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140622 tn?1190098929

What's the lowest Hemoglobin level before transfusion??

How low can ones hemoglobin go before a transfusion is necessary?
100 Responses
Avatar universal
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.
140622 tn?1190098929
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.
92903 tn?1309904711
I was in the low sevens for a while - but my doc was unaware. Afterwards he said he would have transfused...
264121 tn?1313029456
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.
Avatar universal
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 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?  
Avatar universal
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.
Avatar universal
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.

647958 tn?1223747395
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.
Avatar universal
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.
144210 tn?1273088782
I don't think a transfusion is anything to worry about. Procrit takes a little while to work. Trust the doctor.
Avatar universal
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
Avatar universal
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
Avatar universal
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!
547836 tn?1302832832
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
Avatar universal
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?
1117750 tn?1307386569
1200 to 600 mg  your funeral my friend drop to 1000 mg max especialy if they give you epo
Avatar universal
I collapsed at home with hgb at 7.4.  They transfused me in ER.
Avatar universal
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!!! :)
Avatar universal
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!
1412365 tn?1281712629
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.
Avatar universal
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.
1491755 tn?1333201362
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.  
Avatar universal
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
179856 tn?1333547362
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.
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