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Suggest Treatment For Low Hemoglobin Count

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Posted on Fri, 26 Sep 2014
Question: I have been low hemoglobin on and off from 6.4 -12 but for a month it has remained low 9,4-10.2
yesterday blood test showed:
High HAPTO 128
High LAP 152
Red blood cell distribution width high 18%
Lymph hi ute H1 low 12%
Neutrophils high 80%
Eosinophils low 8%
iron low 24 ug/dl
bound iron was low 7%
glucose high 128

can you sum that up for me….

doctor
Answered by Dr. Michelle Gibson James (52 minutes later)
Brief Answer:
iron def anemia

Detailed Answer:
HI, thanks for using healthcare magic

Anemia is a reduction in red cell mass. It can occur from: (1) reduced production of red blood cells (2) blood loss (3) increased destruction of red blood cells

(1)Haptoglobin is used to evaluate anemia. It determines whether the anemia is due to hemolysis (break down/increased destruction of the red blood cells) or other causes.
It is normally decreased in hemolysis. Haptoglobin is also an acute phase reactant which means that it would go up in any infection or any inflammation in body.

Your elevated levels may occur as a result of any inflammation.

(2)Lap- leukocyte alkaline phosphatase is not as commonly used as previously.

It measures the amount of alkaline phosphatase (an enzyme) in the white blood cells.
It used to be used to distinguish one type of a leukemia particularly distinguishing chronic myeloid leukemia from non cancerous increase in white blood cells.
Because better tests are available, it is not used commonly now.

High LAP is found: (1)leukemoid reaction- increase in white blood cells not is not due to leukemia for example infection/inflammation
(2)leukemia- chronic myeloid leukemia
(3)essential thrombocytosis- increase in platelets would cause also cause an increase
(4)polycythemia vera- this is an increase in the red blood cells. Blood is 'too thick'
(4)myelofibrosis- this is a condition where the bone marrow is replaced by fibroid tissue

Your increase may indicate any one of these. Though the increase in mild. The upper limit is 100.

Further testing can distinguish the cause.
Your doctor may either repeat or do other testing.

(3)The lymphocytes, neutrophils and eosinophils are also types of white blood cells. These are mainly interpreted with the total white cell count.
They respond to different types of infection or inflammation of the body.

This is the main use of these parameters. They may also increase in some types of leukemia.

(4)red blood cell distribution width- this looks at differences or variation in the volume of the red blood cells . High values indicate that there is a wide variation in the sizes of the red blood cells.

High values occur in iron deficiency anemia, anemia due to low vit b 12 and folate, recent blood loss

(5)iron levels - indicate the level of iron in the blood- low levels may indicate that you have iron deficiency

(6)low bound iron-also found in iron deficiency

(7)high glucose- this depends on time test was taken.
If it is a fasting blood sugar it is in the diabetic range
If it is a 2 hr blood sugar (2 hours after meals) then it is normal
Random blood sugars are no longer used commonly to diagnose diabetes.

Summary: (1)the results are consistent with iron deficiency anemia
(2)the increase in haptoglolin and the increase in lap may be due to co existing inflammation and infection


I hope this helps feel free to ask any other questions
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
doctor
Answered by
Dr.
Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16808 Questions

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Suggest Treatment For Low Hemoglobin Count

Brief Answer: iron def anemia Detailed Answer: HI, thanks for using healthcare magic Anemia is a reduction in red cell mass. It can occur from: (1) reduced production of red blood cells (2) blood loss (3) increased destruction of red blood cells (1)Haptoglobin is used to evaluate anemia. It determines whether the anemia is due to hemolysis (break down/increased destruction of the red blood cells) or other causes. It is normally decreased in hemolysis. Haptoglobin is also an acute phase reactant which means that it would go up in any infection or any inflammation in body. Your elevated levels may occur as a result of any inflammation. (2)Lap- leukocyte alkaline phosphatase is not as commonly used as previously. It measures the amount of alkaline phosphatase (an enzyme) in the white blood cells. It used to be used to distinguish one type of a leukemia particularly distinguishing chronic myeloid leukemia from non cancerous increase in white blood cells. Because better tests are available, it is not used commonly now. High LAP is found: (1)leukemoid reaction- increase in white blood cells not is not due to leukemia for example infection/inflammation (2)leukemia- chronic myeloid leukemia (3)essential thrombocytosis- increase in platelets would cause also cause an increase (4)polycythemia vera- this is an increase in the red blood cells. Blood is 'too thick' (4)myelofibrosis- this is a condition where the bone marrow is replaced by fibroid tissue Your increase may indicate any one of these. Though the increase in mild. The upper limit is 100. Further testing can distinguish the cause. Your doctor may either repeat or do other testing. (3)The lymphocytes, neutrophils and eosinophils are also types of white blood cells. These are mainly interpreted with the total white cell count. They respond to different types of infection or inflammation of the body. This is the main use of these parameters. They may also increase in some types of leukemia. (4)red blood cell distribution width- this looks at differences or variation in the volume of the red blood cells . High values indicate that there is a wide variation in the sizes of the red blood cells. High values occur in iron deficiency anemia, anemia due to low vit b 12 and folate, recent blood loss (5)iron levels - indicate the level of iron in the blood- low levels may indicate that you have iron deficiency (6)low bound iron-also found in iron deficiency (7)high glucose- this depends on time test was taken. If it is a fasting blood sugar it is in the diabetic range If it is a 2 hr blood sugar (2 hours after meals) then it is normal Random blood sugars are no longer used commonly to diagnose diabetes. Summary: (1)the results are consistent with iron deficiency anemia (2)the increase in haptoglolin and the increase in lap may be due to co existing inflammation and infection I hope this helps feel free to ask any other questions