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Severe exhaustion, experience severe bleeding. Suspicion of anemia. What tests can I ask him to do?

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I m 42, feeling exhausted for last 4 years. Had very very heavy periods for a couple of years before, meaning could not go out for 10 days each months. Doctor at time did not understand why, maybe fibroids, or adenomyosis he said, he retired. After a couple of years, decided to have IUD with progesterone to stop the heavy flow. But many symptoms started like extreme fatigue, dizziness, blurred vision and spots in my vision, ringing in ears, night sweats and inability to have normal life. My doctor does not know why... I keep saying I feel like I have anemia, short of breath so badly I cannot walk some days, tachycardia ... It s been been hell for last 4 years.
He said I XXXXXXX t have anemia. What tests can I ask him to do? M sure that the heavy bleeding I was experiencing so badly with huge clots is responsible for my Antigua and the rest. I cannot see how someone could feel great with losing so much blood for so many years. I m dying for help. My doc put me on antidepressant! Does not do anything!
Posted Tue, 21 May 2013 in General Health
Answered by Dr. Timothy Raichle 1 hour later
Hello, I would be happy to help you with your question.

Did you doctor do tests of your thyroid?
Do you still have heavy periods now?
When was the last ultrasound of your uterus?

Thank you.
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Follow-up: Severe exhaustion, experience severe bleeding. Suspicion of anemia. What tests can I ask him to do? 7 minutes later
Thyroid checked with blood test is fine.
Periods now much better, only 3 days not a lot of bleeding
Uterus last ultrasound 3 years ago, slightly enlarged. My doc thinks it s ok.
My bleeding now is not a concern anymore, but the exhaustion is.
Answered by Dr. Timothy Raichle 4 hours later
Thank you for the followup and I am sorry for the delay.

So to summarize, you are a 42 year old with
1. Extreme fatigue
2. Dizziness
3. Blurred vision / spots in my vision
4. Ringing in ears
5. Night sweats
6. Shortness of breath
7. Tachycardia

And from what you are also telling me, you are not anemic and have had normal tests of thyroid function. This is difficult because of the numerous complaints. It might be easier to think about it from the perspective of one or two problems that if explained, might help with the others. Lets take tachycardia, shortness of breath and fatigue. This could point to cardiovascular disease. You are not too young to experience problems in this regard. I would consider asking for a referral to a heart specialist and approach this from a more limited perspective, zero-ing in on specific symptoms that can be linked together.

I hope that this helps and good luck!
Above answer was peer-reviewed by
Follow-up: Severe exhaustion, experience severe bleeding. Suspicion of anemia. What tests can I ask him to do? 9 hours later
I have a cardiologist and I go to him once a year for check up as I had ablation for tachycardia couple of years ago. He says all is fine with my heart, even though still have arrhythmia s but he says nothing can be done for arrhythmias. Tat is the problem you go to a specialist and they say all is right without connecting all the dots it seems... Well that has been my experience.

I would like to know what are ALL the tests that can be done to detect anemia, and if its still possible to have anemia that can go undetected.
Thanks for you reply.
Answered by Dr. Timothy Raichle 14 hours later
Thank you again for the followup. I am sorry about the delay.

Not all problems are able to be completely fixed. It sounds like they have made an attempt to correct your arrhythmia, but if they are not comfortable pursuing it further, it is probably related to the fact that it is not safe to do so.

The tests that are done for anemia include:
1. CBC (which might be normal in the setting of borderline anemia, but the specifics that are reported regarding the red blood cells are useful in sorting out the cause)
2. Ferritin (a measure of iron)
3. Transferrin (a measure of the bodies desire to 'get' iron from your diet)
4. B12 level

This would be a starting point. Certainly, a consult with a hematologist would be appropriate as well. I hope that this helps and good luck!
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