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Is there a correlation between Hbg E trait and Iron Deficiency w/o Anemia?

(Also posted accidentally in the General Health forum-oops!)

I am a 39 year old pre-menopausal woman. My recent labwork has shown that I have Hbg level of 12.5, Serum Iron of 49, % saturation is 13%, and my Serum Ferritin is 9 ng/mL. I have a childhood health history of Iron Deficiency Anemia. As an adult I have experienced years of non-specific symptoms that could be associated with Iron Deficiency, such as fatigue, tingling/numbness in my legs and feet, easy bruising, depression, and sleep disturbances. Within the last few months I have experienced the above symptoms with the addition of hair loss and shortness of breath*.

Some years ago I found out I have Hemoglobin E trait, which I know is almost always asymptomatic. My MCV as an adult has stayed in the range of 72-76 and my MCH is usually around 23-24. My Hgb is usually on the lower end of the normal range (this 12.5 is the highest it has been in years). ANOTHER confounding factor is that I am a long-time vegetarian (not vegan), although I wasn't as a child, when I was most often actually anemic. I know that insufficient dietary iron intake is one of the main causes of IDA/iron deficiency. Since my most recent labwork I have decided to start eating meat again and have started oral iron supplementation. As an aside, my brother (37 years old) is also a Hemoglobin E carrier and has had symptomatic Iron Deficiency Anemia for most of his life. I know IDA is not as common in healthy males. Neither of us have any underlying conditions.

My main questions are:

1.) Can having a genetic predisposition to microcytic, hypochromic RBCs make one more susceptible to iron deficiency (latent or anemia)?

2.) Is it possible to have a latent iron deficiency that lasts for many years without progressing to anemia?

3.) Is it possible to for a Hemoglobin E carrier to be symptomatic?

*Regarding my symptoms I have had both my TSH and Vitamin D levels tested and both are in the normal range. I will be having hormone panels run soon.

Thanks for your insight!
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973741 tn?1342342773
These are excellent questions for the doctor who ordered the report showing this information. When do you follow up with them regarding this?  What do you do for the low iron? Do you take Slow Release Iron tabs, for instance?  

As to chronic iron deficiency, well, it's anemia when it moves you to the area of side effects associated with anemia.  Those include extreme fatigue, insomnia, heart rate fast, pale skin, headache, cold hands and feet, etc.  Here is a whole list: https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034  What would cause a chronic situation of anemia?  There are different reasons such as blood loss if you have heavy periods.  But also something like celiac disease which causes malabsorption of iron from your diet.  And obviously a diet very low in iron. Always check in with your doctor before taking iron supplements because 'too' much can be detrimental too (hard on the liver).  

I'm trying to understand what you are saying though.  You are diagnosed with microcytic anemia?  I'm just a little confused by your post.  Here's a study though about absorption of iron and issues with the blood disorder you mention. https://ghr.nlm.nih.gov/condition/hypochromic-microcytic-anemia-with-iron-overload  

I would not take iron or really do any self diagnosis or treatment until you are given full guidance by your doctor.  I know iron is sold over the counter but if you have 'other' things going on, you want to make the right choice for yourself about this.  

Hemoglobin E is not uncommon but what it normally does in terms of complications is that it causes . . . anemia.  Which you are saying you have?  

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