anemia of some sort?

[frootbar]

Dear Dr.,
I'm a Hashimoto's person now for 15 years.  I have had about 5 years or so of ferritin levels at about
25, below 30 here is considered depletion of iron stores and fairly serious.
I have some slight problems with other CBC values, but nothing severe, the biggest one being platelets
a bit near the low end.  I have been having small and slightly small red spots near my toes on my feet,
and in the arch area.  And petechaie I think they are (?) more noticeable on arms and chest, and swollen
areas that are reddish near the fingernails.  My ESR is on the border of normal.  TSH is 4.96 last week.
I have taken a bit of iron but not regularly, and I have as yet to get the value up.  In fact, I could have been
lower than 25 and have been in the past.  Any chance the thyroid is connected, or some form of anemia
that is autoimmune associated?  Thanks.

FB.

[frootbar]

Thank you for the feedback.
Always quite helpful.
My antibodies are sky high, both of them.
I had the celiac blood test for tissue transglutamase,
and it was just about positive once, then almost zero
the second try.  I have gotten no real answer yet as
to why that would be.

[Mark Lupo, M.D.]

This is a complex situation.  The ferritin levels suggest low iron status.  The bleeding into joints is unusual - have you been tested for different hemophilias?  This would be done by a hematologist.

The TSH is high-normal and not likely the link to the other issues but consideration of testing for Hashimotos is reasonable (TPO antibodies).  If these are positive then one other possibility would be another autoimmune problem such as celiac sprue with iron deficiency.

[frootbar]

Oh, Dr. Lupo, I forgot a few things, I had spontaneous bleeding into
the knees, x-ray showed nothing, except remarkably undamaged joints,
and I always have bleeding from nose, but not streams of it, just lightly
but never goes away.
(Months back, you discussed with me a potential tumor in the forearm
that may be parathyroid related, MRI and other tests showed whatever
it was pretty much went away, and they are still baffled as to what it
was.  I have residual pain and a small lumpy muscle tissue from it.  I
have had same thing show up in right axilla area, and parathyroid tests
show fluctuating values, sometimes a bit high, sometimes just under
high but considered normal.)