Brief Answer:
Symptomwise approach

Detailed Answer:
Dear
Thanks for contacting with your health concern and after reviewing your query I'm of the following opinion:

1. Since low hemoglobin [anemia] is a qualitative or quantitative diminution of RBC/or Hemoglobin concentration in relation to standard age and sex and is best observed CLINICALLY thus make sure to have a direct interaction with a physician or Pathologist.

PS. Anemia is not a disease but manifestation of some disease

2. Since problem comes every 2-3 years, look for the source of blood loss [if any], like hookworms, piles, peptic ulcer, any malignancy

3. going by your value it is in range of mild to moderate anemia and is totally a clinical assessment [subjective sign] and may not correspond with laboratory findings

4. do you suffer from any symptoms referable to anemia like weakness, fatigue, giddiness, breathlessness, ringing in ears, lack of concentration?

5. The common causes which I do look into my patient(s) are/are: Is it
. Nutritional [iron deficiency anemia]
. hookworm infestation.
. chronic bleeding hemorrhoids.
. any blood disorder.
. uremia
. malignancy
. stool for the occult blood.
. tropical sprue.
. endocrinal disorder [hypothyroidism]
. Any liver/spleen enlargement or if bleeding tendencies like epistaxis/ bleeding gums are there.

6. Some of the things to be kept in mind are:

- Anemia exaggerates practically all vague complaints like joint pains, chest pain, backache, weakness, anorexia, digestive disturbances, breathlessness, so one must go for clinical evaluation for pallor in tongue & conjunctivae of every patient

- Anemia is very common and Hemoglobin of more than half the patients, even in well-to-do families can be below normal

7. till you get a complete evaluation done, please follow the dietary regimen as follows:

Take old brown rice, rice gruel, green gram, turnip, turmeric, white gourd, methi, carrot, banana, garlic, honey, buttermilk, amla, dates, beetroot, mild laxative

Avoid: black gram, sour things, sesame seeds, asafoetida, alcohol, fish, excess water, going out during peak hours, daytime sleeping, excess physical/mental exertion, undue anger/grief

Dr. Munish Sood
Consultant Physician
Naimittika

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