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What Does This Blood Report Indicate?
Question: My mother (58+ yrs) is under treatment for Hypothyroid (Eltroxin 50 mcg), Hypertension (Olmezest 20 mg) & Osteoarthritis of knee joints (Gemcal D3). She was diagnosed with mild anemia (Hb 10.7) in Sep, 2016 while Ferritin (100), Vit B12 (894) & RBC Folate (883).
The treating doctor diagnosed this as iron deficiency anemia & since the stool report was occult negative, she was put on 'Uprise XT' once daily for next 6-weeks. However, even after 6-weeks there is not much improvement in Hb (10.8) while serum BUN (14), creatinine (0.8) & vit D3 (43).
The treating doctor then asked to take 'Uprise XT' in between lunch (to improve iron absorption) & added one more medicine (Folvite). After a week Hb increases to 11.0 while FBS (97), Ferritin (83) & TSH (3.75). The iron profile results are as follows -
1) Serum Iron - 56
2) UIBC - 199
3) TIBC - 255
4) TSI - 22
5) Retic Count - 1.2%.
I've also uploaded the old & new CBC reports for your kind reference.
1) Are we on the right track of treatment ? Is this really iron deficiency or some chronic anemia ?
2) If chronic, what could be the cause e.g. risk of any tumor ? What should be our next steps ?
The treating doctor diagnosed this as iron deficiency anemia & since the stool report was occult negative, she was put on 'Uprise XT' once daily for next 6-weeks. However, even after 6-weeks there is not much improvement in Hb (10.8) while serum BUN (14), creatinine (0.8) & vit D3 (43).
The treating doctor then asked to take 'Uprise XT' in between lunch (to improve iron absorption) & added one more medicine (Folvite). After a week Hb increases to 11.0 while FBS (97), Ferritin (83) & TSH (3.75). The iron profile results are as follows -
1) Serum Iron - 56
2) UIBC - 199
3) TIBC - 255
4) TSI - 22
5) Retic Count - 1.2%.
I've also uploaded the old & new CBC reports for your kind reference.
1) Are we on the right track of treatment ? Is this really iron deficiency or some chronic anemia ?
2) If chronic, what could be the cause e.g. risk of any tumor ? What should be our next steps ?
Brief Answer:
Nothing to worry about tumor.
Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
Your mother has hemoglobin of 11 now. So it is not a major cause of concern.
Her iron, ferritin vitamin B12, folic acid all are within normal range. But her peripheral smear report suggest mild hypochromic RBCs. Most common cause is iron deficiency anemia. And her hemoglobin is improved by iron folic acid supplements. So most likely it is nutritional anemia. Nothing to worry about any tumour or other chronic disease.
In next step you should complete your course of anemia treatment. You are on right tract. Continue your medicine for hypothyroidism, osteoarthritis and hypertension according to advice.
Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic. Wish you very good health.
Nothing to worry about tumor.
Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
Your mother has hemoglobin of 11 now. So it is not a major cause of concern.
Her iron, ferritin vitamin B12, folic acid all are within normal range. But her peripheral smear report suggest mild hypochromic RBCs. Most common cause is iron deficiency anemia. And her hemoglobin is improved by iron folic acid supplements. So most likely it is nutritional anemia. Nothing to worry about any tumour or other chronic disease.
In next step you should complete your course of anemia treatment. You are on right tract. Continue your medicine for hypothyroidism, osteoarthritis and hypertension according to advice.
Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic. Wish you very good health.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks Dr. Sanghvi for the answer. Couple of concerns I have are as follows -
1) Last year also she had a Hb drop from 11.7 to 10.6, which got improved to 12.4 after 3-months of daily 'Orofer XT'. However, due to gastritis problems, the doctor had reduced 'Orofer XT' once a week & after 3 more months Hb became 12.0. After that 'Orofer XT' was stopped & then Hb reduced to 10.7 over next 4-months. Why is this Hb drop happening repeatedly ?
2) Usually for iron deficiency anemia, MCV should be < 80, while her Hb is always > 90 & sometimes > 95. Why is this so ?
1) Last year also she had a Hb drop from 11.7 to 10.6, which got improved to 12.4 after 3-months of daily 'Orofer XT'. However, due to gastritis problems, the doctor had reduced 'Orofer XT' once a week & after 3 more months Hb became 12.0. After that 'Orofer XT' was stopped & then Hb reduced to 10.7 over next 4-months. Why is this Hb drop happening repeatedly ?
2) Usually for iron deficiency anemia, MCV should be < 80, while her Hb is always > 90 & sometimes > 95. Why is this so ?
Brief Answer:
Due to some bleeding or nutritional deficiencies.
Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
She may have some internal bleeding that leads to fall in hemoglobin or may have nutritional deficiencies. Stool occult blood is negative so its confusing. But many times in gastritis also there may be some bleeding and at the time of test it comes negative.
Your MCV is high. In routine cases MCV is low in iron deficiency anemia. But you may have mixed deficiency. So average MCV may be high. But peripheral smear suggest hypochromic rbcs so its OK.
Don't worry much about that. Just continue your treatment.
Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic. Wish you very good health.
Due to some bleeding or nutritional deficiencies.
Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
She may have some internal bleeding that leads to fall in hemoglobin or may have nutritional deficiencies. Stool occult blood is negative so its confusing. But many times in gastritis also there may be some bleeding and at the time of test it comes negative.
Your MCV is high. In routine cases MCV is low in iron deficiency anemia. But you may have mixed deficiency. So average MCV may be high. But peripheral smear suggest hypochromic rbcs so its OK.
Don't worry much about that. Just continue your treatment.
Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic. Wish you very good health.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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