you, but just be aware that it's entirely possible to have significant liver damage without deranged Liver Function Test (LFT) numbers.  Many others on these forums can attest to the same experience. Wishing you the best -
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