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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for anemia

Answered by
Dr.
Dr. Praveen

General & Family Physician

Practicing since :2008

Answered : 1055 Questions

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Posted on Tue, 4 Nov 2014 in Blood Disorders
Question: Good day Dr XXXXXXX I trust you doing ok. Thank you for all your suggestions, and follow up but want to inform you that I am at a dead end now.

My doctors are not in agreement with your diagnosis and treatment suggested, reason been that any related disease to anemia, the patient should have a PCV value of not more than 36 - 38 but in my own case my PCV value is 48% so Megalomaniac Anemia is unlikely in their own opinion.

This is really becoming worrisome for me as I am not in a good shape at all and not having a normal life. I wound mind starting the prescription recommended but I can't administer myself as I need a professional to do so. A blood investigation is recommended by my doctors to re confirm the B12 level and frolic acid before any further views on that.

Dr. XXXXXXX how do I move from here?Please advice

Please not the increased symptoms:
the symptom is recurring more often in recent time - I become so weak in every part of my body and movement becomes almost impossible for me for very long hours before I start regaining my strength back just feel like I am paralyzed. What could chase this ?


doctor
Answered by Dr. Praveen 16 hours later
Brief Answer:
B12 1500 mcg sublingual tablets is one option

Detailed Answer:
Dear XXXXXXX

Sorry to hear about your ill health.

I were to suggest to procure folic acid tablets(5mg)- to swallow along with sub-lingual B12 tabets 1500mcg from the pharmacy and take them once daily for 4 weeks

I donot understand the reason for your doctors for not administering B12 injections.Your reports are absolutely normal except for bigger RBC with hypersegmented neutrophils which are suggestive of Megaloblastic anemia.According to me there is absolutely no harm in taking this treatment if it can really really relieve your symptoms.

Further I were to discontinue treatment for PCV since JAK 2 is negative.

Hope you shall get well soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen 17 hours later
Dear Dr. XXXXXXX trust you are doing ok. As discussed about further investigations, the reports are out and uploaded for your review and advice.

From the interpretation of my doctor, some issues were noticed but not life threatening if properly managed.

Please assist review with your peers and experts for further advice. I will appreciate if I can get swift response on same so I could start treatment as soon as possible.

Many thanks
doctor
Answered by Dr. Praveen 44 hours later
Brief Answer:
Recommend Neuro and hematologist opinion

Detailed Answer:
Hi XXXXXXX

I have reviewed through your reports and thanks for sharing the same.According to me-
1. I were to suspect that lack of folate supplementation which might have resulted in tiredness and neurological symptoms.Recommend folic acid supplementation as early as possible.

2. Hematological abnormalities in the blood reports need correlation with the findings in the CT scan and this needs a hematologist as well as neurologist's opinion.

3. Since you donot have abdominal symptoms I were to suggest that presence of gall stones is an incidental finding and nothing to panic.

Hope this answers your query.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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